Design and Realization of Digital Intensive Care System

Transcription

1 Design and Realization of Digital Intensive Care System Abstract This paper expounds the development process of digital intensive care system, including evaluating and analyzing the workflow and management requirements of ICU based on requirements of ICU medical staff in hospital sufficiently and using computer technology, database technology and software engineering technology design and realization digital intensive care system This system can increase the working efficiency of ICU medical staff,improve the quality of s and provide better medical service to patientsthe main innovation points of this system is the use of dynamic analysis data structure for data backing store which can store the content variety and structure complicated s data simplyforpatient from different specialties,it supply different output formats Tingting Chen #1,Chuandi Pan *2 #1 student, *2 professor &The first clinical medical college Wenzhou Medical University,Wenzhou,China will Keywords intensive care,dynamic analysis data structure, s, data sharing improve nursing quality and medical staff's technology II THE DEVELOPMENTPURPOSE OF SYSTEM The development purpose of system is using computer technology, database technology and software engineering technology to develop a high-performance, high integration and high availability digital intensive care system Besides, we do an in-depth study about the intelligent doctor's advice retrieval, templated writing of s, pipelines/intake and output record and data sharing This system cover all clinical work process associated with intensive care and make the ICU daily work standardization and automation, so that the work-hour of medical staff writing patient vital signs and s manually reduced and working efficiency is raised It lays a solid foundation for achieving patient-oriented therapeutic process and improving the nursing level and realizes digital management of ICU I INTRODUCTION Managing and processing medical data can be very time consuming and this is very obvious in ICU[1], ICU patients who in a critical condition and change quickly, need more instruments and pipelines during the monitoring process and produce various kinds of vital signs, so the accuracy and instantaneity of the on medical care demand more urgently[2] The traditional way of writing s and data records manually not only has occupied much of medical staff's working time but also cannot collect the various data scientifically and rapidly[3], which will influence the medical staff to know the patient condition changes and make correct judgment in time Hence in traditional way, the direct nursing work-hour for patients will be reduced and it is not conducive to III OVERALL DESIGN A System architecture This system combines C/S architecture with B/S architecture, making best use of the advantages and bypassing the disadvantages and playing their respective advantages adequately Due to doctor s advice processing demand higher data processing ability and response rate, we adopt C/S architecture for this But the background processing of s processing and pipelines/intake and output records is complex, we adopt B/S architecture for these s to avoid a bloated client B Network architecture The center monitoring station, intensive care workstation, wireless router and mobile devices compose the main network of the system The data ISSN: Page 337

2 acquisition of the system is central data acquisition pattern We connect the medical devices to switches through the LAN and collect medical data intensively with the aid of a center monitoring system host We configure a computer for each sickbed serve as intensive care workstation In order to realize the full coverage of wireless network in ICU ward, the wireless routers are placed on the top of ICU wardthe bed-side mobile devices can connect to the server via wireless network The network architecture of this system is shown in figure 1 HIS server LIS server PACS server groups The menu available is different when the group login system different Finally, we assign appropriate group and authority level to users in accordance with the actual work requirement So when users want access corresponding menu, the group authority and corresponding authority level is a must In this way, we can not only control the use permission of system flexibly, but also ensure the use safety of system The flow chart of background processing when users login system is shown in figure 3 start Mobile device Ap Intranet of hosipital Access layer Intensive care workstation Intensive care workstation Enter user name and password Password is correct? Obtain the group authority of user Have the group authority of this system? more than the maximum mistake times? Center monitoring station Monitor respirator Fig1 Network architecture of this system IV DETAILED DESIGN A Design of function Center monitoring station Based on the result of requirement analysis, the whole system can be divided into six s: doctor s advice processing, s processing, pipelines/intake and output record, user management, data maintenance, query statistics The diagram of system is shown in figure 2 B System security design This system realizes the menu level of authority control and each menu has its own level of authority First, we set different system application groups based on different system roles (eg head nurse group, nurse group, etc ) Then, we distribute the menu as required to different system application Select the group Enter password of the group Password of the group is correct? Initialize the menu Record the user login Finish more than the maximum mistake times? Exit Fig 3 The flow chart of background processing when users login system ISSN: Page 338

3 Digital intensive care system Doctors advice processing Nursing record processing Pipelines/intake and output Volume records User management Data maintenance Query statistics Import doctors advice Process doctors advice Confirm doctors advice Add new Modify the Delete the Print the nursing record Add new record Modify the record Statistical intake and output volume Obtain last record Maintain the user Assign system authority to user record code record format record format code record template Query patient Query historical data of patient Sync the record to Maintain pipelines Print the intake and output record Fig 2 Module diagram of system C System performance design performance of system is improved In this system, 1) Caching technique:one of the main problems we construct a connection pool by creating custom of websites running is that the time spent getting data class such as: database connection class, database from file system and database and presenting the connection pool class, pool class, etc Then, we write generated page to concurrent access users[4]caching some methods which can get and release the is a common method to solve this problem The connection object from the connection pool in the caching API is adopted in this system and the cache custom class object of caching API can store any serializable data D Database design (concept data modeling) objects For example, the content of the pipelines During the concept data modeling of database table is often used in the pipelines/intake design, we abstract the conceptual model of system and output record, so we store it in the cache through the analysis of user requirements and Then the performance of system is improved business process and descriptive analysis the system significantly with conceptual model Because the system is 2) Database connection pool technology:the core complex, we just draw part of the s idea of database connection pool is the reuse of processing s conceptual model using the connection By using the existing connection, the PowerDesigner165 The diagram is shown in figure resource consumed by establishing and closing the 4 database connection frequently is reduced and the ISSN: Page 339

4 Nur si ng r ecor d t abl e Pat i ent Tabl e pat i ent I D <pi > Number ( 8) Pr i mar y Key <pi > nur si ng r ecor d I D r ecor d t i me nusi ng r ecor d t i me pat i ent I D Pr i mar y key <pi > <pi > Number ( 8) <pi > <pi > Dat e & Ti me Number ( 8) Number ( 8) pat i ent I D Pat i ent f or mat code t abl e Number ( 8) Format t abl e <pi > Pr i mar y key <pi > speci al i st I D Speci al i st code l i st t abl e Number ( 4) code name Pr i mar y key <pi > For mat code t abl e Code t abl e <pi > Number ( 6) Var i abl e char act er s ( 100) speci al i st I D speci al i st name pr i mar y key <pi > Speci al i st t abl e <pi > Number ( 4) Var i abl e char act er s ( 40) nur si ng r ecor d I D pr i mar y key <pi > Cont ent t abl e <pi > Number ( 12) <pi > t empl at e I D t empl at e name speci al i st I D pr i mar y key <pi > Templ at e t abl e <pi > Mul t i byt e ( 6) Var i abl e char act er s ( 40) Number ( 4) Fig 4 The part of system s concept data modeling E Dynamic analysis data structure design The dynamic analysis processing procedure mainly includes three parts: pre-process, transform kernel, data storage The transform kernel is the core part The flow chart of pre-process is shown in figure 5 We make the patient ID and the hospital admission time as the unique identification of patient, because patient may have been admitted to hospital several times The main function of the pre-process part is to get the ID, format ID, style ID and admission time in the current Then,all these is the input parameter of transform kernel Enter patient ID, admission time Retrieve index table Exist? Obtain specialist of patient by patient ID Reading the specialist format table and obtain format ID Reading the style table and obtain style ID Generate ID Save the new index data Return ID, format ID, style ID, the time Fig 5 The flow chart of pre-process part The flow chart of transform kernel is shown in figure 6 First the transform kernel part receives the ISSN: Page 340

5 incoming parameter from pre-process The transform kernel part gets the format definition in current and loops over all of the code in it, including reading code definition data, reading style definition data, reading patient data which code corresponding(get from content table or modification trace table by time ) Then, we call the corresponding data type processing function, passing in these reading data as structure parameter and get the HTML code which used to construct nursing record interface dynamically Last, after finishing dynamically constructing interface, we return the ID and the value of each code as the input parameter of data storage part Enter ID, format ID, style ID, time Obtain the definition sets of format form format table by format ID Obtain the definition of each code from code table by the code ID in format definition sets Read the data nearest to the time point form modification trace table Exist data? Have history point parameter? Read the data in the table Read the data in the table at the time point or before the time point Obtain the style definition from style table by style ID Generate complete definition of nursing record code by the data from code table, content table, style table(str) Call the corresponding data type processing function by the data type of code, input parameter is STR Processing of format define sets is complete? Return page, include the ID,code ID, value set Fig 6 The flow chart of transform kernel part The data storage part save the modified data in content table and save the raw data in the modification trace table, hence the modification trace of s is reserved and the s data can be output according time point The reserve of modification trace function accomplish by Oracle Trigger The flow chart of data storage is shown in figure 7 ISSN: Page 341

6 Insert the data into the modification trace table by Oracle Trigger Enter the ID,code ID, value set Insert successfully? Update the current code data of this nursing record(value, modification time, modification doctor) Update successfully? Process of value set is complete? Commit, return success Retrieval the table by ID and code ID The current code data already exist? Insert current code data into table of this Rollback, return errors Insert successfully? Fig 7 The flow chart of data storage part V CONCLUSION This system combinesthe original workflow of ICU medical staff and optimizes the workflow The digital intensive care system is running normally in our hospital and obtains a significant effect This system covers all clinical work process associated with intensive care and achievesfunctions like retrieval doctor's advice intelligent, templated writing of s, pipelines/intake and output record statistics, data sharing with HIS/LIS/PACS, so the repeated data copying and manual operation link is reduced Through this system ICU can reduce the burden of work, improve the work efficiency and realize digital management REFERENCE [1]Eric Levesque, EmirHoti, DanielAzoulay,etal, The implementation of an Intensive Care Information System allows shortening the ICU length of stay, Journal of Clinical Monitoring and Computing,vol29,PP ,2015 [2]XikunMa, YanjunWu,PengWang, Development and Application of Clinical Information System for Intensive Care Unit, China Medical Devices,vol27,pp54-56,2012 [3] NaZhao, Application and Experiences of Clinical Information System for Intensive Care Unit, Medical Equipment,vol23,pp91-92,2010 [4]Anne Parker*, Eugene Bragin, Simon Brent, etal, Correspondence Using caching and optimization techniques to improve performance of the Ensemblwebsite, BMC Bioinformatics, vol11,pp239,2010 AUTHOR DETAILS A TingtingChen,firstauthor,medicalinformatics,De partment of Biomedical Engineering Address: hospital department,first Affiliated Hospital of Wenzhou Medical University,NaibaixiangTown,Wenzhou, Zhejiang Province,china B ChuandiPan,correspondingauthor,working as a professor from department of biomedical engineering in Wenzhou medical university,wenzhou,chinahis main research direction is medical informaticshe has experience in teaching field more than 15 years Address: hospital department,first Affiliated Hospital of Wenzhou Medical University,NaibaixiangTown,Wenzhou, Zhejiang Province,china Fund project: Project of Wenzhou Municipal Science and Technology Bureau <Research and Development of the digital critical patient monitoring system(number: 2014G0006)> ISSN: Page 342