Client-server, distributed database strategies in a health-care record system for a homeless population.
Client-server, distributed database strategies in a health-care record system for a homeless population.
复制标题
无家可归者医疗记录系统中的客户端-服务器分布式数据库策略。
DOI：
10.1136/jamia.1994.95236148
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Barnett,GO
中科院分区：
文献类型：
--
作者：
Chueh,HC;Barnett,GO
目标：设计和开发基于计算机的医疗保健记录系统，以满足无家可归人群的患者和提供者的需求。设计：为波士顿无家可归者医疗保健计划 (BHCHP) 开发的基于计算机的医疗保健记录系统采用客户端-服务器技术和分布式数据库策略，为这一流动人口提供通用医疗记录。图形应用程序界面专门解决了医生、护士和社会工作者的不同信息需求，以促进综合的医疗保健方法。这种基于计算机的记录系统专为远程和便携式使用而设计，可顺利融入无家可归者护理提供者的日常实践中。该系统使用远程网络技术和常规电话线来支持远程护理站点的多个并发用户。结果：独立的试点系统正在 BHCHP 医疗暂托单位运行。已输入来自 37 个独特地点的 129 名患者就诊的信息。一个完整的客户端-服务器系统已经设计完成。基准测试显示，虽然基于电话线的通信链路的相对性能是局域网的 0.07 到 0.15，但优化允许足够的响应。结论：流动人口中的医疗记录访问会带来特殊问题。使用客户端-服务器和分布式数据库策略可以提供技术基础，从而在此环境中提供安全、可靠且可访问的基于计算机的医疗记录。
Objective: To design and develop a computer-based health-care record system to address the needs of the patients and providers of a homeless population.Design: A computer-based health-care record system being developed for Boston's Healthcare for the Homeless Program (BHCHP) uses client-server technology and distributed database strategies to provide a common medical record for this transient population. The differing information requirements of physicians, nurses, and social workers are specifically addressed in the graphic application interface to facilitate an integrated approach to health care. This computer-based record system is designed for remote and portable use to integrate smoothly into the daily practice of providers of care to the homeless. The system uses remote networking technology and regular phone lines to support multiple concurrent users at remote sites of care.Results: A stand-alone, pilot system is in operation at the BHCHP medical respite unit. Information on 129 patient encounters from 37 unique sites has been entered. A full client-server system has been designed. Benchmarks show that while the relative performance of a communication link based upon a phone line is 0.07 to 0.15 that of a local area network, optimization permits adequate response.Conclusion: Medical records access in a transient population poses special problems. Use of client-server and distributed database strategies can provide a technical foundation that provides a secure, reliable, and accessible computer- based medical record in this environment.