跨院區醫療影像系統暨遠距報告 之規劃與管理-以敏盛醫療體系為例

Planning and Management of Cross Hospital of PACS Systems and Remote Reports for Healthcare Sharing –An Example of Min-Shuang Hospital Group

張智凱(Chih-Kai Chang)

指導教授 ： 洪文斌

淡江大學/工學院/資訊工程學系碩士在職專班/碩士(2009年)

https://doi.org/10.6846/TKU.2009.00568

摘要

隨著電子病歷的需求、網路技術的提升，醫院間跨院區的醫療整合成了不可忽視的課題，為了促使醫療資源妥善的運用，以減少不必要的重複檢查，中央健保局也已經建置「重要醫令即時報備系統」，對於單價較高的儀器檢查項目採用即時報備制度，提供醫院二十四小時內以網際網路通知健保局，並建立回饋機制，以提供院方進一步查詢該病患之相關檢查病史資料，以強化醫師對病患的服務。
醫療資訊整合包含層面廣闊，有網路工程、硬體工程、軟體工程、安全機制、交換機制、備援機制、故障復原機制等；其軟體系統又包含了醫院醫療資訊系統(HIS)，檢驗系統(LIS)，醫療影像系統(PACS)，護理資訊系統(NIS)等與病人有相關的電子病歷資料。
本論文主要在於規劃如敏盛醫療體系下之聯盟醫院，院區間如何達到「影像交換」「報告交換」之資源共享與影像管理等機制，以強化遠距醫療，社區醫療整合及與健保局之作業事宜。

關鍵字

醫療影像儲存系統 ； 電子病歷 ； 醫院資訊系統 ； 醫療影像標準 ； 第七層協定 ； 醫療資訊整合規範

並列摘要

A modern hospital includes many information systems, such as Hospital Information System (HIS), Laboratory Information System (LIS), Picture Archive and Communication System (PACS), Nurse Information System (NIS), and so on. All of the above systems need to consider backup, data exchange, software design, security, etc.
A hospital system which wants to share data with another hospital system should consider some technology issues, such as network, security, database, and data format. The sharing data include images and reports. For example, the Min-Shuang Hospital Group consists of over 100 hospitals in the world, in which modality resources will be shared by the hospital group, DICOM images will be transferred to the Image Data Center (IDC) for image storing and backup, and radiology doctors will finish their reports and transfer them back to source hospital by requirement.
This thesis will focus on the PACS systems for sharing. The required hardware, software, and workflow will be suggested for implementation of transferring and sharing of image and reports.

並列關鍵字

Picture Archive and Communication System ； Electronic Medical Record ； Hospital Information System ； Digital Image Communication in Medicine ； Health Level 7 ； Integration Healthcare Enterprise

參考文獻

[8]www.hl7.org美國Health Level Seven 網站. Health Level Seven Standard ,Version 2.4 標準文件 。

[39]范振添，民91年:醫療影像傳輸及資料探索之系統開發，中原大學醫學工程學系碩士學位論文。

[1]Digital Imaging and Communications in Medicine (DICOM 3.0) 2003標準文件。

Integration the Healthcare Enterprise (IHE) 規範文件。

[13]D. B. Baker, R. M. Barnhart, and T. T. Buss, "PCASSO: applying and extending state-of-the-arts security in the healthcare domain," Proceedings of the 13th Annual of Computer Security Applications Conference, 1997, pp.251-260