符合DICOM協定之遠距居家照護資訊系統設計

先進國家平均國民壽命增長，使人口結構老化的趨勢顯現而出，其所衍生出的問題日益嚴重，如醫療資源短缺為其一。本研究之目標透過醫療網路的遠距醫療之概念，設計一套遠距居家照護資訊系統，期望其系統可大量的減少大量老人長期照護所需的資源。本系統大致可分為用戶端子系統、通訊傳輸子系統以及醫療資訊管理子系統，其中用戶端子系統另有掌上型生理訊號擷取器，現階段的量測項目有ECG、體溫和PPG，並將獲得之生理訊號以DICOM標準封裝成檔案，並透過DICOM協定整合裝置在醫院的醫療資訊管理子系統，以進行資訊的交換與檔案的傳送。而醫療資訊管理子系統包含多部個人電腦，每台電腦各司其職，其間以區域網路組成一個類PACS系統，進行快速的儲存與管理，並簡單又有效率的提供醫生等人員查詢與調檔的服務。系統測試結果顯示，本系統自行封裝之DICOM ECG檔案，可被其他現有符合DICOM格式的ECG Viewer程式解讀，證實其是符合DICOM標裝，並套用於其他未明確定義之生理訊號。在功能性驗證部分，可看到各工作站功能與效率的表現上皆不錯，但測試中發現在傳輸檔案時會有很小機率發生傳輸異常，導致區域警衛程式的執行緒堵塞，為修正此錯誤，在程式偵測到傳輸異常時，會自動斷開連線，並重新嘗試連線，連上後再從出現傳輸錯誤之檔案重新傳輸。而在系統穩定度評估方面，在系統修正上述測試所發現的錯誤後，將系統連續執行七天，測試期間系統的執行效率並未發現有下降之情形，而檔案傳輸成功率亦達到百分之百。

關鍵字

DICOM ；醫療資訊系統；遠距居家照護

並列摘要

Shortage of medical resource has been a major issue to many developed countries. This issue is largely worsened due to the huge increase in the aging population. A thought of integrating computers, networks, and medical examination technologies is often suggested as the solution. The theme of the thought is to monitor vital physiology signals such as electrocardiograph (ECG), blood pressure (BP), saturated pulse oxygen (SPO2), and body temperature (BT) from distance by medical experts. A term for this thought is tele-home health care. In this work, a tele-home care test-bed system has been developed to aim on the medical resource shortage issue. It includes a signal acquisition (SA) subsystem, communication subsystem and a management subsystem. The SA subsystem mainly includes a hand-held physiology signal device and a personal computer (PC). The device can simultaneously acquire waveform signals from one ECG channel and two PPG channels. In addition, a body temperature data can be obtained as well. The signals and data are then formatted to become files which are compliant with DICOM (Digital Imaging Communications on Medicine) protocol in the PC. The formatted files are then transferred to the manager subsystem. The subsystem contains several PC’s which function as section guards, section managers, viewers and database managers. A 100-Mbps Ethernet links these computers as a functional unit. All software modules developed are written in C++ language. The formatted DICOM files including ECG wave signals were successfully parsed, opened, and viewed with existing ECG applications and the viewer developed in this work. The test-bed system has been validated for seven days continuously without any system malfunctions.

並列關鍵字

Tele-homecare ； Medical information system ； DICOM

參考文獻

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[30] 涂孟魁，“遠距居家照護資訊系統之醫療資訊管理子系統設計與製作“，中原大學生物醫學工程學系碩士學位論文，民國94年7月

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[3] 行政院衛生署 NII 遠距醫療，

[2] J. H. Hu; C. P. Wei; T. H. Cheng, “Investigating Telemedicine Developments in Taiwan Implications For Telemedicine Program Management Paul,” IEEE, 2002.

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符合DICOM協定之遠距居家照護資訊系統設計

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