醫事檢驗推播通報系統

Medical Laboratory Push Informing System

林丁一(Ting-Yi Lin) ； 蕭明亮(Ming-Liang Hsiao) ； 紀櫻珍(Ying-Chen Chi) ； 湯士滄(Shih-Tsang Tang)

《醫療資訊雜誌》 29卷4期 (2020/12) Pp. 25-36+38

摘要

醫事檢驗是人體生理狀態的重要指標，也是醫療診斷不可或缺的核心資料，因此檢驗結果的即時通報直接影響醫療品質。由於現行的醫事檢驗通報流程涉及大量的人工與書面作業，因此難免會有通報延遲或登錄誤植的問題發生。因為隨著網際網路的普及，絕大部分的人都會使用智慧型手機通訊軟體，因此本研究擬利用LINE通訊平台來開發醫事檢驗推播通報系統，一方面重新設計通報流程，一方面透過即時推播服務來確保醫師可以即時掌握病人檢驗資訊。系統需求由醫事檢驗師與臨床醫師組成焦點團體，共同商討彙整。系統主要分為三個部份：伺服主機、圖形界面與LINE APP。伺服主機負責讀取檢驗值、判斷異常值與發送通報，圖形界面提供系統管理者進行使用者的帳號授權、設定訊息發送與進行手動輔助通報，LINE APP則用來做為通報的接收、回覆與查詢。系統雛型於2020年5月完成，然後在仁濟醫院進行上線測試。從5月至7月共計有16位醫師加入測試，總共進行3則虛擬通報與127則測試數據通報，共計130則。其中91則通報有收到回覆；完成通報流程。但有39則未完成通報程序，其中3則是通報給虛擬的開單醫師，其餘36則因使用者尚未完成授權前就逕行使用或不熟悉操作方式。整體而言，焦點團體相當肯定雛型系統的效能；認為已滿足原先設定的需求。本系統有效改善醫事檢驗通報流程；提升通報的時效性與正確性，並緩解醫事檢驗單位負責進行通報的人力負擔，而且因通報記錄留存於資料庫，因此醫事檢驗部門可以很有效率地進行回覆時間與回覆率等資料的統計分析。不僅醫事檢驗通報流程可以使用推播服務，醫療機構的其他部門也可以透過推播技術的導入來提升資訊共享的程度，廣泛提昇醫院整體的醫療品質與服務效能。

關鍵字

醫事檢驗 ； 異常通報 ； 推播技術

並列摘要

Medical laboratory test results are the important indicators of the human physiological statuses, and that are also the main evidence data for diagnosis. Therefore, timely informing of test results directly affects the quality of medical treatment. Since the current laboratory result informing involves a lot of manual and hand-writing work, it is inevitable that there will be problems of delayed informing or incorrect records. Because of the widespread of the Internet, the most people have the experiences of smartphone communication applications. Therefore, this research intends to use the LINE communication platform to develop a push informing system for medical laboratory, which re-design the current informing process and ensure physicians timely receive patient's data via push messages. The system requirements were conducted by a focus group composed of laboratory scientists and clinicians. The proposed system is constructed by host server, graphical user interface, and LINE APP. The host server is responsible for the test results acquisition, filtering abnormal results, and issuing notification. The graphical user interface provides the system administrator for user authorization, setting notification sending, and manual support informing. LINE APP is used for informing reception, response and notifications inquiry. The system prototype was completed in May 2020, and then held the online evaluation at medical institute. From May to July of 2020, a total of 16 physicians participated in the evaluation. There was three virtual informing with no data and 127 real informing with pseudo notifications. Among them, 91 informing events received replies; completing the informing process. However, 39 informing events failed to finish the informing procedure, of which three events were informing to the virtual physician, and the remaining 36 failed events were due to unfamiliar with the LINE operation or not completed the authorization. On the whole, the focus group members are quite sure of the effectiveness of the prototype system; they believe that the proposed requirements have been met. This system effectively improves the informing process; increases the timeliness and accuracy of the informing, and eases the labor burden of the medical laboratory unit. Also, because the informing records are stored in the database, which provides efficiently statistical analysis of data such as reply time and response rate. More than the medical laboratory informing process, other departments of medical institution could also be beneficial by the push message technology, which would increase the level of information sharing and improve the overall medical quality and service efficiency.

並列關鍵字

Push message ； Medical laboratory ； Abnormal informing