臺灣博碩士論文加值系統

隨著行動通訊技術不斷的精進，帶動了資訊系統的成長。生物醫學工程與應用成為時下熱門研究主題之一，然而醫療與健康照護相關系統中，除了醫院資訊系統（Hospital Information System, HIS）及放射資訊系統（Radiology Information System, RIS）外，醫療影像歸檔與傳輸系統（Picture Archive and Communication System, PACS）亦為一熱門研究領域；醫療影像歸檔與傳輸系統是一種專門用來儲存、取得、傳送與展示醫療影像的電腦或網路系統，其取代了傳統處理醫療影像的方式，使得醫療影像更容易被存取及管理，應用於PACS系統之醫療影像傳輸、儲存及交換標準，稱為醫療數位影像傳輸協定（Digital Imaging and Communications in Medicine, DICOM）。
如何運用現代的科技技術，使得醫療影像歸檔與傳輸系統，能夠突破原有的使用限制，使其具有行動性，並透過與HIS及RIS互相關聯的架構下，來分析其病患於掛號到就診時，所需要的時間及改善之道。
本論文提出了一個基於醫院內私有雲之概念，建構一個具行動性及二維條碼身份驗證與影像同步之醫療影像檢索系統，並模擬病患於就診時所花費的時間進行分析及改善。

Mobile technology and Applications are growing rapidly which provide another service way. In the area of Engineering in Medicine and Biology, which contains Hospital Information System (HIS), Radiology Information System (RIS) and Picture Archive and Communication Systems (PACS), and it is a positively affected by new technology and availability. PACS is one of popular research area at mobile technology and application, and it is an evolving healthcare technology for the short and long term storage, retrieval, management, distribution and presentation of medical images, which has replaced traditional handling way of medicine images, and it makes medical images can be access and management easier. In addition, Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical image.
Based on the relational structure of PACS, HIS and RIS, this study will make medical image portable where uses modern technology as well as analyze waiting time of patient and propose improvement, which is process during register until diagnosis. In this thesis, we proposed a prototype of mobile DICOM image retrieval and synchronization application with QR-Code authentication, moreover we simulate and analyze waiting time of patient and propose improvement.

中文摘要 i
ABSTRACT iii
誌　謝 v
圖目錄 x
表目錄 xii
第一章 緒論 1
1.1 研究背景 1
1.2 研究動機與目的 3
1.3 論文架構 4
第二章 文獻探討 5
2.1 醫療影像歸檔與傳輸系統 8
2.1.1 PACS系統功能及架構 8
2.1.2 雲端運算服務與PACS系統 10
2.2 醫療數位影像傳輸協定 11
2.2.1 資料集與資料元素 13
2.2.2 傳輸協定與服務類型 14
2.3 DICOM工具套件 18
2.4 WebSocket 18
第三章 資訊加密、編碼及傳輸格式 21
3.1 快速反應碼 21
3.2 進階加密標準 23
3.2.1 增加回和金鑰（AddRoundKey） 25
3.2.2 替換位元組（SubBytes） 25
3.2.3 橫向位移（ShiftRows） 28
3.2.4 混合多欄（MixColumns） 28
3.3 Base64編碼 29
3.4 JavaScript物件表示語言 31
第四章 系統規劃建置及模擬門診 34
4.1 系統規劃及建置 35
4.1.1 應用程式介面 36
4.1.2 QR-Code加密 37
4.1.3 影像同步 38
4.2 存取醫療影像及標籤解析 40
4.2.1 查詢醫療影像 41
4.2.2 檢索醫療影像 46
4.2.3 轉換醫療影像 47
4.2.4 解析醫療影像標籤 48
4.3 模擬門診 50
4.3.1 設計模擬門診流程 51
4.3.2 變數、函數及參數設定 52
4.3.3 提出改善流程 53
第五章 實作結果 55
5.1 醫療影像檢索APP應用程式 55
5.2 模擬門診之分析 58
第六章 結論與未來展望 61
6.1 結論 61
6.2 未來展望 62
參考文獻 63
附　　錄 65

[1] Joan Daemen, Vincent Rijmen, "AES Proposal: Rijndael", The First Advanced Encryption Standard Candidate Conference, NIST, 1998.
[2] Duerinckx AJ, Pisa EJ. Filmless, “Picture Archiving and Communication System (PACS) in Diagnostic Radiology”, Proc SPIE 1982;318;9-18. Reprinted in IEEE Computer Society Proceedings of PACS'82, order No 388.
[3] Doukas, C.; Pliakas, Thomas ; Maglogiannis, I., “Mobile healthcare information management utilizing Cloud Computing and Android OS”, Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE
[4] ECMA International, “Standard ECMA-262 -ECMAScript Language Specification”, June 2011
[5] Eriksson J., Melício M., Carlos C., José Luís O., “A DICOM Viewer based on Web Technology”, 2013 IEEE 15th International Conference on e-Health Networking, Applications and Services (Healthcom 2013)
[6] A Frost &; Sullivan Healthcare Article, “Prepare for Disasters &; Tackle Terabytes When Evaluating Medical Image Archiving”, 2008 Frost &; Sullivan
[7] IEFT, “The Base16, Base32, and Base64 Data Encodings”, October 2006. RFC 4648. Retrieved March 18, 2010.
[8] NEMA Standards Publication PS3.x, “Digital Imaging and Communications in Medicine (DICOM), Part 7: Message Exchange”, National Electrical Manufacturers Association, 1300 N. 17th Street, Rosslyn, Virginia 22209 USA, 2003
[9] Peter, L., Frank, G., Kaazing, C., “HTML5 Web Sockets:A Quantum Leap in Scalability for the Web”, http://www.websocket.org/
[10] Pimentel, V., Nickerson, B.G., “Communicating and Displaying Real-Time Data with WebSocket”, Internet Computing, IEEE (Volume:16 , Issue: 4 )
[11] Vaishali Sankale, Dr. Ashok M.Spakal, “Picture Archving and Communication System”, International Journal of Next Generation Computer Applications ISSN 2319-524X
[12] Chia-Chi Teng, Carter Green, Rob Johnson, Paul Jones, Craig Treasure, “Mobile Ultrasound with DICOM and Cloud Connectivity”, Proceedings of the IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI 2012)
[13] Chia-Chi Teng, Jonathan Mitchell, Christopher Walker, Alex Swan, Cesar Davila, David Howard, Travis Needham, “A Medical Image Archive Solution in the Cloud”, Software Engineering and Service Sciences (ICSESS), 2010 IEEE International Conference on 16-18 July 2010
[14] United States National Institute of Standards and Technology (NIST), "Announcing the ADVANCED ENCRYPTION STANDARD (AES)", Federal Information Processing Standards Publication 197. November 26, 2001.
[15] Westlund, Harold B., "NIST reports measurable success of Advanced Encryption Standard", Journal of Research of the National Institute of Standards and Technology 2002.
[16] DICOM Standard, http://medical.nema.org/
[17] DICOM@OFFIS, http://dicom.offis.de/dcmtk.php.en
[18] JavaScript Object Notation, http://www.json.org/
[19] OFFIS, http://www.offis.de/en/start.html
[20] OFFIS DCMTK Documentation, http://support.dcmtk.org/docs-dcmrt/index.html
[21] OsiriX DICOM Sample Image Sets, http://www.osirix-viewer.com/datasets/
[22] PicomCloud, https://www.picomcloud.com/
[23] QR Code, http://www.qrcode.com/
[24] The WebSocket Protocal, RFC-6455, http://tools.ietf.org/html/rfc6455
[25] 顏振榮，「門診預約病患約診時間與實際看診時間之分析」，碩士論文，2003年7月。
[26] 楊昌儒、何金玲、簡明興、趙嵩豐，「護士行動查房系統建置之研究」，進階資訊技術國際期刊，第一期第五卷
[27] 國泰醫院，http://www.cgh.org.tw/index.html