Reconstruction of Hospital Information System from the viewpoint of Conquest of Factors to Spoil Reliability of Patient Data

健康记录的计算机化并不是最终目标。必须使用电子健康记录（EHR）。通过分析适用案例中的负面因素，我们假设用于诊断、医疗和评估患者的存储信息的可靠性存在问题。根据研讨会讨论的结果，并借助日本卫生保健委员会信息设备与IT部门会议的问卷调查，我们研究了医疗中以患者为中心的目标是什么，以及电子病历在治疗过程中对这一“目标”有哪些要求和问题。调查结果表明，负面因素可分为四个层次的结构模型；准确性、连续性、概括性和叙事性。在保证数据层面的“准确性”和“连续性”的基础上，必须通过对长期数据的系统划分和可见性来保证电子病历的“调查”。此外，达到“目标”的过程应该用可理解的表达来描述，从而产生令人满意的“叙事性”。最后，对单个因素的含义进行了梳理，提出了软件、硬件和人为因素的复合解决措施。

The computerization of Health Records is not the final goal. The electric Health records(EHR) must be utilized. Analyzing the negative factors in applicable cases, we presumed that the reliability of stored information for diagnosis, medical treatment, and assessment for a patient is problematic. Based on its result of discussion in workshops, and the questionnaire survey with the help of Information Equipments and IT Sectional Meeting of Japan Council for Health Care, we studied what the patient-centered goal in medical treatment is, and what requirement and issue EHR have in the treatment process to this“goal”.The survey showed that the negative factors are categorized into four levels of thestructure model; accuracy, continuity, survey, and narrativity. Based on assured “accuracy” and “continuity” in data level, “survey” must be assured on EHR by a systematic division and visibility of long term data. Moreover, the process to the“goal” should be described by intelligible expression, leading to satisfactory “narrativity”. Finally, we arranged the meanings of individual factors and proposed the compound solution measures for soft ware, hard ware, and artificial factors.