1 团体标准 T/HENANPA003—2022 住院电子药历构建规范 Basicspecificationforelectronicinpatientpharmaceuticalrecord 2022-08-05发布 2022-08-10实施 河南省药学会发布 全国团体标准信息平台 1目次 目次.............................................................................................................................................................1 前言.............................................................................................................................................................3 引言.............................................................................................................................................................4 住院电子药历构建规范................................................................................................................................5 1范围.......................................................................................................................................5 2规范性引用文件..................................................................................................................5 3术语和定义...........................................................................................................................6 3.1药品...........................................................................................................................6 3.2临床药师..................................................................................................................6 3.3药学监护..................................................................................................................6 3.4药学查房..................................................................................................................6 3.5用药教育..................................................................................................................6 3.6入院药学评估..........................................................................................................6 3.7药学监护分级..........................................................................................................6 3.8药学监护计划..........................................................................................................6 3.9药品不良反应..........................................................................................................6 3.10药品不良事件..........................................................................................................6 3.11病历.........................................................................................................................6 3.12电子病历................................................................................................................7 3.13护理记录................................................................................................................7 3.14药历........................................................................................................................7 3.15电子药历................................................................................................................7 3.16医院信息系统........................................................................................................7 3.17住院医师工作站....................................................................................................7 3.18住院临床药师工作站............................................................................................7 3.19实验室信息管理系统.............................................................................................7 3.20影像归档和通信系统...............................................................................................7 3.21合理用药监测系统..................................................................................................8 3.22静脉用药集中调配中心.........................................................................................8 4电子药历的基本要求..........................................................................................................8 5电子药历的数据结构与信息模型......................................................................................8 全国团体标准信息平台 2