應用動態xml對映機制建置長照電子病歷交換架構之研究

A Study of Using Dynamic XML Mapping Mechanism on Long-term Care Electronic Medical Record Exchanges Framework

蔡明學(Ming-Syue Tsai)

指導教授 ： 吳帆

國立中正大學/管理學院/資訊管理系醫療資訊管理研究所/碩士(2015年)

摘要

由於我國國民平均壽命延長，且生育率持續降低，近年來我國面臨人口快速老化及少子化的情形，高齡化加上少子女化與家庭結構的改變，家庭照顧的人力縮減，照護意願也因此下滑。為了改善人口照護問題，政府近年來正積極擬訂長期照護相關政策，因此未來家庭可能有更多的長者交由機構照護。
這些長者(以下稱住民)在機構的照護紀錄就如同病歷一樣，是整個健康照護過程中所產生的資訊，未來長期照護保險通過後，將會有更多的住民或其家屬根據他們的健康狀況選擇是否要從一個照護類型轉介到另一個照護類型，因此，為了要提供給住民一個連續性的健康照護紀錄，長期照護機構間的病歷交換是必要的。
然而，目前電子病歷交換僅侷限在醫療院所間，並尚未應用在長照機構間或醫療院所與長照機構的病歷交換，因此，本研究應用XML對映機制並提出一個交換協定，其中包括標籤、交換流程、授權與檢查機制。在最後將建置出一個長照電子病歷交換平台，協助長照機構間能做病歷的交換，此外，希望透過長照機構病歷交換標準的擬定，未來醫療院所也能藉由電子病歷交換取得病患於長照機構的照護紀錄，除了能提供醫師能做診斷外，也能增加病人在醫療與照護之間的連續性。

關鍵字

長期照護 ； 電子病歷交換 ； XML

並列摘要

Since the national average life period being extended and declining fertility rates, our country faced with a rapidly aging population and declining birthrate situation in recent years. The change of family structure, aging problem and the trend towards fewer children make not only human resources of family care but also care intention decline. In order to improve care of the population problem, the government is actively formulate long-term care policies in recent years, therefore the future of the family may have more to institutional care for the elderly.
These elderly’s care records in institutions like medical records, as is the entire health care process information generated. In the future, after the long-term care insurance could pass, there will be more elderly people or their families to choose whether they want to convert the type of care agencies in accordance with their health. Therefore, in order to provide a continuity of elderly’s health care records, medical records exchange between the long-term care is necessary
However, EMR is currently only limited exchange between medical institutions, and have not been applied in medical long-term care agency or medical institutions and long-term care institutions exchange. Therefore, this study use XML mapping mechanism and propose an exchange agreements, including labeling, exchange process, licensing and inspection mechanisms. In the last we will build a long-term care EMR exchange platform to assist long-term care institutions to exchange medical records. In addition, I hope to develop exchange standards through long-term care institution records, future medical institutions can achieve care record in long-term care institutions by exchanging electronic medical records for patients, in addition to providing doctors do diagnose, but also to increase continuity between medical and patient care.

並列關鍵字

long-term care ； EMR exchange ； XML

參考文獻

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