醫(yī)院門診就醫(yī)流程改進(jìn)1

1、基于信息技術(shù)的醫(yī)院門診流程再造研究1 引言牛津英語大辭典（Oxford English Dictionary）對(duì)流程（Process）的定義是，“一個(gè)或一系列連續(xù)有規(guī)律的行動(dòng)，這些行動(dòng)以確定的方式發(fā)生或執(zhí)行，導(dǎo)致特定結(jié)果的實(shí)現(xiàn)一個(gè)或一系列連續(xù)的操作（Operation）?！?Oxford University Press,1978)所謂的就醫(yī)流程，就是病人就醫(yī)開始到結(jié)束的一系列活動(dòng)，它屬于醫(yī)院的內(nèi)部行為，醫(yī)院安排作用較強(qiáng)。醫(yī)院的業(yè)務(wù)流程不同于一般企業(yè)，它是一個(gè)流程系統(tǒng)，由三大類流程作為支撐，分別為核心流程、支持流程和管理流程，其中核心流程又可以細(xì)分為門診流程、急診流程和住院流程?？紤]到無論服務(wù)

2、的“面上”，還是“量上”，對(duì)病人影響最大的流程是門診流程。因此在本次就醫(yī)流程討論的重心放在“門診就醫(yī)流程”。The definition of word “process” in Merriam-Websters Collegiate Dictionary is “a natural phenomenon marked by gradual changes that lead toward a particular result”. Hospital process is defined by patient activities from beginning to end of hospit

3、alization. It is an internal behavior under the arrangement and control of hospital itself. The business process of hospitals is different from normal enterprises. It is a workflow system, supported by three categories of workflows, which are core workflow, supportive workflow and management workflo

4、w. The core workflow comprises outpatient workflow, emergency workflow and inpatient workflow. Taking into account the volume of outpatients and current service quality, outpatient workflow is essential to the patient satisfaction. Therefore this paper focuses on “outpatient workflow”.有學(xué)者通過問卷調(diào)查法隨機(jī)抽取

5、200名門診患者，對(duì)當(dāng)日門診數(shù)據(jù)及門診各部門相關(guān)工作情況進(jìn)行分析，研究發(fā)現(xiàn)目前我國(guó)大部分醫(yī)院人均掛號(hào)至就診時(shí)間平均為157.2 分鐘，診室診斷時(shí)間為18.89 分鐘，預(yù)約至檢查時(shí)間平均為106.4 分鐘，取藥等待時(shí)間平均為12.84 分鐘(何謙, 廖清書, 劉建萍, 2005)。以上數(shù)據(jù)直觀說明了醫(yī)院門診流程再造的緊迫性，如何從患者的角度考慮安排就診過程，簡(jiǎn)化門診流程的各個(gè)環(huán)節(jié)，減少患者在門診的停留時(shí)間，以達(dá)到科學(xué)管理，提高門診整體服務(wù)水平。Some researchers interviewed 200 outpatients randomly by using questionnaires

6、 and analyzed the daily data from outpatient departments (OPD). It showed that in most hospitals in China, in average the waiting time from visit registration to doctor consultation is 157.2 minutes, the time of consultation is 18.89 minutes, the waiting time from appointment to examination is 106.4

7、 minutes, the waiting time for pharmacy dispensary is 12.84 minutes (何謙, 廖清書, 劉建萍, 2005). The above data explicitly illustrated the immediate urgency of hospital outpatient process reengineering. How we can re-arrange the process of outpatient visit and how we can simplify the steps to decrease wait

8、ing time are questions in order to improve OPD service by scientific management.由于“醫(yī)院流程再造(Hospital process reengineering)是一種有關(guān)作業(yè)改善的哲學(xué)，它在對(duì)原有流程深刻理解和科學(xué)分析基礎(chǔ)上，以病人為核心，通過對(duì)原有流程進(jìn)行系統(tǒng)性重新整合或重組，增加流程中有價(jià)值的活動(dòng)，減少無價(jià)值活動(dòng)，以達(dá)到改善服務(wù)質(zhì)量，提高對(duì)病人特殊需要的反應(yīng)速度和降低工作成本的目的”(馮薇, 2005)，本研究主要從三部分來分析醫(yī)院流程再造活動(dòng)：一是對(duì)現(xiàn)有流程的科學(xué)分析以及存在的問題剖析；二是找出現(xiàn)有問題原因

9、并提出再造分析思路；三是提出改進(jìn)方案，給出流程再造后的流程圖。Hospital process reengineering is a philosophy to improve operations. It is based on the profound understanding and scientific analysis, to refactoring or regrouping previous workflow operations systematically from a patient centric point of view, to increase value add

10、ed activities and decrease valueless activities, for the purpose of improving service quality, accelerating response to patient and reducing cost. (馮薇, 2005). This paper analyzes the process reengineering activities in three folds. Firstly we analyze existent workflow and problems. Then we explore t

11、he reasons to the problems and paradigm to process reengineering. Thirdly, we propose improvement plan and workflow diagram after process reengineering. 2 醫(yī)院傳統(tǒng)門診流程現(xiàn)狀及存在的問題OPD workflow and existent problems 2.1現(xiàn)狀 Current situation一般看來，普通門診大致可以區(qū)分為“掛號(hào)-診斷-檢查-處方-取藥-治療”這幾個(gè)過程，但在實(shí)際過程中，醫(yī)院門診流程并不是清晰的呈現(xiàn)出以六個(gè)流程，而

12、出現(xiàn)了“五多一短”的現(xiàn)象，即1）醫(yī)院病人集中多，2）治療環(huán)節(jié)多，3）人群雜、病種多，4）應(yīng)急變化多，5）醫(yī)生變換多，6）診療時(shí)間短。Theoretically, an outpatient visit can be divided into procedures of registration, diagnosis, examination, prescription, pharmacy dispensary and treatment. However, in practice, OPD workflow presents a more complicated process with a

13、phenomenon of 1) large volume of patients, 2) complex medical tasks, 3) mixed groups of patients and miscellaneous diseases, 4) various emergency cases, 5) variation of caregivers services and 6) short time of consultation.圖1：醫(yī)院門診流程現(xiàn)狀2.2問題與挑戰(zhàn)圖2：門診流程工序現(xiàn)狀分析表1 就診流程程序統(tǒng)計(jì)活動(dòng)次數(shù)操作9移動(dòng)8檢驗(yàn)1等待98總計(jì)276由于病人到醫(yī)院就診時(shí)間是

14、一個(gè)隨機(jī)事件（取決于病人生病的客觀事實(shí)）且取決于病人的主觀意向，因此，就診時(shí)間往往比較集中，門診高峰現(xiàn)象是門診工作最顯著的特點(diǎn)之一。深層次的研究可以發(fā)現(xiàn)，導(dǎo)致這一現(xiàn)象的直接原因是患者有效就診時(shí)間很少（大約只占患者在醫(yī)院時(shí)間的10%），而如果將病人有效就診時(shí)間提高到30%，病人在醫(yī)院的停留時(shí)間將會(huì)減少三分之二；若提高到50%，則減少了將近五分之四的停留時(shí)間(韓煒, 2004)。為了醫(yī)院更好的實(shí)施門診流程再造，研究首先對(duì)現(xiàn)有流程進(jìn)行了梳理(如圖1所示)，以更好的發(fā)現(xiàn)問題、解決問題，為下一步流程再造夯實(shí)基礎(chǔ)。由圖1不難發(fā)現(xiàn)，現(xiàn)有流程存在以下幾個(gè)方面的問題。Time of patient visit

15、is a random event depending on patient subjective intention. Patient visit time tends to be centralized. High peak phenomenon is one of the most significant characteristics in outpatient department. Another significant phenomenon is that effective time for seeing a doctor is very short, which only c

16、omprise 10% of patient time in hospital. If we can increase the effective consultation/treatment time to 30%, patient waiting time will be reduced by two thirds. If we increase it to 50%, patient waiting time will be reduced by four thirds(韓煒, 2004). In order to better implement OPD process reengine

17、ering, we first analyzed the existent workflow, as shown in figure 1, in order to analyze the problem and further solve the problem. (1) 自然過程長(zhǎng)。完成一次看病過程，大致要排6次隊(duì)(掛號(hào)、候診、檢查劃價(jià)、付費(fèi)、藥品劃價(jià)、取藥)，付三次費(fèi)（掛號(hào)費(fèi)、藥費(fèi)、輔助檢查費(fèi)）1. Large number of steps: in order to complete a hospital visit, a patient need to wait in lines fo

18、r six times (registration, waiting for consultation, pricing for examination, payment, medication pricing, pharmacy dispensary), and pay three times (registration fee, medication fee and examination fee).(2) 門診“三長(zhǎng)一短”。掛號(hào)時(shí)間長(zhǎng)、候診時(shí)間長(zhǎng)、檢查取藥時(shí)間長(zhǎng)以及診察時(shí)間短。2. OPD three longs and one short. Registration time is l

19、ong; waiting time for consultation is long; waiting time for medication/examination is long and consultation/treatment time is short. (3) 檢查過程過于煩瑣。部分檢查預(yù)約，如CT、B超等；部分檢查具有特殊要求，如空腹、腸道清理等；檢查場(chǎng)所分散。3. Examination process is overly complicated. Some examination needs on-site schedule, e.g. CT, Type-B Ultraso

20、nic. Some examinations have special requirements. e.g. limosis or intestinal requirement. Some examinations are remotely distributed. (4) 導(dǎo)醫(yī)服務(wù)欠缺，服務(wù)標(biāo)識(shí)不清。病人盲目流動(dòng)4. Lack of guide service and clear signs. Patients walk around without clear roadmap. 這些現(xiàn)象導(dǎo)致病人在門診無效、非診治時(shí)間延長(zhǎng)(如圖2以及表1所示)，造成門診的擁擠，病人的煩躁，醫(yī)院和病人成本（金

21、錢、時(shí)間）增加，導(dǎo)致醫(yī)患矛盾增加，病人就醫(yī)滿意度下降，醫(yī)院服務(wù)受到社會(huì)多方指責(zé)。The phenomenon results in inefficient and long non-medical time, as shown in Figure 2 and Table 1, which further leads to OPD crowding, patient upset, hospital and patients cost increasing, medical disputes, patient satisfaction decreasing and hospital being c

22、riticized by public. 3. 醫(yī)院門診流程再造方案設(shè)計(jì)Hospital outpatient process reengineering plan3.1 流程再造的必要性Necessity of process reengineering 為了提高門診服務(wù)的運(yùn)行效率，為患者提供優(yōu)質(zhì)快捷的服務(wù)，流程再造以分析現(xiàn)有的門診流程為切入點(diǎn)，以減少門診流程的中間環(huán)節(jié)為突破口，提高病人的滿意度。具體而言，門診流程再造要把握三條原則：1）以病人為中心，優(yōu)化面向病人的就醫(yī)流程；2）以價(jià)值為導(dǎo)向，提高醫(yī)院經(jīng)濟(jì)運(yùn)行效率；3）以人為本，強(qiáng)調(diào)服務(wù)團(tuán)隊(duì)的整合。In order to improve th

23、e operation efficiency of outpatient service and provide fast and high quality service, process reengineering starts from analyzing existent outpatient workflow, breaks through by reducing intermediate steps of outpatient visit to improve patient satisfaction. In this regards, outpatient process ree

24、ngineering is based on three principles. (1) Patient centric: optimize for patient hospitalization; (2) Value: guided by value to improve hospital economic efficiency; (3) People oriented: emphasize on integration of service team. 3.2分析Analysis(1) 首先明確流程中增值和非增值的環(huán)節(jié)1. Clarify value added and non value

25、 added steps.n 增值環(huán)節(jié)：就診、檢查、治療Value added activities: consultation, examination, treatmentn 非增值環(huán)節(jié)：掛號(hào)、候診、交費(fèi)、取藥Non value added activities: registration, waiting, payment, pharmacy dispensary.(2) 把握病人的“排隊(duì)問題”2. Seize patient waiting problemn 每周的高峰期在星期一Peak time during a week is on Monday.n 每天的高峰期在上午Peak t

26、ime during a day is in the morning. n 上午的高峰期在9時(shí)至11時(shí) Peak time during morning is from 9am to 11am. (3) 確定影響流程的瓶頸3. Find out the bottlenecks of processn 非增值環(huán)節(jié)耗費(fèi)時(shí)間過長(zhǎng)Non value added activities take too much time. n 空間布局不夠合理和人性化Spatial layout is not rational and humanized. n 標(biāo)識(shí)不夠清晰Guiding signs are not c

27、lear enough. 門診患者就診流程中，非就診消耗時(shí)間長(zhǎng)，存在問題多，制定相應(yīng)的策略以優(yōu)化門診流程，縮短患者就診等待時(shí)間是非常必要的(何謙, 廖清書, 劉建萍, 2005)針對(duì)瓶頸，實(shí)行門診就醫(yī)流程再造或優(yōu)化In the process of outpatient visit, a large part of the time is consumed by non medical activities besides other problems. Its essential to make a strategy to optimize outpatient process and de

28、crease the waiting time of patient (何謙, 廖清書, 劉建萍, 2005)3.3 設(shè)計(jì)方法Methodology n 清除：清除對(duì)醫(yī)院服務(wù)增值無效的環(huán)節(jié)和步驟。Sweeping: clean the activities and steps not contributing to value of hospital service. n 簡(jiǎn)化：在盡可能清除了非必要性任務(wù)之后，對(duì)于剩下的工作進(jìn)行簡(jiǎn)化。Simplification: make remaining tasks simple after cleaning unnecessary steps.n 整合

29、：經(jīng)過簡(jiǎn)化的任務(wù)應(yīng)該進(jìn)行整合，使其流暢、連貫，以滿足患者需求。Integration: integrate the simplified tasked to make them ease and smooth to satisfy patient requirements. n 自動(dòng)化：也可稱為數(shù)字化，由于人力資源的短缺和為了使運(yùn)營(yíng)更有效率。Automation: also known as digitization, automate as many steps as possible to solve problem of human resource deficiency and mak

30、e operation more efficient. 4. 基于信息技術(shù)的醫(yī)院門診流程再造的措施Measures for hospital outpatient process reengineering 4.1 掛號(hào)系統(tǒng)的優(yōu)化(1) 增加咨詢和導(dǎo)診的服務(wù)臺(tái)。(1) Add service desk for consultation and guidance.增加了兩個(gè)環(huán)節(jié)“導(dǎo)診”和“預(yù)檢”是否應(yīng)先講一下做什么用的？。 導(dǎo)診可以大大方便患者就診，減少患者因掛錯(cuò)號(hào)造成的徒勞，同時(shí)由于導(dǎo)診的疏導(dǎo)和指示，可以減少醫(yī)生因患者掛錯(cuò)號(hào)而進(jìn)行的解答，讓醫(yī)生把更多的精力投入到診斷中。經(jīng)過指示的患者在醫(yī)院的就

31、診更加順暢，事實(shí)上減少了對(duì)醫(yī)院資源的占用時(shí)間率。在診斷之前加上一個(gè)“預(yù)檢”環(huán)節(jié)，其作用是對(duì)每一個(gè)排隊(duì)的患者進(jìn)行初步問診，讓必須進(jìn)行輔助檢查的病人先去做檢查，待檢查結(jié)果出來之后再進(jìn)行實(shí)質(zhì)意義上的排隊(duì)診治。預(yù)檢則是考慮到醫(yī)生在詢問完病情后，往往需要輔助檢查手段才能下診斷結(jié)論，造成患者二次排隊(duì)得到正確診斷，患者第一次排的隊(duì)伍意義不大，患者花費(fèi)很長(zhǎng)時(shí)間的排隊(duì)其結(jié)果只是被轉(zhuǎn)移到另外一個(gè)地方，去另一次排隊(duì)。實(shí)際過程中，國(guó)內(nèi)諸多醫(yī)院，醫(yī)生見到患者后略加詢問后就是開各種檢驗(yàn)的單據(jù)。，但這兩個(gè)環(huán)節(jié)并非增加了患者的停留時(shí)間。從實(shí)際情況看，導(dǎo)診前不存在排隊(duì)環(huán)節(jié)，而預(yù)檢前的排隊(duì)要么與就診前的排隊(duì)屬同一個(gè)隊(duì)伍，要么由于

32、其對(duì)這個(gè)隊(duì)伍的疏導(dǎo)作用增加的時(shí)間將不會(huì)存在。把確定是否需要檢查的環(huán)節(jié)調(diào)整至預(yù)檢環(huán)節(jié)，理論上講這個(gè)環(huán)節(jié)的醫(yī)護(hù)人員完全有能力判斷是否需要進(jìn)行輔助檢查，在不能判斷的情況下完全可以向醫(yī)生進(jìn)行咨詢。這兩個(gè)環(huán)節(jié)的增加，其作用是抵消了就診前的排隊(duì)（將人流疏散至數(shù)個(gè)輔助檢查部門），減少了因掛錯(cuò)號(hào)造成的資源浪費(fèi)。We add two steps “guidance” and “pre-exam”, which will not increase the patients waiting time. In practice, (2) 網(wǎng)上或電話預(yù)約在通訊及網(wǎng)絡(luò)比較發(fā)達(dá)的地區(qū)與國(guó)家，還可以采取網(wǎng)絡(luò)或電話預(yù)約看病，可

33、以大大節(jié)省看病時(shí)間。以上變化帶來的結(jié)果是，減輕了醫(yī)院候診空間人群聚集的壓力，可以緩解改變醫(yī)院公共空間混亂繁雜的環(huán)境，節(jié)省醫(yī)院中的等候空間。(黃錫繆, 2003)具體實(shí)施方面，首先對(duì)公眾和病人進(jìn)行教育，讓他們接受7 天內(nèi)首診或復(fù)診預(yù)約觀念。在辦理預(yù)約手續(xù)交費(fèi)后，當(dāng)場(chǎng)向他們發(fā)放“實(shí)名預(yù)約票”，病人憑“實(shí)名預(yù)約票”。其次，按預(yù)約時(shí)段就醫(yī)。建議把兩個(gè)小時(shí)作為一個(gè)預(yù)約時(shí)段，例如上午8時(shí)10 時(shí)可為一個(gè)時(shí)段。再次，預(yù)約的時(shí)間最好安排在下午，這樣可在一定程度上緩解門診上午的人流高峰。它的本質(zhì)是流程優(yōu)化的問題，即如何找到和解決瓶頸的問題。參考案例：餐廳18 時(shí)21 時(shí)是晚飯高峰期，為了調(diào)節(jié)人流，可以設(shè)立打折制

34、度：即18 時(shí)以前結(jié)賬的8 折，21 時(shí)以后點(diǎn)菜的7 折，那么顧客就會(huì)隨著價(jià)格杠桿自動(dòng)調(diào)節(jié)分流。醫(yī)院可仿此做法來緩解上午門診人流高峰。建議下午就診的預(yù)約掛號(hào)費(fèi)減半，這可吸引部分因?yàn)閽焯?hào)費(fèi)便宜而選擇下午就診的病人。這個(gè)建議不可行，醫(yī)院的掛號(hào)費(fèi)都是物價(jià)局規(guī)定的，無法更改(3) 觸摸屏式自助掛號(hào)掛號(hào)、病人自助掛號(hào)，手按觸摸屏即可自己掛號(hào)，減少排隊(duì)等候。目前不論是三級(jí)醫(yī)院還是二級(jí)醫(yī)院，掛號(hào)收費(fèi)環(huán)節(jié)掛號(hào)和收費(fèi)是一起的，應(yīng)該說掛號(hào)收費(fèi)環(huán)節(jié)。自助掛號(hào)需要“自動(dòng)收費(fèi)”系統(tǒng)的支持。目前不論是三級(jí)醫(yī)院還是二級(jí)醫(yī)院, 在上午就診高峰時(shí), 就診人員排長(zhǎng)隊(duì)的現(xiàn)象還是比較普遍。引入門診自助掛號(hào)系統(tǒng), 可以實(shí)現(xiàn)自助掛號(hào),

35、以此分流就診高峰時(shí)的就診人員在人流低谷時(shí), 自助掛號(hào)機(jī)可以起到醫(yī)院宣傳和查詢的作用。所以適當(dāng)增加門診自助掛號(hào)系統(tǒng)可以減少醫(yī)院人力成本的支出, 縮短就診高峰時(shí)段就診人員門診掛號(hào)排隊(duì)時(shí)間。4.2收費(fèi)系統(tǒng)的優(yōu)化：醫(yī)院一卡通的運(yùn)用醫(yī)院一卡通以磁條卡、條碼卡、卡Smartcard等識(shí)別卡為基礎(chǔ), 通過使用識(shí)別設(shè)備將就診人員信息讀入醫(yī)院信息系統(tǒng)，主要是病人掛號(hào)預(yù)付費(fèi)用或醫(yī)保帳戶鎖定，反應(yīng)在實(shí)際操作中，門診就診卡可以避免人工輸入就診人員編碼時(shí)的錯(cuò)誤其次在門診就診卡中引入現(xiàn)金儲(chǔ)值的方式，病人在接受各種輔助檢查時(shí)直接刷卡而無須付費(fèi)，最終的結(jié)果是變3次收費(fèi)為最后一次收費(fèi)，以減少收費(fèi)環(huán)節(jié)合排隊(duì)等候。此外，在應(yīng)用一卡

36、通系統(tǒng)劃價(jià)等環(huán)節(jié)就一并取消了，大大的減少了病人的排隊(duì)次數(shù)，縮短了等待時(shí)間。在具體實(shí)施上，可以與本地銀行聯(lián)合，除在醫(yī)院設(shè)立沖值與取現(xiàn)的服務(wù)外，還應(yīng)在合作銀行設(shè)立專門的沖值服務(wù)，方便病人對(duì)一卡通的管理。具體實(shí)施如下：圖3：一卡通系統(tǒng)在醫(yī)院門診的應(yīng)用4.3 檢查系統(tǒng)的優(yōu)化(1) 候診優(yōu)化：候診拿號(hào)系統(tǒng)門診排隊(duì)候診系統(tǒng)排隊(duì)系統(tǒng)最早被應(yīng)用于銀行系統(tǒng), 根據(jù)排隊(duì)心理學(xué)，等候時(shí)間不可知比可知等候較長(zhǎng)時(shí)間更難以忍受。近些年來排隊(duì)系統(tǒng)逐漸在醫(yī)院得到廣泛的應(yīng)用, 如門診?？频暮蛟\區(qū), 醫(yī)技檢查候診區(qū), 取藥等待區(qū)等。其主要的功能是, 通過屏幕顯示就診人員的排隊(duì)信息, 讓就診者能及時(shí)了解自己所處的候診位置以及等待的

37、大致時(shí)間，如果顯示屏采用的是等離子或液晶顯示器,還可以在顯示候診信息以外, 在空余的版面顯示娛樂或醫(yī)療信息, 減少就診人員的焦慮度。門診排隊(duì)候診系統(tǒng)的應(yīng)用有效改善了候診區(qū)的秩序, 提高了就診的滿意度。(2) 建立醫(yī)囑傳輸系統(tǒng) 目前患者在診治過程中所產(chǎn)生的信息收集基本上都是以紙張和膠片為載體:如處方箋、檢驗(yàn)單、CT 單等；患者擔(dān)負(fù)著各種單據(jù)的傳遞任務(wù)，攜帶和保存大量的單據(jù)，給醫(yī)生及醫(yī)院收集患者資料上帶來一定的困難。以患者為中心的第三代醫(yī)院信息管理系統(tǒng)OCS(Order Communication System) 即醫(yī)囑傳輸系統(tǒng)就是緊緊圍繞就診過程中產(chǎn)生的醫(yī)療文書進(jìn)行規(guī)范化管理。4.4藥房系統(tǒng)優(yōu)化

38、(1) 門診醫(yī)生站系統(tǒng)。門診醫(yī)生站系統(tǒng)是醫(yī)院臨床信息系統(tǒng)的重要組成部分, 改變了早期醫(yī)院信息系統(tǒng)中, 由醫(yī)師手工開處方或醫(yī)技檢查單, 患者二次排隊(duì)后, 由收費(fèi)員錄入處方及醫(yī)技費(fèi)用的模式, 在醫(yī)師在與就診人員交流過程中, 直接通過醫(yī)生工作站錄入處方及醫(yī)技檢查單, 收費(fèi)處無需錄入處方及醫(yī)技費(fèi)用, 直接調(diào)取患者相關(guān)收費(fèi)信息后結(jié)算, 加快了收費(fèi)處的結(jié)算速度。尤其是對(duì)持儲(chǔ)值功能就診卡的患者, 醫(yī)師在門診醫(yī)生站中為其錄入處方或醫(yī)技檢查單, 系統(tǒng)自動(dòng)從儲(chǔ)值金額中扣除, 患者無需二次排隊(duì), 直接可以到相關(guān)科室獲得相應(yīng)醫(yī)療服務(wù), 直到確認(rèn)結(jié)束就診, 一次性到收費(fèi)處結(jié)算。門診醫(yī)生工作站在緩解收費(fèi)處排隊(duì)擁擠的同時(shí), 也提高了收費(fèi)的準(zhǔn)確性。由此可見門診醫(yī)生工作站可以顯著提高患者就診滿意度,在不改變醫(yī)院門診布局的情況下, 加速了就診速度, 增加了就診人次。因此門診醫(yī)生工作站在門診量大的醫(yī)院得到廣泛的應(yīng)用。(2) 藥品自動(dòng)包裝系統(tǒng)。藥品自動(dòng)包裝系統(tǒng)通過與醫(yī)院信息系統(tǒng)的軟件接口, 從醫(yī)院信息系統(tǒng)中獲取待發(fā)藥品的信息, 對(duì)于已使用門診醫(yī)生站的醫(yī)院信息系統(tǒng), 藥品自動(dòng)包裝系統(tǒng)還可以獲得處方中藥品按頻次服用的信息, 因此在藥品自動(dòng)包裝系統(tǒng)確認(rèn)發(fā)藥時(shí), 不但可以一次性包裝處方中的藥品, 而且可以按照每次服用劑量包裝藥品, 指導(dǎo)患者按劑量服用。藥品自動(dòng)包裝系統(tǒng)的應(yīng)用在提高藥品發(fā)放準(zhǔn)確性的同時(shí), 也增強(qiáng)了藥品的保存時(shí)間