遠距居家照護系統之創新架構與實務應用

Practical Application and Innovation of a Home Telehealth System

余家杰(Chia-Chieh Yu)

指導教授 ： 徐業良

元智大學/工程學院/機械工程學系/博士(2009年)

摘要

利用遠距居家照護技術將醫療照護延伸至居家環境，藉由持續追蹤使用者（高齡者、病患等）長期的健康記錄，讓使用者能夠有尊嚴地留在家中居住、生活，維持的時間越久越好，同時也能接受到完整、高品質的健康照護，已經是高齡化社會中健康管理與照護上重要的潮流。
本研究首先整理國內外已經進行商業化營運的遠距居家照護服務，歸納出遠距居家照護系統的典型架構，並探討典型的遠距居家照護系統面臨的問題，同時以「分散式遠距居家照護系統(Decentralized Home Telehealth System)」的創新架構，試圖解決目前遠距居家照護系統面對的問題。
本研究也提出遠距居家照護系統有組織的建置程序，提供遠距居家照護廠商建置系統服務的依據，並依照此程序與敏盛醫院共同建置40人規模、分散式遠距居家照護系統架構下的糖尿病遠距居家照護系統，完整執行從建置到系統服務整體的服務練，詳實紀錄、整理每一項建置與服務的資料，進行系統使用成效評估分析，堪稱目前國內首次針對遠距居家照護系統，執行整體服務鍊的評估報告，並提出系統服務的各項建議。於研究的過程中，同時修正現行分散式遠距居家照護系統架構，僅能使用固定IP與專屬硬體所遭遇的問題。

關鍵字

遠距居家照護 ； 分散式遠距居家照護 ； 糖尿病遠距居家照護 ； 成效評估

並列摘要

Home has become the centerpiece of health delivery system today. Intensive monitoring of health parameters in the home environment has been an important trend for health care and management. The advantage of using the telehealth systems for people (chronic, elderly, etc.) has been widely recognized. This thesis first presents a survey of 18 representatives commercialized home telehealth systems worldwide, and then a generalized model of telehealth systems is concluded. A discussion of overcoming the present difficulties and future challenges of home telehealth systems are also presented.
In this study, an innovative structure of Decentralized Home Telehealth System is proposed in an attempt to overcome the difficulties and challenges for current home telehealth system. An structured process of how to develop a home telehealth system is also presented, and a home telehealth system for diabetes patients based on the decentralized structure was constructed in cooperation with Ming-Sheng Hospital.
40 diabetic patients selected by Ming-Sheng Hospital participated in this pilot project for a complete assessment of its user acceptance, economic evaluation and clinical outcome. This evaluation results provide a reference for home telehealth service providers. The current structure of Decentralized Home Telehealth system was also modified.

並列關鍵字

Home telehealth system ； health care ； decentralized home telehealth system ； diabetes care ； evaluation

參考文獻

Health Level Seven, Inc., 2003, “What is HL7?” http://www.hl7.org/.

Anna Esséna, Moya Conrickb, 2008, “New e-service development in the homecare sector: Beyond implementing a radical technology,” International Journal of Medical Informatics, Vol. 77, pp. 679-688.

Bellazzi R., Larizza C., Montani S., Riva A., Stefanelli M., d’Annunzio G., 2002. “A telemedicine support for diabetes management: The TIDDM project,” Comput Meth Programs Biomed, Vol. 69, pp. 147-161.

Bensink M., Hailey D., Wootton R., 2006, “A systematic review of successes and failures in home telehealth: preliminary results,” Journal of Telemedicine and Telecare, Vol.12, No. 3, pp. 8-16.

Cheng, C. M., Hsu, Y. L., Young, C. M., Wu, C. H., 2008, “Development of a portable device for tele-monitoring of snoring and OSAS symptoms,” Telemedicine and e-Health, Vol. 14, No. 1, pp. 55-68.