S Y T THANH HA

CNG HA X HI CH NGHA

VIT NAM
BNH VIN K TNH

c lp T do

Hnh phc

HON CHNH H THNG MNG INTERNET CC

PHNG XT NGHIM HNG TI KT NI VI H
THNG CHUNG CA BNH VIN A KHOA TNH
THANH HA

I. TNH HNH THC T

Hin nay, lng ngi n khm mi ngy Bnh vin K Tnh
Thanh Ha cng ngy cng nhiu, s lng bnh nhn nhp vin
ngy cng tng nn s lng xt nghim trong ngy cng tng
theo. Mc d nhn lc ca phng xt nghim lm vic qu ti
nhng xt nghim ca bnh nhn vn chm hoc tht lc. Nhiu
tnh hung nh hng n vic cc bc s lm sng khng x l
kp hoc lm cho tnh trng bnh trn bnh nhn ngy cng nng
hn, ng thi cng ko di thi gian ch i ca bnh nhn, dn
ti nh hng n cht lng chuyn mn v uy tn ca bnh vin.
Cng vi l nhu cu bc thit v qun l xt nghim, hch ton
kinh t . Chnh v vy khoa Ha Sinh chng ti ngh Ban Gim
c cho php chng ti tng bc hon chnh h thng mng BV
gim thi gian ch i v tng vng qun l xt nghim. Chng ti
xin c a ra n : Hon chnh h thng mng internet
cc phng xt nghim hng ti kt ni vo h thng chung
ca bnh vin
thc hin n ny chng ti xin chia lm gm 3 giai on:

o Giai on 1: Hon thnh h thng LIS ca phng xt

nghim Ha Sinh,

k tr kt qu ti phng khm cho

bnh nhn ngoi tr.

o Giai on 2: Hon chnh cc LIS ca cc phng xt
nghim cn li. Kt ni gia LIS vi HIS hon chnh h
thng mng
o Giai on 3: Tr kt qu n tng khoa, tng bn khm,
ch k in t, v qun l hch ton kinh t cho mi khoa
phng.
Do iu kin v tnh hnh thc t chng ti xin trnh by ni dung
giai on I.
Giai on 1
HON THNH H THNG LIS CA PHNG XT NGHIM HA
SINH, K TR KT QU TI PHNG KHM CHO BNH NHN
NGOI TR

I. Hin trng my mc trang thit b v trnh mng tin

hc ti lab Ha Sinh
1. My mc v trang thit b xt nghim:
o Cobass 8000, Cobass 4000, B121, Urisys2400, EA
9180 ca Roche Dianosgtic.
o AU 640, AU 680, DXI 800, Gastas 6000 ca Backman
Coulter.
o 02 My li tm tin phn tch.
2. Trnh mng tin hc:
Hin ti chng ti c:
1 My ch HP (server) ca hng Roche cung cp, c cu hnh cao:
c 2 CPU

Xeon E5 - 2620 12 dng x l tc 2Ghz/1 dng

x l c cache L3 l 15MB, b nh RAM 16 GB, 2 cng HDD vi

dung lng lu tr mi cng 1TB. Li th khi c 2 CPU chnh l
im 2 CPU c th thay nhau hot ng, khi lu lng x l cng
vic tng th c 2 CPU cng hot ng. ng thi cng thun li
trong qu trnh bo dng hoc thay mi CPU khi cn nng cp (Ch
cn 1 CPU l h thng hot ng v c th thay CPU cn li).
7 b my tnh HP do Roche cung cp, 8 thit b c m vch, 1 my
in kt qu tc cao, 2 my in barcode.
c phn mm Cobas IT 5000 ca hng Roche qun l thng
tin bnh nhn v cc kt qu xt nghim.
Hin ti cc cn b v nhn vin trong khoa s dng thun thc
phn mm Cobas IT 5000 trong vic nhp thng tin bnh nhn v
ly kt qu cng nh in ra c kt qu xt nghim.
II. Ni dung cc cng vic, tin trnh thc hin v yu cu k
thut ca LIS ti lab Ha Sinh.
1.Thi gian v a im thc hin
- Thc hin ti lab Ha Sinh v phng ly mu khoa khm bnh.
Thi gian t 1 thng 7 n 30 thng 9 nm 2015.
2. Yu cu k thut.
Yu cu t ra l s xy dng mt h thng mng ti phng xt
nghim bnh vin a khoa tnh vi cc c im:
o n gin, thng minh, d qun l v s dng
o n nh v ph hp vi a s cc my c
phng xt nghim
o Tnh bo mt cao, hot ng 24/24 v 7/7
o C tnh m v tng tc cao, d dng kt ni vi 1
thit b mi.
3. Ni dung cc cng vic thc hin
Cng vic th nht : La chn phn mm qun l

Hin nay Khoa Ha Sinh chng ti c phn mm qun l Cobas

IT 5000, nhng phn mm mi ch kt ni vi nhng my ca Roche
cn nhng thit b thuc s hu ca cng ty Minh Tm th cha kt
ni. Cng ty Minh Tm c xut s dng phn mm Labconn.
Tuy nhin nu c 2 phn mm qun l song song th s xy ra tnh
hung: xt nghim ca bnh nhn A ang lm trn h thng ny,
cn chuyn sang h thng kia s cn thm 1 giai on in v dn
barcode khc, phi chnh li trn h mi nhng xt nghim cha
lm (qu trnh ny ph thuc vo KTV nu qun i th c th lm
li c 10 mc, dn n lng ph). Hu qu ko di thi gian, kh
qun l d liu bnh nhn v phi lm trn 2 h thng.
Vi hiu bit ca mnh cng nh s tham kho cc bnh vin
tuyn trn. Chng ti xin chn duy nht phn mm Cobas IT 5000
cho h thng LIS ca lab.
Di y l nh gi, so snh v hai phn mm th hin s
u vit ca cobas IT 5000 v l do chng ti chn phn mm ny.

Bng so snh gia Cobas IT 5000 v labconn

Cobas IT 5000
Ch cn 1 ln i m t HIS

Labconn
Cn ti 3 ln i m t HIS
(trong 2 ln i m chy

Chy v qun l trc tip trn

Cobas 8000) tng s sai st.

Cn hot ng trn my ch

my ch (Roche c sn my

(Labconn phi i thu my ch)

ch)
Server : 2 CPU 12 dng x l,

Hot ng trn my trm l 1

tc 2.0 GHz/ dng, Cache L3

Destop, khng p ng c

: 15MB

nhu cu chy lin tc, v ko

C th t ch thay i cu hnh

ngng ngh, ng thi lu lng

tng tnh bo mt

x l thp, d xy ra tnh trng

treo h thng, lm ko cp nht

H thng c qun l bng

c xt nghim.
Chy trn nn MySQL, tnh bo

Oracle, l 1 nn tng thng

mt thp, phi cu hnh phc

minh, mang tnh bo mt cao,

tp, d dng truy sut t bn

thun tin cho qun l

ngoi c th lm mt thng tin

cu bnh nhn.
Cc bnh vin ln ca c, Mi ch c 1 bnh vin
Thy s, Thy in, Anh. Indonesia p dng v ang gp
hin nay ang p dng
C th t ch hot ng

cc s c.
Phi ph thuc vo k s ca

n nh cao

hng nhiu
Thng xuyn xy ra sp h
thng, treo h thng. VD : Khoa
Ha Sinh BV Bch Mai: 1 tun

Kt ni trc tip vi Server qua

sp d liu t 2 3 ln
Phi kt ni qua 1 my tnh

cng Lan

trung gian, ri mi kt ni ti

n gin, thng minh, d qun

LIS host, tng tnh phc tp

Qua nhiu giai on, nhiu

l
Sa cha : t server ca hng

bc, phc tp, tng chi ph.

Kt ni qua h thng Team

Roche, kt ni trc tip ti

Viewer , nn d dng b xm

Server khoa, tng tnh bo

nhp. gim s xm nhp th

mt, nn tit kim thi gian

cn i ng k s trc tip vo

D dng cu hnh thnh Root

nn lm chm thi gian.

Khng th cu hnh thnh Root

server

server do khng c Server, v

server l i thu nn khng ch

H thng sao lu d liu trc

ng
Phi sao lu ln server, ph

tip trn Server , d dng back

thuc vo my khc.

up khi gp s c
Phi mt tin mua bn quyn
(Hin nay Hng cho min
ph)
C th hot ng c i vi
c mng Huyt Hc ln Vi Sinh.
Cng vic th hai : Kt ni cc my cn li vi Cobas IT 5000
Cn kt ni nhng my xt nghim cn li vi h thng Cobas IT
5000 gm cc my xt nghim sau:
o AU 640
o AU680
o DXI 800
Tuy nhin:
o kt ni cc my AU 640, AU 680, DXI 800 vo Cobas IT
5000 th cn c s ng ca Hng Roche.
o Vi s kt ni ny vo Cobas IT 5000 th hng Roche yu
cu cng ty Minh Tm tr tin cho s kt ni ny. Roche
m bo s kt ni ny l kt ni 2 chiu.
Vy chng ti xut lnh o bnh vin c kin cng ty Minh
Tm v hng Roche ln kt hoch thc hin kt ni sm nht.
Cng vic th 3: Sa cha sp xp li phng lab, phng ly mu
khoa khm bnh, ko dy cp quang, lp t h thng my tnh
v my in, my qut m vch.
Hnh1: M phng phng ly mu, in tr kt qu ti khoa khm
bnh

Hnh 2 : M phng qu trnh thc hin hon chnh mt xt nghim

 Cng vic th t: o to cho cc KTV, chy th h thng, x

l cc pht sinh, p dng thc hin thng quy.
III. Yu cu h thng my mc v trang thit b cn b sung
hon thnh cng vic ng tin , chng ti ngh ban
Gim c trang b thm nhng vt t sau:
1. Trang thit b IT
o 4 b my vi tnh mi (Core i3 2.6GHz, RAM 2GB)
o 3 my in in kt qu. (HP laser pro 400M)
o 2 converter quang in, 4 si quang hn quang 2 u,
mi s di 300m
2. Thay i phng Lab v phng ly mu ti phng phm
o Ci to li phng ly mu bnh phm ngoi phng
khm (C th theo s trn)
o 1 bn chng rung chn st mt bn lm bng (2,5m
x 0,5m x 0,6m)
o 2 my iu ha mi (12000 PTU), 2 qut tng mi cho
b phn ngoi phng khm
o Thm 2 qut cy Misubitsi, 15 gh ngi
o Thay th 2 iu ha v lp mi 1 iu ha cng sut
12000 PTU ti phng xt nghim chung.
o Mt xe tim inox 3 tng.
IV.

Nhn lc

Do nhu cu thc tin ng thi vi cc yu t ca khoa c

chng ti xin ban gim c b xung thm:
o 1 h l lm cc cng vic lau dn, ra, ti ch ng
nghim cho khoa.
o Thm 1 bc s hoc 1 dc s tng cng cng
vic k xt nghim v s nng cao cht lng ca xt
nghim.

 o to :
o ngh hng Roche diagnotics Vit Nam c k hoch
o to cho nhn vin khoa xt nghim Ha Sinh s
dng mng tin hc theo m hnh cm tay ch vic v o
to nng cao ti Medilab Si Gn.
V.

Kt lun
y l mt d n quan trng, c tnh bc ngot trong tin

trnh xy dng v hin i ha bnh vin. D n thc hin s lm

gim ng k thi gian ch i ca ngi bnh, nng cao cht
lng dch v, khng nh uy tn thng hiu bnh vin ng thi
minh bch ha cng cc qun l kinh t y t. Chnh v tm quan
trng chng ti xin Ban Gim c v cc phng chc nng
ng v to mi iu kin thc hin cc d n. Chng ti tin
tng rng vi s nht tr ca lnh o bnh vin, s ch o trc
tip t ban Gim c, tinh thn on kt ca tp th khoa, chng
ti s hon thnh giai on 1 trc 30 thng 9 nm 2015.
Thanh Ha, 3 thng 7 nm
2015