臨床12導程心電圖資訊系統與醫療資訊系統、影像儲存系統的整合

The Integration of Clinically-Used 12-Lead ECG Information System, HIS and PACS

王鴻武(Hung-Wu Wang)

指導教授 ： 謝瑞建

元智大學/資訊學院/資訊管理學系/碩士(2008年)

https://doi.org/10.6838/YZU.2008.00224

摘要

目前醫療用心電圖儀之數位輸出格式主要為心電圖標準通訊協定(SCP-ECG)及可擴充標示語言式心電圖(XML-ECG)，卻因廠商的不同定義，造成電子心電圖報告在院際間交換受到限制。使用醫療數位影像傳輸協定(DICOM)作為心電圖標準其優點是可整合至醫療院所既有醫療資訊系統(HIS)及影像儲存傳輸系統(PACS)中，提昇心電圖檢查程序效能，增進電子病歷交換可能性及醫學研究收集方便性。
目的：本研究以DICOM 3.0制訂之心電圖(ECG)儲存格式，設計PACS模組搭配醫療院所既有的醫學影像瀏覽器發展可與PACS及HIS整合的以DICOM為基礎的12導程心電圖資訊系統，並整合心電圖檢查的臨床作業。
方法：根據DICOM-ECG在PACS上的臨床應用，依序開發(1) HIS-PACS的檢查排程資訊介面、(2)整合患者資訊與心電圖儀波形的資訊介面、(3)收取與儲存DICOM-ECG的資訊介面、(4)整合瀏覽DICOM-ECG的資訊介面。
結果：由PACS系統直接管理與儲存DICOM-ECG，透過PACS瀏覽器即可立即看影像並整合HIS進行診斷及報告。且在資料庫保留了原始心電訊號，提供在醫學研究或臨床資料比對處理。
結論：本研究設計的12導程心電圖瀏覽器，以國內多數醫院心電圖儀數位輸出檔案(PHILIPS XML-ECG)做轉換，透過與HIS及PACS的整合交換，提昇DICOM-ECG的實用及效能，也供醫院評估SCP-ECG、XML-ECG外另一方案。

關鍵字

醫療資訊系統 ； 影像儲存及傳輸系統 ； 醫學影像通訊協定心電圖 ； 標準通訊協定心電圖 ； 可擴充標示語言式心電圖

並列摘要

The major data formats of 12-lead ECG were followed by SCP-ECG and XML-ECG. However, the interoperability of the computerized 12-lead ECG was limited by those formats, which were modified by most 12-lead ECG manufactures. DICOM-ECG was a medical informatics standard, which can enable the integration of DICOM-based images and the connection with HIS and PACS, to improve the efficiency of 12-lead ECG examination procedures, ECG record interoperability, and to increase the efficiency on ECG waveform collection for advanced medical researches.
Objective : The major objective of this study was to develop a DICOM-based 12-lead ECG information system, which can be integrated with HIS and PACS.
Method : Based on the clinical applications of DICOM-ECG under PACS, the following 4 information modules were developed (1) the ECG examination scheduling interface;(2) the interface, which can show patient information and ECG waveforms for data confirmation, (3) the interface for ECG data retrieve, and (4) the PACS viewer, which can browse medical images and 12-lead ECG.
Result : By the developed DICOM-ECG information system in this study, the clinicians can browse medical images and 12-lead ECG through PACS viewers. In additional, the raw ECG waveforms were kept for advanced medical researches. Conclusion : In this study, the commonly-used PHILIPS XML-ECG records were used and then converted into DICOM-ECG. The developed 12-lead ECG system can be applied on clinical 12-lead ECG examination and provide clinicians with the comparisons between XML-ECG and DICOM-ECG.

並列關鍵字

HIS ； PACS ； DICOM-ECG ； SCP-ECG ； XML-ECG

參考文獻

[1] World Health Organization（WHO）Portal：

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