建構 Taiwan-LOINC 知識庫

Building Taiwan-LOINC Knowledge base

呂新傑

指導教授 ： 劉建財

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2004年)

摘要

在1995年美國Regenstrief Institute 與病理學會(the College of American Pathologists)資訊委員會開始集合七家大型的檢驗實驗室開始共同制定Logical Observation Identifier Names and Codes (縮寫為LOINC)編碼系統，其主要目標就是提供統一通用的名稱與編碼用來辨識檢驗 (laboratory test)和臨床觀察(clinical observation)結果報告，以利電子病歷訊息交換。 為了落實減少重複檢驗或檢查醫療資源，除了推動電子病歷交換之外，更需要研擬國內檢驗項目編碼的標準化。在台灣的健康保險制度為單一保險公司體制，為因應檢驗醫療保險費用給付的問題，台灣中央健保局已經制定健保支付標準碼已作為醫療院所醫療費用申報採用，因此，健保支付標準碼與LOINC碼若能建立對應關係，實在不必另行訂定國內檢驗項目標準碼，只要LOINC編碼系統導入，以符合國內作業需求，就可以使國內各醫院院內碼正確地轉換至LOINC碼，提供一致的檢驗編碼系統，以利檢驗資料在國內外的各資訊系統間能夠相互溝通、交換、使用及分析。 本研究主要目的是希望將LOINC 利用健保支付標準碼作為介面資料庫，藉由健保支付標準碼和LOINC對應產生的知識庫，再讓各醫療院所使用中的院內碼藉由各院已經存在的院內碼轉換到健保支付標準碼的流程，透過健保支付標準的介面順利的對應成LOINC碼，更希望將LOINC碼快速且正確的和各醫療院所或檢驗中心的院內檢驗代碼相對應，以達到檢驗資料在國內外的各資訊系統間能夠順利的交換及使用的目標。 所以本次研究的目的就是希望利用本國特有的、全國通用的、統一的健保檢驗支付標準來建構TAIWAN LOINC 的知識庫，讓所有醫療院所都能很簡單的利用健保隻付標準的轉換機制而對應上TAIWAN LOINC知識庫，再參酌各院的的檢驗項目條件而制定出所屬的LOINC 碼。以期達到檢驗資訊不論在國內或國外均能在不同的檢驗資訊系統之間相互溝通、了解及使用。

關鍵字

檢驗資訊系統 ； 全民健康保險 ； 醫學標準字彙

並列摘要

The American Regenstrief Institute and the College of American Pathologists information committees gathered seven large clinic laboratories to formulate the Logical Observation Identifier Names and Codes (LOINC) coding system in 1995. The main purpose is to identify uniquely the name and code for laboratory tests and clinical observations for the convenience of the electronic medical recordmessage exchange. Exchanging medical information by electronic means is one of the ways of reducing the strain on medical resources. However, if the standard code can be built for the clinic laboratory items between LOINC Code and Taiwan’s NHI standard code, we could save time on translation codes between different medical networks once over. Universal code could be used in Taiwan and abroad. Currently, the health insurance system of Taiwan is an insurance company-based system. For the medical laboratory insurance benefits, the Bureau of National Health Insurance（BNHI）in Taiwan had established the code of health insurance settlement standards for medical institutions to declare the healthcare payment. Therefore, if we can create a corresponding relation between the NHI standard code and LOINC code, we would not need to establish another standard code of laboratory item in our country. As long as we can tap into the LOINC code system to meet domestic needs, we can convert each local code inside hospitals to the LOINC code accurately. This would provide a consistent laboratory coding system for the convenience of clinic laboratory data in Taiwan and abroad. Therefore, there is no need to translate medical information manually. The main purpose of this study use LOINC to NHI payment standard code to be the interface database, and correspond with the knowledge warehouse. Currently, each hospital has its own local code for the medical records, and that local code has a translation system to convert it to the NHI standard code. If the translation code between NHI standard codes and LOINC codes could be established. We hope that the LOINC code could be work with the translation between the local code of each medical institution or clinical lab fastly and accurately . We also hope that translated lab data can reach domestic and international institutions reliably. The purpose of this research is to make use of Taiwan’s medical database and to make the data available to united health insurance payment standard to construct the TAIWAN LOINC of knowledge base. In this case, each hospital can easily convert its codes to Taiwan LOINC codes , and the Taiwan LOINC codes can also covert the special medical terms that are not covered by the existing LONIC code. This knowledge base of Taiwan-LOINC makes it is easier to organize the medical information. With this organized data, Taiwan will be able to exchange, and research the same medical issue with foreign experts easily. Another purpose is to make the conversion mechanism available of all exploitation health insurance payment standards with simple medical institution ability to should ascend the knowledge base of Taiwan- LOINC, then consult and deliberate the term of lab of each hospital and establish the LOINC code belonged to reach to examine the information in spite of at all can communicate and understand and use mutually between the different laboratory information system in all country.

並列關鍵字

TAIWAN-LOINC ； LOINC

參考文獻

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