| 1. Summary" Silver wave " has gradually hit us with the development of our economic society and civilization. Our country has launched all-round pension patterns, such as institution care, home care, estate care etc. However, comparatively with the endowment experiences and practices aboard, endowment services in our country still have some shortcomings. Social development and the progress of medicine promote the average life expectancy getting longer and longer, while the elderly population is the main chronic diseases group, coupled with China’s traditional concept are more likely of children care the elderly. So the demand for today’s home care of the elderly is rising and has not only limited to providing, but also more concerned about the health of the medicine. Nevertheless, the problems of irrational allocation of medical resources, most institutions still preclude "medical-providing separation" mode and the aversion of nursing risk caused structural imbalance of the community elderly market covered population, families or the elderly themselves evade the risk of medical community agencies causing a large number of community health resources wasted and many other issues. These exacerbated the conflict between elderly and health care services. Due to the widespread practice of family planning, the one-child-oriented "four - two - one" small family has become the main family structure. Children have no time to take care of four elderly people, under the grim situation of gradual weakening and lack of institutional care in family pension function, Chinese government actively respond to the aging population. The government work report this year has mentioned the word pension for 14 times and proposed "to accelerate the formation of Trinity Pension Service Pattern, as home-based care, community services as the base, institutional care for the auxiliary, and web of things with mobile Internet convergence to improve automation, intelligent health information service. And these requires innovative mode for the supply of our aging services, including innovative the supply forms and mainstays of aging services.To innovate pension mode, it is necessary to grasp the basic needs of the elderly, containing elderly services to health care management, integrating pension and medical resources and strengthen the pension services, promoting the development of "medical-nursing" pension mode. Hospital management mode has been unable to meet the service needs of the elderly and regional health information sharing is the inevitable trend of the times. The Morgan Stanley report pointed out that in 2013 with the fastest growing areas of big data, the medical industry occupies the first place. Therefore, through the establishment of a medical information platform to integrate existing health and pension resources, using of clinical data sharing and exchange to achieve large medical data mining and optimization of the elderly health management and treatment processes is an inevitable trend in the development of health services management.In direct at this special group of the elderly pension issues, this paper in the found of the medical information technology assumed that we can on the basis of the literature in the use of electronic information platform status quo at home and abroad and then through semi-structured interviews / expert advice and other research methods to understand the needs of building the collaborative medical-nursing integration health information platform in line with the elderly, comprehensive medical institutions, community health service centers, public health administrative departments, third party pension services industry, multi-level needs of regional collaboration to support the integration of medical information platform.2. ObjectiveBuilding regional medical information technology medical-nursing collaborative platform designed to take the elderly as a target, with the help of information technology within the area of information systems open up various medical and health institutions and public health institutions, building a unified data repository management areas. In order to achieve the establishment of the elderly health records, elderly home care services, chronic disease tracking management, and lift information silos between medical institutions and the elderly, establish of regional medical association, provide convenient services to the elderly home care and chronic disease intervention which can relieve pressure on large integrated medical institutions and achieve public health management health administrative departments to promote the development of new pension services. At last, it will achieve the purpose of optimizing allocation of medical resources. By building medical information integration platform and full use of information technology tools to promote high-quality medical resources longitudinal flow, finally achieve active aging and smart building pension mode.2.1 Through literature study, semi-structured interviews and other research methods to learn the needs of the main involved core of regional medical-nursing integration platform and summarize feasibility construction technology of the platform.2.2 Learn from abroad advanced concepts and modes to build on elderly regional medical-nursing integration homecare platform on which can provide a viable condition for the study of medical information home care service development.2.3 Design the core function of home care medical information resource platform, and improve the social support system construction platform to facilitate the elderly home health-care management, to realize medical resources sinking into the community, providing data for a large public health services, and protecting the value of this study.All in all, effectively achieve the desired healthy aging "sense of security" and "sense of medical care" and the diversified target of "giving priority to family pension, community pension as bases, institution pension as supplement".3. SignificanceThroughout recent years, the fast trend of China’s elderly care services and the information technology development has become an essential trend, building this regional medical-nursing elderly homecare platform which can be a bridge between elderly at home pension and social services. The elderly not only can stay in both daily life environment, but also to get health care and enjoy a full life health management at the same time without departing from the original living conditions and social relations; meanwhile, it can be convenient to children care for the elderly in their leisure time, fully integrate the use of family, community and general hospital resources, saving time and greatly reduce pension costs; creating a "holistic medicine concept" to the elderly as a whole, long-term health centers to strengthen preventive health and self-care, realize continuity of the elderly chronic disease treatment. By means of complementation between the hospital’s strengths and disadvantages, truly achieve high-quality medical resources’ strategy forward and center downsizing, as well as innovative pension mode.If we can introduce platform mode into the pension industry, we will create a dynamic and profitable potential ecosystem, and achieve the establishment of a win-win situation with growing in the balance. It will also subvert the existing health care market structure and promote community and home care services to the scientific and effective advanced ranks, which can better integrated medical resources.4. Research Methods4.1 literature study: literature studies concentrate on the theme of this article, the mainly focus on domestic and foreign medical information platform, mobile health, home care, older people and other related keywords. By summarized the use of domestic and foreign medical information platform, as well as homecare pension application as an important theoretical support and bedding to the late semi-structured interview outline design.4.2 Consultation method: Select experts who familiar to medical informatics, software engineering, hospital management, health economics, epidemiology, social medicine and health management and other related disciplines, IT specialists and experts in health administration to consult for stakeholders about their demand of medical information integration platform, and give their advice and requirements to the construction of the platform mode designation.4.3 Semi-structured interviews: The study conducted interviews around the theme of this article, to develop an interview outline which mainly related to advisory of technology research on elderly home health care information platform, try to understand the elderly and their families, community health services, Information Section, Department of Radiology and the relevant laboratory department staff, as well as hospital administrators’ views and recommendations to chronic elderly home medical services platform. Meanwhile, revise their interviews outline during the interview process in order to better access to more information.5. Results5.1 By the method of literature review, we found that technologies application in the medical field service abroad started early and has accumulated some experiences, such as US, UK, Canada and Australia, home-care mode and related institutions has developed comparatively mature, which has a certain significance to the domestic integrated services mode construction; while, exploration to the domestic pension mode of the elderly despite a late start, but also has some success, especially in today’s combined pension mode of medical support exploration, some domestic Large cities have been trying to build up medical wisdom pension information platform as a goal, while still in the exploratory stage.5.2 Clear the stakeholder interests of regional collaborative medical-nursing home-care platform and then make semi-structured interviews and expert advice to the stakeholders. Depending on the interview subjects, we designed outline of five interviews, selected stakeholder representatives to summarize the health needs of medical information platform which is divided into two parts:the users’needs, including the elderly and the elderly health management services especially the family home care for elderly people with chronic diseases, advice of health-related department services, the bottleneck of community health services, medical large data collection needs of public health services and so on; another is platform design requirements, through the semi-structured interviews to technology department, obtain that the required platform for building data collection, information standardization, integration and sharing of data use and data security and other information data, and draw on a vision of existing information technology support under the condition which can be reached.5.3 From basic applications and service needs, the research based on the choice of Service-Oriented Architecture, health records to build regional collaboration medical-nursing information platform which supported by medical information platform, according to the service stakeholders design as service module, and realize the collection and sharing health records of residents. By means of community information exchange and collaboration between general hospital services, health services, health authorities, as well as general practitioners to realize services process reengineering and optimization on the platform. Via the platform making elderly health information management, monitoring and treatment of chronic process, third-party inspection process, third-party and third-party medical imaging workflow distribution service processes come true. In order to improve information utilization, optimize basic medical services, to achieve health management cloud platform and First Aid for remote, closed-loop management of community health services for the network, and construct the regional medical-nursing information service platform which centered on large hospital to create a looping management.6. Conclusions6.1 Whatever demand or technology, to build regional medical-nursing information platform is realizable and achieve certain social benefits. Improving medical information sharing, optimizing resource allocation for health sciences, providing protection to healthcare management, improving the development of healthy value-added services, beneficial to create a "holistic medicine concept" and to achieve continuity treatment of chronic diseases, saving the elderly and their families and caregivers of the doctor visiting time, reducing medical costs.6.2 Construction of regional integrated medical-nursing health information platform still faces many challenges, such as long-term funding mechanism has not established, countries do not form a complete mature standard system, Medicare has not been involved in the settlement, the grass-roots level of information is weak, and the government monitoring and evaluation system is not perfect,. The question who needs information platform, where to build and by whom the problem be charged is still undefined. Legal responsibilities and obligations of telemedicine has not clear and many other problems, which will lead to many obstacles to the establishment of regional integrated medical-nursing information platform.6.3 Facing so many challenges, our country should strengthen the construction of government running manage mechanism, improve the legal system to making the establishment of regional integrated information platform legalization and standardization. Enrich multi-service resources to expand funding sources, establishment of government, markets and pluralistic society positive interaction between the main mechanism in order to stimulate the creative vitality and endogenous dynamics of market players; Meanwhile, domestic should learn from foreign advanced concepts and technologies, according to the needs of the elderly, taking a flexible approach to service mode; missionary and targeted training to the elderly, so that they can accept advanced network technology. |
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