以XML將DICOM SR整合至HL7 CDA之網頁系統的研究

Integrating DICOM SR into HL7 CDA by XML in Web information system

黃獻誼(Shian-Yi Huang)

指導教授 ： 蘇振隆

中原大學/工學院/醫學工程研究所/碩士(2010年)

https://doi.org/10.6840/cycu201000117

摘要

隨著E化時代的來臨，在醫療體系中，由紙本轉換成電子病歷過程，衍生出醫學資訊處理問題。各醫院體系若未有統一格式的電子病歷系統，在電子病歷的交換仍受到阻礙，有賴標準格式之推動來解決此問題。因而本論文之目的是整合HL7之臨床文件架構(CDA)與DICOM的結構性報告(SR)以利交換，並建置Web資料庫以供查詢與瀏覽。
由於XML語言能有效的運用於資料之整合及JSP有利Web之建置，本研究主要是透過以上兩種工具來建置系統。為了瞭解此建構系統的功能，以5組模擬訊號分別測試系統的各項功能。首先以不同的帳號測試登入系統，進而以4組不同條件的訊號測試新增文件系統中各項機制，最後以1組訊號測試瀏覽系統是否能即時更新。此外為測試系統對於醫學資料的適用性分別以11筆符合DICOM SR標準的資料與6筆不具標準格式之生理訊號與影像來驗證系統的執行的功效。最後以CDA Validator驗證儲存的CDA的架構、以Excel列表的方式比較原始XML檔案與網頁內容值，最後以差異影像驗證影像的傳輸效果。
藉由不同模擬訊號的測試後，可以發現系統在文字資料的轉換與影像資料的傳輸之功能，都能達到預設的效果。針對標準格式資料與非標準格式資料的測試後，發現(1) 17份由本系統產生的CDA文件經CDA Validator驗證，該批文件皆符合標準的CDA架構。(2)系統產生的17份CDA的XML文件與經過JSP網頁語法轉換後於網路頁面呈現的內容，經由Excel列表做比對，其值均相符。(3)在各式影像的呈現上，亦證實了本研究在影像的傳輸上是準確的。
本論文提供了一套醫療資訊整合系統，其功能包含了資料登入、新增文件與處理非標準文件的轉換，進而藉由查詢、瀏覽系統於網頁中瀏覽相關電子病歷。本系統之建立讓電子病歷可藉由網路傳輸與瀏覽，達成了病歷交換的可行性，期望能做為未來電子病歷交換的參考雛形。

關鍵字

DICOM ； HL7 ； 結構化報告 ； 臨床文件架構 ； XML

並列摘要

Along with E generation, in order to transfer paper medical records into electronic medical records, it will derive many medical information processing problems in the clinic environment. Electronic medical records will be hard to exchange, if there is no standard format for electronic medical records system in the clinic environment. Thus, a standard format was promoted to solve this problem. Therefore, the purpose of this thesis is to integrate HL7 Clinical Document Architecture (CDA) and the DICOM structured report (SR) to facilitate the exchange, and build Web database for query and browsing.
In this study, the Extensible Markup Language (XML) and JavaServer Pages (JSP) are severed as tools to construct a medical record exchange prototype. Five simulate signals were used to test functions of this constructed system. These tests including: 1. testing of login mechanism by different account number, 2. testing of functions in adding new report system by 4 different kinds of signal, and 3. testing of real-time update ability for viewing system. Eleven DICOM SR standard’s data and 6 non-standard physiological signal and image were used to test the applicability of the system for medical data and verify the effectiveness of the implementation of the system. Furthermore, stored in the structure of CDA were validated by CDA Validator and the original value of XML files were compared with Web content by Excel list. Finally, difference of two images was used to verify the effect of image transmission.
By different simulate signals test in our study, our system achieved the estimated effect not only in the text data conversion but also in image transmission. And then, in test of standard formatted data and non-standard formatted data, we found that 17 CDA documents generated by the system were verified by the CDA schema validation and confirmed the standard CDA framework. And, through Excel listing, it was consistent that 17 XML documents of CDA compare with the content of web page conversion by JSP. In the image presentation, the transmission of images in the study was accurate by difference image.
This study provided a medical record exchange prototype which including log-in system, adding new documents system, and switch non-standard information system. This prototype also supported the related electronic medical records by query and browsing system on the website. We hope our system would be a good reference for the exchange of electronic medical records in the future.

並列關鍵字

DICOM ； HL7 ； SR ； CDA ； XML

參考文獻

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[10] 林振冬,符合臨床文件架構標準的電子並立之研製, 成功大學工程科學系碩士論文, 民國九十三年七月, 台南..