(3.232.129.123) 您好!臺灣時間:2021/03/06 00:17
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:林子豪
研究生(外文):Tzu-hao Lin
論文名稱:委外檢驗資訊流程規劃
論文名稱(外文):Developing an Information System Architecture for Outsourcing of Laboratory Examinations
指導教授:蕭嘉宏蕭嘉宏引用關係
指導教授(外文):Chia-Hung Hsiao
學位類別:碩士
校院名稱:慈濟大學
系所名稱:醫學資訊研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2010
畢業學年度:99
語文別:中文
論文頁數:87
中文關鍵詞:LISIHEHL7XDSCDA
外文關鍵詞:LISIHEHL7XDSCDA
相關次數:
  • 被引用被引用:3
  • 點閱點閱:481
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:93
  • 收藏至我的研究室書目清單書目收藏:0
現今的醫療環境中,醫療文件已經漸漸走向數位化,相關醫療儀器也逐步採用自動化作業。縱使如此,有部分的醫療作業仍使用紙本作業。以醫學檢驗為例,當院內沒有相關儀器可提供病患作檢查時,醫生就需要向委外的檢驗中心申請提出檢驗需求,但委外檢驗的資訊作業程序中許多步驟都需以書陎方式進行,但手寫開單耗費較多的時間,另外也可能發生資料填寫錯誤、紙張遺失等風險,在執行上造成許多不便。本論文希望可以透過Web相關技術,提供檢驗委外標準之資訊整合架構,來進行線上醫學檢驗開單、結果報告回傳、檢查狀態查詢等作業。將分析委外檢驗資訊傳輸的需求,並參照IHE所提供之跨院病歷文件分享架構(Cross Enterprise Document Sharing; XDS)以病歷索引中心搭配病歷文件庫結合,進一步探討委外檢驗之資訊流程與傳輸協定。調閱報告再以HL7提出的臨床文件架構(Clinical Document Architecture; CDA)方式呈現,檢查開單及狀態資訊是以 HL7 V2現有訊息封包於CDA的文件當中,形成醫院處方報告文件以及檢驗所狀態回應文件,便於我們利用相同的XDS文件註冊與查詢機制達到資訊跨機構的互通。利用Web方式檢視報告結果,相信可以節省相當多的人力與時間,相較之下也可以解決醫院對於醫學檢驗委外的不方便。
Because of cost and efficiency, lots of hospitals outsource their laboratory examinations currently. But there has no standards information sharing infrastructure for the outsourcing processes. This paper addresses a web solution for exchanging clinical data, such as prescribed examination orders, examination results, and the processing status of the orders, in the outsourcing processes,. The wed solution for information exchange in outsourcing processes is basing on IHE Cross Enterprise Document Sharing (XDS). XDS registry and repositories with corresponding standard web services would be used for sharing laboratory orders and results. And we would use HL7 Clinical Document Architecture (CDA) to deal with examination results. We would use standard HL7 messages to handle exam orders and processing status. However, the messages of exam orders generated by hospitals and messages for processing status in external laboratory would be further packaged as CDA documents also. Consequently, we can utilize the same XDS document registry and sharing infrastructure for handling both orders, processing status, and exam results. The infrastructure for outsourcing of laboratory examinations is a web solution with standard HL7 messages and documents. Using the web solution and information system integration architecture can save much manpower and time than that would be required with traditional outsourcing processes.
致謝 ........................................................................................................................................ III
摘要 ........................................................................................................................................... I
Abstract .................................................................................................................................... II
第一章、緒論 ........................................................................................................................... 1
1.1 研究背景 ........................................................................................................................ 1
1.2 研究目的 ........................................................................................................................ 5
第二章、文獻探討 ................................................................................................................... 6
2.1 檢驗資訊管理系統 ........................................................................................................ 6
2.1.1 檢驗部門電腦化與自動化 ..................................................................................... 7
2.1.2 LIS追求的目標 ....................................................................................................... 7
2.2 醫療資源系統整合主要的標準 .................................................................................... 8
2.2.1 IHE的簡介 .............................................................................................................. 9
2.2.2 IHE XDS的介紹 ..................................................................................................... 9
2.2.3 IHE LTW介紹 ....................................................................................................... 11
2.2.4 醫療資源交換標準HL7 ....................................................................................... 13
2.2.5 IHE 提出的委外檢驗流程 ................................................................................... 16
第三章、研究方法、步驟和程序 ......................................................................................... 22
3.1 系統架構 ...................................................................................................................... 24
3.1.1 架構流程圖簡易說明 ........................................................................................... 25
3.1.2 醫師利用HIS開立處方 ....................................................................................... 27
3.1.3 HIS通知檢體中心取得檢體 ................................................................................. 27
3.1.4 利用Register Server建置處方文件 .................................................................... 28
3.1.5 檢驗所透過Register Server查詢處方文件 ........................................................ 29
3.1.6 檢驗所作業方式 ................................................................................................... 30
3.1.7 透過Register Server調閱檢驗報告 .................................................................... 30
3.1.8 報告查詢流程說明 ............................................................................................... 31
3.1.9 醫師報告查詢 ....................................................................................................... 32
3.1.10 病患報告查詢 ..................................................................................................... 33
3.2 安全防護機制 .............................................................................................................. 33
3.2.1 加密傳輸 ............................................................................................................... 34
3.2.2 權限控管 ............................................................................................................... 35
3.3 處方檢驗單格式標準化 .............................................................................................. 38
3.4 檢驗報告格式 .............................................................................................................. 41
3.5 XDS Metadata ............................................................................................................... 47
第四章、研究成果 ................................................................................................................. 49
4.1 權限管控 ...................................................................................................................... 49
4.2 開立處方與查詢 .......................................................................................................... 54
4.3 報告調閱 ...................................................................................................................... 58
4.4 結果說明 ...................................................................................................................... 63
第五章、討論 ......................................................................................................................... 66
5.1 院內檢驗系統標準化之要求 ...................................................................................... 66
5.2 跨院交換之資訊安全 .................................................................................................. 70
第六章、結論與未來展望 ..................................................................................................... 73
6.1 未來展望 ...................................................................................................................... 74
6.1.1 透過一套系統完成所有程序 ............................................................................... 74
6.1.2 委外檢驗單標準的制定 ....................................................................................... 74
6.1.3 資訊安全管控 ....................................................................................................... 75
6.1.4 索引中心的管理 ................................................................................................... 75
6.1.5 系統普及化 ........................................................................................................... 75
參考文獻 ................................................................................................................................ 77
1. 柴惠珍、李正華。1998。檢驗資訊系統建構之系統思考。醫檢會報,13:3,頁33-39。
2. 張錦標、許芸瑋、袁援。2001。檢驗室資訊系統(LIS)。生物醫學暨檢驗科學雜誌。
3. Tilzer, L. L. and Jones, R. W.1988. Use of Bar Code Labels on Collection Tubes for Specimen Management in the Clinical Laboratory. Arch Pathol Lab Med, 112, 1200-1202.
4. 高全良。1998。台大醫院檢驗資訊電腦化之經驗。醫檢會報,13:3,頁28-32。
5. 鄒濟勳。1983。整體醫療資訊系統。榮民總醫院電腦中心,頁38-40;51-60;250-259。
6. 高智雄。1998。LIS 門急住診檢驗電腦化之經驗。醫檢會報,13:3,頁48-54。
7. IHE, http://www.ihe.net.
8. IHE Cross-Enterprise Document Sharing http://wiki.ihe.net/index.php?title=Cross_Enterprise_Document_Sharing
9. IHE Laboratory External Laboratory Ordering Whitepaper
10. Detail about the IHE Laboratory domain may be found at: http://www.ihe.net/Laboratory/index.cfm
11. Details about the structure of IHE Technical Frameworks and Supplements may be found at: http://www.ihe.net/About/process.cfm and http://www.ihe.net/profiles/index.cfm
12. The current version of the IHE Laboratory Technical Framework may be found at: http://www.ihe.net/Technical_Framework/index.cfm
13. R.H. Dolin et al., “HL7 Clinical Document Architecture, Release 2.” American Medical Informatics Association, 13(1), p.30-39, 2006.
14. 林景嘉、黃仁竑、郭光明。2006。以Web Services建構臨床文件架構(CDA)之電子病歷交換系統,醫療資訊雜誌,15(2),p.17-28。
15. 莊文銘。2002。以HL7/CDA為基礎之電子轉診病歷交換架構之研究,淡江大學資訊管理學系。
16. 張慧朗等20位。2007。醫學資訊管理學。台北:華杏出版社。
17. Steve Graham 等著、洪靜宜譯(2002),以Java建置Web Services 有效利用XML、SOAP、WSDL 和UDDI,台北:培生,頁1-17。
18. XML Signature Syntax and Processing (Second Edition), W3C Recommendation 10 June 2008, available: http://www.w3.org/TR/xmldsig-core/
19. XML Advanced Electronic Signatures (XAdES) ,W3C Note 20 February 2003, available:http://www.w3.org/TR/XAdES/
20. 連中岳、蕭嘉宏、楊宗龍、高材(2008)。建構符合IHE XDS架構之新一代可攜式電子病歷。台灣國際醫學資訊聯合研討會 (JCMIT2008),p 116-119
21. Integrating the Healthcare Enterprise-Japan, http://www.ihe-j.org
22. Japan Industries Association of Radiological Systems http://www.jira-net.or.jp/e/index.htm
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔