以CORBA為基礎之元件化醫療資訊安全機制

Security Mechanism in Medical Informatics by Using Enhanced CORBA Based Component

陳錦城(Jin-Cheng Chen)

指導教授 ： 劉立

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2002年)

摘要

在現今健保支付制度變革及醫療環境之變遷下，如何在有效的成本控制下，提供民眾滿意之健康照護服務是醫療機構體系的重要課題。跨院際的醫療資訊交換，除了可避免醫療資源的重覆浪費，並可藉由網際網路與電子病歷，使得醫療服務人員能即時獲得完整之醫療資訊，對病患的病情給予更精確的診斷與及時且適當的處置，以期提高醫療品質。因此，建立完整的醫療資訊交換環境，以提供醫療相關之應用，實有其必要性。 而目前醫療資訊交換的管理機制，對於資料或整個系統的安全管理、跨不同平台間的資料交換、委外開發在安全及限制的顧慮、乃至於系統的建置成本及維護複雜度等，仍存有許多問題。因此，本研究提出以擴充公用物件請求仲介者架構（Enhanced CORBA）為基礎，以元件化（Component-based）設計包含身份識別（Identification）、認證（Authentication）及安全（Security）等需求之分散式物件，便利地提供不同醫療服務機構對物件的Reuse，藉此降低各醫療服務機構開發資訊系統的成本。並透過由衛生署委託研究機構所開發之醫學資訊交換物件，提供各醫療服務機構與廠商分享，並藉由對物件之管控來確保醫學資訊交換的品質與安全。

關鍵字

擴充式公用物件請求仲介者架構 ； 密碼學 ； 元件化基礎架構設計 ； 醫療資訊交換標準第七層 ； 可擴展標示語言

並列摘要

Under today’s National Health Insurance (NHI) system, changing of the payment procedures and medical environment are becoming more rapidly and complicated. It has become more and more important to achieve the satisfactory and quality healthcare, to meet expectation of the patients and at the same time to keep the cost under careful, efficient, and effective control. By implementing the inter-hospital medical information exchange, we could avoid the repeating and overlapping wastes of medical resources. In addition, by using the Internet and Electronic Medical Record (EMR), the medical personnel could immediately gather the most complete and up-to-date related medical information of the patients, therefore can be able to make more precise diagnosis, provide timely and appropriate treatments, and as the result raise the quality of healthcare. For this reason, building a complete medical information exchange environment to provide any related medical information and applications are absolutely necessary. However, there are still many problems presented in today’s medical information exchange. Things such as security management of data and information system, the exchanging medical information across different platforms, the security concerns and limits for outsourcing service, the costs of building such an information system, and the complexity of system maintenance are just a few challenges it faced. In this study, we proposed to use the enhanced CORBA as the foundation to implement component-based architecture design. Components such as identification, authentication and security will be conveniently for all medical organizations to reuse and thus reduce the cost of system development. The medical information exchange components, developed by the research organizations that are commissioned by Department of Health (DOH), can be used or enhanced by medical organizations and suppliers’ on their own information systems. Through this method, DOH is able to manage and maintain the quality and security of the medical information exchange.

並列關鍵字

Enhanced CORBA ； Cryptography ； Component-based architecture ； HL7 ； XML

參考文獻

11.陳威:CORBA技術整理。國立中正大學資訊工程研究所碩士論文，2001/06。

16.陳嵩榮:GML、HTML與XML之比較。輔仁大學圖書資訊學系，1998。

18.Liora Alschuler. SGML/XML in healthcare information exchange standards. SGML/XML Europe 98, Paris, May 1998.

19.American Academy of Pediatrics, Pediatric Practice Action Group, Task Force on Medical Informatics. Privacy protection of health information: patient rights and pediatrician responsibilities. Pediatrics. 1999; 104: 973-977.

20.Gostin LO, Turek-Brezina J, Powers M, Kozloff R, Faden R, Steinauer DD. Privacy and security of personal information in a new health care system. J Amer Med Assoc 1993; 270: 2487-2493.