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1.Overview and analysis of the construction of primary medical and public health information system

The so-called “primary medical and public health institution” refers to the medical and public health institution with rural primary and township community medical institutions as its core. To improve the primary medical and public health service system, the following contents should be achieved:

（1）Accelerating the construction of rural township hospitals, village hospitals and urban community health service institutions, achieving the overall coverage of primary medical and public health service network.

（2）Strengthening construction of the primary medical and public health worker teams, especially training of general practitioners, focus on improving the service level and quality of primary medical and public health service institutions, enable farmers to see doctors without leaving the village and the urban residents may enjoy convenient and effective community health services.

（3）Transforming the operation mechanism and service mode of primary medical and public health institutions, improve the investment mechanism, gradually establish the grading clinics and dual-way referral diagnosis system.

（4）Releasing the burden of urban and rural residents from primary medical and public health service fees, obviously improve the utilization of primary medical health services.

Through improving the primary medical and public health service system, we may alleviate the medical resource pressure, play the advantages of large hospitals, enable the patients to see the doctor in big hospitals and receive rehabilitation in smaller hospital, so that to ensure the treatment effects, reduce diagnosis costs form patients, solve the medical difficulties and expenditures of the public.

The main purpose of the primary medical and public health service information system construction is to improve the service level of the primary medical and public health institutions through information manners. Through years of development, there are still many difficulties, mainly reflected in three aspects: human resources, financial and materials

1、 Severe shortage of personnel and talents;

2、 Inadequate investments in funds and technology;

3、 Unbalanced resource development.

Due to the above constrains, the information construction of the primary medical and public health service system has not been completely implemented, thus the medical and health knowledge can not be effectively popularized, unbalanced resource development leads to unreasonable flows of patients, the bridge role of township hospitals can not be played. All these have exacerbated by medical difficulties, high expenditures and long distance of patients.

2. Primary medical and public health information construction program design

Primary medical and public health information mainly has the following characteristics: 1) Relatively small scale, dispersed regions, thus the implementation costs is relatively higher; 2) Poor computer knowledge of operators; 3) Lacking of professional computer maintenance personnel (or no at all), difficult to perform maintenance on the computer system, difficult to ensure the safe and effective operation of the system database; and 4) Generally, the economic base is relatively weak, difficult to bear the high software purchase costs.

To realize the information construction, the rural township medical institution shall, at least, configurate 2 computers, 1 server, 1 set of hospital information system, coupled with some peripheral equipments and network, wiring and bandwidth, at least dozens of ten thousand yuan has to been spend in phase I of the project. “If plus the operator training and later operation maintenance, even the medium hospitals with an annual income over millions are difficult to bear that.”

Cloud computing is a type of technology developed rapidly in the recent years, deepening on its excellent business and computing mode, its application fields are gradually increasing. In the construction of the primary medical and public health information system, we will build the system by using the SAAS cloud computing (Software as a service) mode.

As shown in the figure above,we may take a county or a city as a unit to built the primary medical and public health cloud, township hospitals, village hospitals and community health service centers within the region governed should all be connected with the primary medical and public health cloud center through dedicated lines or WAN. Every grassroot institution does not need to implement design, construction and maintenance of physical facilities in information construction process.

In such an application mode, various grassroot medical institutions will put more emphasis on development of the business system, information is only an adjunct means of medical service, it does not need to occupy too much manpower and material resources.

3. Benefits from grassroot medical and public health information construction

Construction of the primary medical and public health information system is able to ensure the authenticity of primary data sources, improve diagnosis efficiency, strengthen the chronic disease management ability, significantly reduce the cost of medical treatment.

However, due to the uneven regional economic development, the investments to primary medical and public health service institutions are not sufficient, both funds and staff are in shortages. Personnel at some township hospitals and most village hospitals can not master enough IT knowledge, thus the information construction of the primary medical and public health institution is only in its infancy state.

Presently, many township hospitals and community service centers still use the manual accounting and settlement method. Although some township medical service centers have applied computer-oriented management, this is only focus on financial management, fundamental documents registration and drugs warehouse entry and departmental. In the traditional handwriting and manual transmission mode, diagnosis records are easily lost, damaged or missed, drug administration is often in confusion, effective management can not be achieved on chronic disease, women and children.

Strengthening the information construction of primary medical and public health service institutions may significantly improve the information transmission ability of the primary medical institutions, improve the diagnosis means and efficiency, ease pressures for large hospitals.