網路元件導向照顧排程系統之開發與應用：以糖尿病照顧爲例

如何彈性擴充系統功能配合健康照顧工作流程，已成爲健康照顧資訊系統建置時面臨的重要挑戰。本研究建立以網路元件爲基礎的網路健康照顧系統，提供健康照顧排程的功能，讓使用者自行設定計劃流程，並提供流程引導，提供簡化彈性的擴充與更新功能。本研究以ASP.NET關發，並以建置糖尿病個案照顧元件爲例，配合照顧流程網路服務與排程工具，讓使用者自行建立適用於本身環境的糖尿病個案管理系統。系統功能包括照顧流程控制引擎、照顧流程排程工具、使用者操作介面與照顧流程控制資料庫。並輔以個案資料、聯絡資料、衛教、護理評估、檢查與病變六大項共三十一組個案照顧預設元件提供使用。研究結果發現元件式軟體開發技術在開發需求變動快速的健康照顧系統時，需注意元件具有「高內聚力與低聯結力」，以使開發工作的複雜度降低。經公衛護士透過科技接受度模式的知覺易用性與知覺有用性評估，使用者認爲本系統對於降低更新系統工作負擔與提昇照顧工作效率確有幫助。

關鍵字

網路服務；元件導向；糖尿病個案照顧；工作流程

並列摘要

Retaining flexibility while expanding system functions fit in the workflows has been a critical challenge for the development of healthcare systems. This study shows how a component-based approach can fulfill the above challenge. This approach could enable users to set up a guideline-based workflow support system and expand and update system functions, with ease. This study employed Microsoft ASP.NET to develop the example system, a diabetes case management component-based support system. The diabetes case management components enable a user to set up his or her own customized care support system using web services and workflow scheduling tools. This demonstrative system comprises four top-level menus: the workflow control engine, the workflow scheduling tools, the user interface set-up tools and the workflow control database. A total of 31 components in six groups, which are basic information, communication information, education, nursing evaluate, examination and complication, were developed to support any future system development. The analytical results showed that these components must be kept as highly cohesive and uncoupled as possible to lower the development complexity, while ensuringt that the system remains highly expansable. Nurse subjects perceived that this approach, and the demonstrating tools were helpful in decreasing the maintenance workload and in enhancing efficiency.