CN-121983341-A - Mobile terminal-based dynamic evaluation method for emergency waiting patients

CN121983341ACN 121983341 ACN121983341 ACN 121983341ACN-121983341-A

Abstract

The invention belongs to the technical field of medical information processing, and discloses a mobile terminal-based dynamic evaluation method for the illness state of an emergency waiting patient; the invention provides a method for emergency treatment and diagnosis management and intelligent diagnosis, which comprises the steps of obtaining a patient diagnosis result and baseline sign data, generating a waiting two-dimensional code packaged with a patient identification, a priority weight and a disease baseline feature vector, obtaining queuing information and the baseline feature vector through a mobile terminal code scanning, converting qualitative clinical observation information collected by nurses into quantitative offset values based on a clinical observation semantic knowledge base, carrying out offset calculation on the quantitative offset values and the baseline feature vector, calculating a disease deterioration risk index by combining waiting time, diagnosis level and waiting environment, dynamically adjusting the priority weight of the treatment according to the disease deterioration risk index, triggering the reconstruction of a queuing sequence, synchronizing to an emergency information system for reordering and pushing change notification to related patients and a diagnosis room.

Inventors

GUO HUAYAN
CHEN QIAOPING
HAN QING
XIAO YUNZHEN
GUO SHIHUA
ZHANG LING

Assignees

福建省妇幼保健院

Dates

Publication Date: 20260505
Application Date: 20260409

Claims (10)

1. The emergency waiting patient condition dynamic evaluation method based on the mobile terminal is characterized by comprising the following steps of: Acquiring a triage result and patient baseline sign data of a patient after initial pre-examination triage is completed, and generating a waiting receipt based on the triage result and the baseline sign data, wherein a waiting two-dimensional code is printed on the waiting receipt, and a unique identifier of the patient, an initial triage time stamp, a current visiting priority weight and an illness state baseline feature vector are packaged in the waiting two-dimensional code; The nurse carries out periodic inspection on the waiting area through the mobile terminal, and obtains queuing information and disease condition baseline characteristic vectors corresponding to corresponding patients through scanning the waiting two-dimensional code corresponding to the target patient; The nurse collects qualitative clinical observation information of the target waiting patient based on a clinical collection interface of the mobile terminal, and converts the directional clinical observation information into a quantized offset value through a preset clinical observation semantic knowledge base; carrying out offset calculation on the quantized offset value and the corresponding dimension component of the disease baseline characteristic vector, and calculating the disease deterioration risk index of the patient by combining the waiting time length, the initial diagnosis dividing level and the waiting environment of the patient; Dynamically adjusting the initial treatment priority weight of the target patient according to the disease deterioration risk index, generating a priority adjustment suggestion, judging whether to trigger queuing information reconstruction or not based on the priority adjustment suggestion, and updating the initial treatment priority weight and the disease baseline characteristic vector of the target waiting patient if the queuing information reconstruction is triggered; synchronizing the updated initial visit priority weight to an emergency information system, reordering all waiting patients in the current queuing information based on the emergency information system, and pushing sequence change notifications to related patients and clinics.
2. The mobile terminal-based dynamic evaluation method for emergency waiting patients according to claim 1, wherein the obtaining process of the quantized offset value comprises the following steps: Pre-constructing a clinical observation semantic knowledge base, wherein the clinical observation semantic knowledge base comprises baseline state entries and variation degree entries under five clinical observation dimensions of complexion observation, respiratory state, consciousness state, pain expression and limb activity; Assigning zero reference quantized values to the baseline state entries, and synchronously calibrating semantic distances of the entries of various degrees according to the disease deterioration direction and the deterioration degree to obtain semantic distance reference values; Correcting the semantic distance benchmark value based on the age of the patient and the basic disease information to obtain a specific semantic quantization coefficient corresponding to the corresponding patient; Acquiring a specificity semantic quantization coefficient corresponding to a qualitative description entry selected by a nurse based on a clinical acquisition interface, and performing difference value operation on the specificity semantic quantization coefficient and a corresponding dimension in a disease baseline characteristic vector corresponding to a patient to obtain a quantization offset value under the corresponding dimension; Obtaining quantitative offset values corresponding to different clinical observation dimensions involved in the same observation, performing cross-dimension consistency check on the quantitative offset values, and selecting whether to feed back contradictory prompt information to a nurse or not and requesting confirmation or correction according to a consistency check result; and forming a quantized offset value based on the quantized offset value combination corresponding to different clinical observation dimensions after the consistency check passes.
3. The mobile terminal-based dynamic evaluation method for emergency waiting patients' conditions according to claim 2, wherein the process of performing semantic distance calibration comprises: Aiming at each clinical observation dimension, setting a baseline state entry under the dimension as a semantic origin, arranging all the variable degree entries under the dimension according to the progressive direction of clinical condition deterioration, and constructing a single-dimension semantic ordered entry sequence corresponding to the dimension; performing initial grade assignment on each variable-degree term in the single-dimension semantic ordered term sequence based on a preset clinical severity evaluation standard to obtain an initial severity grade value corresponding to each variable-degree term; Aiming at two adjacent variable-degree vocabulary entries in the single-dimension semantic ordered vocabulary entry sequence, calculating the difference value between initial severity level values of the vocabulary entries to obtain initial semantic intervals between the adjacent vocabulary entries; based on semantic intervals among adjacent terms after non-uniformity verification, taking a semantic origin as an initial accumulation point, carrying out gradual accumulation reconstruction on initial severity level values of terms of various degrees to obtain accumulation reconstruction semantic distance values corresponding to terms of various degrees; Aiming at the situation that the disease deterioration direction is not unique under the same clinical observation dimension, branch semantic ordered entry sequences corresponding to each deterioration direction are respectively constructed, and initial grade assignment and non-uniformity check sum accumulation reconstruction processes are independently executed on each branch semantic ordered entry sequence.
4. The mobile terminal-based dynamic evaluation method for emergency waiting patients according to claim 1, wherein the process of performing offset calculation comprises: Organizing the quantized offset values of all clinical observation dimensions into vector forms to form an instant offset vector of the current observation moment; when the target waiting patient has a plurality of tour records, extracting each dimension quantization offset value of the latest tour record to construct a previous observation vector; Calculating the Euclidean distance between the instant offset vector and the initial baseline vector as the accumulated illness state change amplitude; Normalizing the accumulated disease change amplitude and the interval disease change amplitude, and distributing differential weight coefficients based on the accumulated disease change amplitude and the interval disease change amplitude; and carrying out direction decomposition on the disease change vector, identifying the contribution degree of each clinical observation dimension to the overall disease change, and marking the clinical observation dimension with the largest contribution degree as the dominant deterioration dimension.
5. The mobile terminal-based dynamic evaluation method for the illness state of an emergency waiting patient according to claim 1, wherein the acquisition process of the illness state worsening risk index comprises the following steps: calculating a disease change intensity basic value based on the disease change vector, and carrying out dimensional sensitivity adjustment on the disease change intensity basic value according to the clinical emergency degree of dominant deterioration dimension; Acquiring the waiting time length of a target waiting patient, and setting a safety threshold of the waiting time length according to the initial triage level of the patient; Acquiring environmental load parameters of a current waiting area, and calculating environmental stress coefficients based on the environmental load parameters, wherein the environmental load parameters comprise the total number of waiting patients, the number of the same-level waiting patients and doctor receiving rate; Extracting a reference risk value corresponding to the initial triage level of the patient, taking a disease change intensity basic value, a overtime waiting risk factor and an environmental stress coefficient as risk increment items, and calculating a disease deterioration risk index of the patient through a multi-factor risk fusion function; The method comprises the steps of carrying out dynamic threshold segmentation on a disease deterioration risk index obtained through calculation, dividing the disease deterioration risk index into a low risk interval, a medium risk interval, a high risk interval and an extremely high risk interval, and setting differentiated priority adjustment strategies for different risk intervals.
6. The mobile terminal-based dynamic evaluation method for emergency waiting patients according to claim 1, wherein the dynamic adjustment process of the initial visit priority weight comprises: extracting the current treatment priority weight of the patient as the reference weight before adjustment; Determining the increment adjustment amplitude of the priority weight according to the risk interval in which the disease deterioration risk index is positioned, and adjusting the current treatment priority weight based on the increment adjustment amplitude; Calculating the difference value between the adjusted consultation priority weight and the pre-adjustment reference weight, and generating a priority adjustment suggestion when the absolute value of the difference value exceeds a preset level change threshold value and presenting the priority adjustment suggestion on the mobile terminal, wherein the priority adjustment suggestion comprises a pre-adjustment level, a post-adjustment level, a dominant deterioration dimension and a suggested intervention measure; After confirming the priority adjustment suggestion, the nurse writes the adjusted treatment priority weight into the waiting two-dimensional code, synchronously updates the treatment priority weight of the patient in the emergency information system, and simultaneously records the timestamp, the adjustment basis and the operation nurse identification of the adjustment to form a priority adjustment audit log.
7. The mobile terminal-based dynamic evaluation method for emergency waiting patients according to claim 6, wherein the dynamic adjustment process of the initial visit priority weight further comprises: and checking the rationality of the level crossing condition of the adjusted treatment priority weight, wherein the rationality checking comprises checking whether the adjusted treatment priority weight is matched with the vital sign measured value of the patient, and when the unmatched condition exists, requiring a nurse to supplement the measurement of the current vital sign and readjusting the treatment priority weight based on the updated vital sign data.
8. The mobile terminal-based dynamic evaluation method for the illness state of the emergency waiting patient, according to claim 1, is characterized in that the generation process of the waiting two-dimensional code comprises the following steps: when the initial sub-diagnosis is finished, basic sub-diagnosis data of the patient are collected, and basic information and medical record summaries of the patient are extracted from an emergency information system; The method comprises the steps of generating an encrypted patient identification code based on a unique patient identification, carrying out vectorization coding on vital sign values measured during initial triage to generate a disease condition baseline feature vector, carrying out text structuring processing on complaints recorded by nurses during initial triage, extracting symptom keywords and mapping the symptom keywords into symptom feature codes; inquiring a corresponding initial priority weight value from a preset priority weight mapping table according to the initial triage level of the patient, and carrying out queue normalization processing on the initial priority weight value by combining the overall distribution condition of the current waiting queue; Packaging the patient identification code, the initial triage time stamp, the initial priority weight value, the disease baseline characteristic vector and the symptom characteristic code according to a preset data structure to generate a two-dimensional code data packet, and reserving a dynamic update field in the two-dimensional code data packet; Generating a two-dimensional code of the two-dimensional code data packet, and printing a waiting two-dimensional code on a queuing certificate of a patient; When the priority of the patient after inspection and evaluation is updated, a two-dimensional code updating request is sent to an emergency information system through a mobile terminal, wherein the two-dimensional code updating request comprises a patient identification code and an updated priority weight value, the emergency information system generates a new two-dimensional code data packet after verifying the validity of the updating request and returns the new two-dimensional code data packet to the mobile terminal, and the mobile terminal updates the two-dimensional code data of the patient in a local cache and synchronously displays updated information in the next code scanning.
9. The mobile terminal based dynamic assessment method for emergency waiting patients' condition according to claim 1, wherein the process of reordering all waiting patients in the current queuing information comprises: when receiving the patient information with updated treatment priority weights, the emergency information system extracts the treatment priority weights of all current waiting patients and constructs a waiting queue priority vector; descending order arrangement is carried out on the priority vectors of the waiting queues, so that a theoretical diagnosis sequence based on priority weights is obtained; On the basis of the theoretical diagnosis sequence, identifying a patient with waiting time exceeding a preset time safety threshold and having lower priority weight, and adaptively adjusting the sequence position of the patient in the theoretical diagnosis sequence; performing diagnosis room resource matching on the diagnosis sequence with the sequence position adjusted, and distributing the patient to an optimally-adapted diagnosis room queue according to the special direction and the current load state of each diagnosis room; The method comprises the steps of calculating the sequence position variation of each patient before and after sequence rearrangement, and identifying the patient with the sequence position being significantly advanced and the patient with the sequence position being significantly moved backward; The diagnosis sequence is synchronously updated at the diagnosis room end, the patient number calling is carried out according to the new diagnosis sequence in the number calling system, and the triggering reason, the adjustment amplitude and the influence on the number of patients of the sequence rearrangement are recorded in the emergency information system to form a sequence adjustment log.
10. The mobile terminal-based dynamic evaluation method for emergency waiting patients' conditions according to claim 1, further comprising: A patrol task management module is arranged on the mobile terminal, and generates a patrol priority list according to the initial triage level and the waiting time of the waiting patients, and pushes a target waiting patient list needing key patrol to a nurse; after a nurse scans a waiting two-dimensional code of a target waiting patient, initial triage information and a historical patrol evaluation abstract of the corresponding patient are displayed at the top of a clinical acquisition interface; after the nurse finishes the qualitative description entry selection, the mobile terminal calculates and displays the quantized offset value and the illness state change vector in real time, and presents the change trend of each clinical observation dimension in a visual chart form to assist the nurse in intuitively judging the illness state change degree; When the disease deterioration risk index reaches a high risk interval or an extremely high risk interval, the mobile terminal triggers a doctor consultation suggestion, and a consultation prompt is added in the priority adjustment suggestion; Setting a state of illness dynamic evaluation monitoring instrument panel in a computer terminal device of a triage table synchronously, displaying the latest inspection evaluation time, state of illness worsening risk index and priority adjustment record of each waiting patient in real time, and generating inspection reminding and pushing to a mobile terminal for high-risk patients which do not undergo inspection evaluation beyond a preset time.

Description

Mobile terminal-based dynamic evaluation method for emergency waiting patients Technical Field The invention relates to the technical field of medical information processing, in particular to a mobile terminal-based dynamic evaluation method for the illness state of an emergency waiting patient. Background The existing emergency waiting management technology faces a multi-dimensional technical bottleneck in the process of complex disease dynamic evaluation, and particularly presents the problems of semantic ambiguity and quantitative mismatch in the process of qualitative observation information through multi-source heterogeneous clinical data fusion. As the types of complaints of emergency patients increase, the description granularity, subjectivity intensity and expression specification of different clinical observation dimensions are obviously different, and the traditional fixed scoring table or empirical judgment strategy cannot adapt to the capability difference of observers and atypical disease states in actual diagnosis and treatment. In complex waiting scenarios, when the nurse's clinical experience is inadequate or patient symptoms are hidden, the system remains mechanically scored according to the standardized triage scale, resulting in serious deviations in the severity assessment. To maintain basic triage efficiency, existing procedures are forced to rely on a single objective index (typically vital sign data) to artificially ignore the complementary value of subjective clinical observations. The simplification strategy causes obvious disease characteristic omission, especially the early signs of pale complexion circulatory failure, central nervous system damage signals with blurred consciousness, metabolic disturbance prompts of respiratory rhythm abnormality and other key clinical manifestations, which cannot be quantitatively incorporated into an evaluation system, and emergency doctors often indicate that grading is similar to normal but lack of individuation pertinence. Meanwhile, the existing method generally adopts a single static evaluation architecture, and cannot consider the time domain-crossing information of the initial baseline state and the disease evolution during waiting. Traditional triage procedures perform an assessment only once when the patient arrives and fix the queuing order, either focusing on the initial symptoms to ignore the subsequent worsening, or relying on the patient to actively resort to passive response changes. Particularly, the acute illness state worsening process of the minute level and the accumulated risk of the waiting time length of the hour level are mixed in a dynamic waiting queue, the existing inspection scheme adopts rough observation of a fixed period, and a key time window showing illness state turning is missed while the workload of nurses is controlled. Although a timing re-evaluation mechanism is introduced into part of the system, the re-evaluation result is still an isolated state snapshot due to lack of quantitative measurement tools of the change trend of the illness state, and correlation analysis between the front evaluation and the rear evaluation cannot be established, so that progressive deterioration is difficult to recognize in time. In view of the above, the present invention proposes a mobile terminal-based dynamic evaluation method for emergency waiting patients to solve the above-mentioned problems. Disclosure of Invention In order to overcome the defects in the prior art, the invention provides the following technical scheme for achieving the purposes: a mobile terminal-based emergency waiting patient condition dynamic evaluation method comprises the following steps: acquiring a triage result and patient baseline sign data of a patient after initial pre-examination triage is completed, and generating a waiting receipt based on the triage result and the patient baseline sign data, wherein a waiting two-dimensional code is printed on the waiting receipt, and a patient unique identifier, an initial triage time stamp, a current visiting priority weight and an illness state baseline feature vector of the patient are packaged in the waiting two-dimensional code; The nurse carries out periodic inspection on the waiting area through the mobile terminal, and obtains queuing information and disease condition baseline characteristic vectors corresponding to corresponding patients through scanning the waiting two-dimensional code corresponding to the target patient; The nurse collects qualitative clinical observation information of the target waiting patient based on a clinical collection interface of the mobile terminal, and converts the directional clinical observation information into a quantized offset value through a preset clinical observation semantic knowledge base; carrying out offset calculation on the quantized offset value and the corresponding dimension component of the disease baseline characteristic vector, and calculating