Internet medical care is emerging. Should HIS be "repaired" or "completely reconstructed"?

During the COVID-19 outbreak, Internet medical services, featuring telemedicine and online consultation, have emerged as a new force, and their important role has been widely recognized by hospitals and the public. Coupled with the vigorous promotion of "new infrastructure" and the encouragement of national policies, Internet medical services are expected to develop rapidly.

For hospitals, especially public hospitals, embracing Internet medical care is an important direction to respond to policy requirements and promote information construction. But at the same time, the basic information system deployed by a large number of hospitals, the HIS system, is too old to bear the load, and hospitals are facing the thorny issue of whether the HIS system should be repaired or completely rebuilt.

Huge pressure on Internet medical construction and transformation

In the eyes of many people, Internet medical care is easy to implement. It is nothing more than setting up a website and a public account, making online appointments, and the offline business processes remain unchanged. However, with the development of technology and the drive of policies, this loose combination of online and offline Internet medical care model can no longer meet the construction needs of Internet medical care. Deep integration and participation have become important signs of the new stage of Internet medical care. The Internet diagnosis and treatment closed-loop service of appointment registration, online consultation, prescription circulation, online payment, medical insurance settlement, drug distribution, and health follow-up is being opened up.

However, this change will bring great challenges to the hospital's information system, and the hospital's HIS system will be the first to bear the brunt. First of all, new Internet medical applications do not exist independently, but need to be deeply integrated with existing medical applications and frequently interact with HIS systems. This involves the development and management of business interfaces. The old HIS system is insufficient in interface scalability, and integrating new applications often requires a lot of development work, which is quite disadvantageous for Internet medical applications that emphasize rapid launch and agile expansion.

Secondly, to meet the changing needs brought about by new businesses such as Internet medical care, the HIS system needs to be continuously updated. The consequence of long-term "minor repairs" is that the system will become more and more bloated, the stability will become worse and worse, and the development and maintenance work will take longer and longer. When the HIS system is finally replaced, the hospital will find that the long-term accumulated historical problems will significantly increase the complexity of the HIS system switch and bring hidden dangers to the operation of the new system.

In addition to Internet medical care, hospitals often face problems such as the HIS system not running smoothly enough and backward functions in the context of continued business growth and rapid evolution of smart medical care. These problems affect the realization of the hospital's overall construction goals.

Reconstruction or repair? Hospitals need to think seriously

Therefore, for HIS systems that are too old, it is better to reconstruct the system sooner rather than later. Although this will bring greater development, implementation and switching pressure in a short period of time, it is foreseeable that in the "post-epidemic" era, Internet medical care will develop at an unprecedented speed, and the country's guidance on smart hospitals will continue to strengthen. Timely HIS reconstruction can reduce the possibility of systemic risks.

However, if the HIS system does not have obvious bottlenecks in terms of scalability, performance, stability, etc., then it is best to focus on application expansion at this stage to reduce instability. "For hospitals, it is necessary to carefully evaluate the operating status of the HIS system, especially the system's tolerance for Internet medical applications, in order to make appropriate decisions," said a UFIDA medical expert.

What principles should be referred to in HIS system reconstruction?

So, for those hospitals whose HIS systems are significantly backward and have bottlenecks, but do not want to fall behind in the great wave of Internet medical care, what principles should be followed to reconstruct the HIS system? Experts from UFIDA Hospital gave the following suggestions:

◆Integration: Although there is a voice that believes that since the HIS system must ensure flexibility, it should not emphasize integration, but modularization and sufficient decoupling to reduce the difficulty of subsequent transformation. However, at this stage, a large number of hospitals have not yet achieved basic interconnection between systems. Coupled with the complexity of the HIS system itself and the limitations of the hospital's technical level, integrated development is still an important direction for the evolution of medical information systems. Hospitals need to first do a good job in basic work such as connecting data and processes, and promote the integrated and coordinated development of the front and back ends.

◆Build a data middle platform and a technical middle platform: Driven by digital technology, medical applications will be frequently iterated, and data interaction will reach an unprecedented level. Therefore, under the guidance of the integration idea, it is best for hospitals to uniformly store, process, and analyze data from HIS and other basic hospital information systems, and build a data middle platform and an archiving center for medical data in the hospital information system, and use this to support the star-shaped integrated architecture, electronic medical records, and data secondary utilization.

◆Platformization and easy integration: Platformization means switching the HIS system to a HIS system designed for the latest business environment, with strong performance and stability, and with multi-interface integration, and interconnecting with other business systems, finally achieving quality control and decision support based on data.

The UFIDA HIS system integrated into the "H+" integrated digital hospital platform is built on the concept of "front-to-back integration, group collaboration, and full-process medical and health care". It can not only provide a high-performance, high-availability, and agilely scalable clinical business system, but also achieve a deep integration of business and information technology. UFIDA HIS is developed based on the UFIDA UAP platform, which improves the efficiency and quality of software development. It also supports the division of product underlying codes by business field, and the speed of customized development is fast. The UFIDA HIS system also supports group-controlled organizations with multiple groups, multiple organizations, and multiple business units, and can meet the information technology needs of large medical groups.

With its leading architecture, mature technology, and rich practice, UFIDA HIS can help hospitals build an excellent basic information system for the era of smart healthcare and meet the needs of upgrading outdated HIS systems. At the same time, UFIDA HIS has agile scalability and can continue to support digital construction such as Internet hospitals in the near future.