T/CHIA 53.2-2024 Myocardial infarction electronic medical record dataset standard Part 2: Outpatient (urgent) medical record

Scope

Main technical content: This standard was drafted in accordance with the provisions of GB/T 1.1-2020, "Guidelines for Standardization Work - Part 1: Structure and Drafting Rules for Standardization Documents". This standard is the second part of T/CHIA 53-2024, "Standard for Electronic Medical Record Data Set of Myocardial Infarction", which is divided into the following 14 parts: --- **Part 1**: Basic Patient Information **Part 2**: Outpatient (Emergency) Medical Records **Part 3**: Outpatient (Emergency) Prescriptions **Part 4**: Emergency Observation Medical Records **Part 5**: Examination Records **Part 6**: Laboratory Test Records **Part 7**: Nursing Operation Records **Part 8**: Nursing Assessment and Plan **Part 9**: Hospitalization Case Summary **Part 10**: Admission Records **Part 11**: Discharge Summary **Part 12**: Hospital Orders **Part 13**: Referral (Hospital) Records **Part 14**: Medical Institution Information This standard was proposed by Xiangya Third Hospital of Central South University and is under the jurisdiction of the Chinese Society of Health Informatics and Big Data in Healthcare.

Development Information

Same series standard

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