Exploration of hospital management model supported by medical Internet of Things

1 Introduction

    The medical Internet of Things should be viewed from three aspects: "Things" are objects. Based on standard processes, the concept of the Internet of Things must be elevated to a process that can be controlled. That is, doctors, patients, instruments and equipment, etc.; "Network" is the process. This network must be based on standard processes. The concept of the Internet of Things must be elevated to a process; "Connection" is information interaction. The standard definition of the Internet of Things is that the object is perceptible, interactive and controllable.

Exploration of hospital management model supported by medical Internet of Things

    The concept of the Internet of Things has emerged since 2009, and its discussion and development in China are becoming more rational. In order to occupy a favorable position in the new round of mobile communication technology competition, enhance the competitiveness of domestic enterprises and operators, enhance the research capabilities of scientific research institutions and universities, and improve the industrial chain, the country has made comprehensive deployment of the "Internet of Things and Ubiquitous Network" during the "12th Five-Year Plan"; the project focuses on the research of core key technologies of the Internet of Things, including collaborative and integrated intelligent perception technology; efficient, safe and reliable transmission technology; flexible networking perception network technology ratio; multi-source, heterogeneous equipment access, service collaboration and integration technology, and network collaborative information processing technology, etc., and gradually establish a complete network and information integration technology system for the Internet of Things and ubiquitous networks. Select key areas related to national economy and people's livelihood and with large-scale application prospects for verification, study the integrated technology and information service model that support the sustainable operation of Internet of Things information services, establish industry norms and technical standards for Internet of Things applications, promote the research and development and industrialization of key Internet of Things equipment, and the large-scale application of information services. Strengthen the standardization of key technology systems of the Internet of Things and ubiquitous networks at home and abroad, and become the leading force of international standards in some fields. In the medical industry, the application of the corresponding software system of the medical Internet of Things is still relatively weak, but with the maturity of technology and equipment and other products, it will be more and more widely used in the medical industry. Such as outpatient and inpatient infusion management systems, mobile nursing systems, baby anti-theft systems and other products. Southwest Hospital conducted a trial in the form of a project to explore effective management models and promote the practical application of medical Internet of Things products in the hospital.

2 Current status of the medical industry

    At present, the general public complains that "it is difficult and expensive to see a doctor". The medical and health reform has entered a deep water zone, and medical units and medical staff are facing many challenges and problems. On the one hand, superior medical resources are mostly concentrated in large comprehensive hospitals or specialized hospitals, and a large number of grassroots medical units have a large gap with the former in terms of equipment configuration, financial resources and personnel quality. For example, the average daily outpatient volume of large hospitals is mostly more than several thousand people. Medical staff must complete the treatment of patients in a very short time. However, due to the lack of necessary auxiliary tools, a large number of manual operations will inevitably produce operational errors in the collection and monitoring of relevant clinical information such as equipment management, drug management, personnel identification, and physiological indicators and vital signs, which will inevitably lead to medical disputes. On the other hand, due to limited resources, it is impossible to properly follow up and guide each patient, resulting in a lack of continuity in the diagnosis and treatment of patients, especially for chronic patients and rehabilitation patients who are suitable for follow-up disease management activities in a home environment. There is a lack of effective means to carry out proper management and follow-up services. With the acceleration of the pace of urban life and the aging of the population, the number of elderly people, patients with chronic diseases and sub-healthy people has increased year by year, which has not only aggravated the tension of medical resources, but also lowered the overall health level of the nation.

3. First try of medical Internet of Things technology

    Southwest Hospital selected obstetrics and nephrology departments to try out new medical Internet of Things technologies. Currently, the more mature products include: baby anti-theft system, infusion monitoring system, and mobile nursing information system.

    We have carried out specific scientific research cooperation with a company, implemented the baby anti-theft system in the obstetrics department, the infusion monitoring system in the nephrology department, and the mobile nursing information system. The main equipment of the baby anti-theft system includes: RFID reader, RFID exit monitor, communication gateway, baby tag, electronic wristband (100 pieces/box), sound and light alarm device, etc.; the main equipment of the infusion monitoring system includes: infusion monitor (one per bed), wireless receiver, intelligent controller, LCD display: the main equipment of the mobile nursing information system includes: nurse handheld PDA, doctor mobile assistant, wireless intelligent access point (5-10 APs per ward), wireless controller (50 APs can be controlled), POE power supply switch (each power supply switch controls 24 APs), middleware platform, wristband.

    In order to achieve the purpose of the trial without restricting the trial of new technologies, we use medical Internet of Things equipment, middleware, intelligent handheld data terminals and other products, and transform obstetrics and nephrology through the PDCA continuous improvement model, and make adaptive adjustments to their corresponding business processes and management models. By comparing the work efficiency, error and failure probability, patient service satisfaction and other indicators of the traditional model department, we can obtain the significant changes brought about by the medical Internet of Things and improve the hospital's comprehensive understanding of the medical Internet of Things.

4 Exploration of management service model supported by medical Internet of Things

    After the trial use in the obstetrics and nephrology wards, we can summarize the obvious advantages of the medical Internet of Things, such as: improved work efficiency, personal service for patients, visual monitoring, reduction of medical accidents, etc. Through the understanding of the medical Internet of Things, we can explore some management service models in untried areas, and provide valuable references for their promotion and application when conditions are met. These new models will inevitably replace the traditional management service models. The main areas are: in-hospital goods management model supported by the medical Internet of Things, medical full process management model, and expansion of in-hospital service models. These three aspects are explored here.

    4.1 Changes in the in-hospital goods management model supported by the medical Internet of Things Hospitals focus on curing diseases and saving lives. Whether it is outpatients or inpatients, doctors need the help of auxiliary medical equipment to correctly diagnose patients' diseases. Only by relying on the medical Internet of Things technology and establishing a complete set of medical equipment management systems can the functions of medical equipment be better exerted. Among them, the high-value mobile asset system is a system developed based on the Internet of Things technology. It is a powerful tool for managing medical equipment, which can solve the problem of efficient management of medical equipment in hospitals and realize automatic allocation of medical equipment. For drugs, if a complete set of drug management systems is established, especially the establishment of drug RFID tags, the required drugs can be accurately located, and the entire process from storage to patient removal can be tracked safely and comprehensively. Therefore, it is necessary to explore the in-hospital goods management model supported by the medical Internet of Things, which can be understood from the following four aspects.

    4.1.1 Adjustment of item management process The application of medical Internet of Things actively collects and receives item information through sensing devices, so it is necessary to sort out, optimize and adjust the business process in order to adapt to the new application model.

    4.1.2 Establishment of management system Due to the adjustment of item management process and operation process, the corresponding management model will also be adjusted accordingly to adapt to the application of the new model. It is also necessary to establish a corresponding equipment storage system.

    4.1.3 The superiority index is compared with the traditional model, which has the advantages of convenient operation, accuracy of data, difference in work intensity, and knowability of item distribution.

    4.1.4 Error rate evaluation The evaluation system of item loss rate, data error rate, etc., continues to improve its management model. For example, when taking inventory of drug inventory, the traditional operation mode is to print a blank inventory list, manually count and record the data, and then enter the system; while the new mode of medical Internet of Things is to directly scan the drug barcode through auxiliary tools, and the inventory result automatically generates an inventory difference table. Through this simple inventory method, the intensity of inventory work is reduced, and the efficiency and accuracy of inventory are greatly improved. However, before using it, how to realize the internal hospital item management system of drugs, equipment, etc., how to realize business process adjustment, how to establish a corresponding management system, and how to measure the superiority of medical Internet of Things management are all new topics for most hospitals at present. Only through the exploration of the in-hospital item management mode of medical Internet of Things can the optimization of management mode and the improvement of operation process be realized.

    4.2 The whole process management mode of medical services supported by the medical Internet of Things has changed the visual monitoring induction (infusion monitoring) system in the ward, which uses the Internet of Things technology combining gravity sensing and RFID radio frequency transmission to achieve real-time monitoring of the infusion process. When the infusion volume is lower than a certain amount, the system automatically alarms, thereby replacing the manual inpatient infusion monitoring mode with the naked eye and realizing intelligent infusion monitoring. Through the application of the medical Internet of Things, comprehensive visual monitoring of the service process can be achieved, the quality of medical care can be actively controlled, the awareness of medical safety management can be improved, and the hospital's services can be extended from the nurse station to the patient's bedside.

    The mobile clinical information system, with the hospital information system (HIS) as the supporting platform and the computer system (HIS) as the supporting platform, makes full use of the data resources of HIS, realizes the expansion and extension of HIS to the ward, greatly promotes the informatization construction of the hospital, and takes a big step towards the goal of "paperless, filmless and wireless", which is also the general trend of the development of digital hospitals. Doctors and nurses use the built-in RFID reader of PDA to read the RFID tag preset on the patient's wristband to identify the patient, and then send the required operations and patient identity information to the application server through the wireless network. The application server accesses the hospital's back-end HIS, performs the corresponding operations, and sends the results back to the PDA, realizing the informatization of patient bedside services, which is in line with the hospital's "patient-centered" service concept.

    Through the successful transformation of the mobile clinical information system and the visual monitoring and sensing system for infusion in the ward, we can carefully analyze and summarize the implementation results. It is necessary to explore and analyze the goals and effects in advance in order to select the products well and create conditions for their implementation. Therefore, it is extremely important to explore the whole process management model of medical affairs supported by the medical Internet of Things, mainly from four aspects.

    4.2.1 Management Process Adjustment As new technologies and equipment are applied in clinical practice, the work center moves from the nurse station to the patient's bedside. The corresponding processes need to be redesigned and analyzed, and the management model needs to be continuously improved and the business process adjusted to maximize the efficiency of the use of new technologies and new equipment.

    4.2.2 Establishment of Management System For hospitals with traditional management models, when the Medical Internet of Things is partially enabled, their corresponding management systems and operation manuals should keep pace with the times in order to better manage the equipment and other products of the Medical Internet of Things.

    4.2.3 Indicators for measuring superiority The superiority of the medical Internet of Things can be measured by comparing the new and old operating modes horizontally, counting the workload and intensity, investigating patients' direct feelings, setting equipment detection economic indicators, analyzing the quantitative indicators of detection load, and asking operators for qualitative indicators of perception.

    4.2.4 Error rate assessment The error rate of the three checks and seven questions, data error rate, service quality, automatic data collection accuracy and other assessment systems continue to improve the management model. For example: the patient's body temperature collection, the original model is that the nurse measures the body temperature and then transcribes the information system, while the medical Internet of Things system directly collects the data through the equipment to achieve quality and safety tracking of the whole process. Through the application of the medical Internet of Things, doctors and nurses use their sensing devices to automatically collect data, reduce human factors and input errors, improve data accuracy, so that medical staff can spend more time and energy serving patients, greatly improve medical quality, and effectively ensure medical safety.

    4.3 Extension of the in-hospital service model supported by the Medical Internet of Things The extension exploration of the in-hospital service model supported by the Medical Internet of Things mainly explores the "vertical" medical collaborative service model of multi-level medical institutions in the domain, the "remote" medical collaborative service model between medical institutions of different levels in different locations, and the "horizontal" medical collaborative service model between large medical institutions, in order to solve the problems involved in business processes, information exchange, management system formulation and construction, measurement indicators, and error rate assessment.

    4.3.1 Business Process Adjustment Since the information systems of hospitals are not unified, they must follow unified standards to share information. Only by sorting out business processes under unified standards can we build a bridge between hospitals under the support of the Medical Internet of Things.

    4.3.2 Information Interaction Mechanism Only by establishing standards that provide a common information exchange model can a certain degree of information sharing be achieved and the needs of business process adjustment be met.

    4.3.3 Construction of management system This is an extension of the hospital's business process. It is not the general sharing of examination and test data in a certain hospital, but the sharing of basic medical information of the hospital. Only on this basis can more information about the patient's condition be obtained to help the hospital better diagnose the patient's condition, reduce unnecessary auxiliary expenses, and achieve effective control of patient expenses. Therefore, it is necessary to establish a shared medical management system.

    4.3.4 Measurement indicators Obtain the information on data collected by the Medical Internet of Things, the frequency of data exchange, the perceptual understanding of disease control, questionnaire feedback and other indicators to specifically measure the tremendous changes that the Medical Internet of Things has brought to society and the region.

    4.3.5 Error rate assessment is a brand new theory for data collection, transmission and mutual access between hospitals, and the standards followed will affect the error assessment.

    In short, it is inevitable to explore service management models supported by the medical Internet of Things. Through small-scale trials, hospitals can understand new technologies and products of the medical Internet of Things and recognize the changes that new technologies bring to hospitals, so as to better grasp the opportunity, adjust the structure head-on, enhance service awareness, and improve safety and quality assurance. The medical Internet of Things is a powerful tool for management services for hospitals, and how to use it depends on their own changes.

5 Prospects of Medical Internet of Things

    As a new tool in the hands of medical staff, medical Internet of Things products, if used properly, will hopefully play a positive role in solving problems. Therefore, by exploring the large-scale management model of medical Internet of Things, seeking suitable new technologies and equipment for the use and management of hospitals, when hospitals enter the widespread application of medical Internet of Things products, they can timely adjust the deficiencies that restrict their own development, thereby improving the hospital's management and service capabilities. By changing the medical service awareness of medical staff, they can actively provide patients with high-quality and efficient medical services and reduce unnecessary medical accidents. In the near future, through the widespread application of medical Internet of Things smart devices and software platforms, large hospitals will surely achieve the goal of leading local health centers to improve the level of health care services for the Chinese people.