在醫療資訊環境中,醫療儀器和臨床資訊系統的整合,必須顧及醫療儀器經常在病床之間移動、重新連接。為了讓醫護人員能夠專心照護病患,不必為醫療儀器的連接設定而分心,早在1989年,IEEE 1073標準就著手研擬制定,但時至今日,這個公開標準並未推展開來。原因之一是IEEE 1073標準複雜,而且是從OSI layer 1到layer 7全新設計的介面,導致成本和難度提高,廠商意興闌珊。因而至今仍有相當多的醫療儀器採用RS-232介面,尤其是傳輸資料量不多的醫療儀器,例如:心跳血壓計。 醫療網路有3項重要需求: 一、儀器設備會遷移到不同病患的所在,導致連接狀況改變,因此醫療網路必須能承受每日多次的重新連接設定。 二、醫療網路環境必須支援「隨插即用」,使得醫護人員在進行儀器設備連接時,只需要將接頭接上,即可使用。 三、儀器設備與病患必須能明確關聯。 有鑑於此,本研究針對RS-232介面的醫療儀器,以不更改儀器介面設計為前提,在醫療儀器附加上在一個ID box,達成識別醫療儀器之功能。接著在ID box和臨床資訊系統之間,加上一個連結解析器作為中介設備。連結解析器根據從ID box取得的儀器ID,載入描述封包格式的XML文件,轉換成資料結構,即時解析資料封包,並將病患生命參數資料儲存到資料庫,以供臨床資訊系統取用。如此實作出IEEE 1073標準所要達成的「隨插即用」功能。 此外,本研究更在每一張病床配備一個serial device server,建構出intra-bed與inter-bed network,再利用連結解析器COM port與病床的關聯,以及隨插即用連結資訊,讓儀器設備明確的關聯到病患。
While integrating medical devices with clinical information system (CIS) in hospital monitor environment, the frequently shifting of monitoring devices between beds should be taken into consideration. In order that clinicians could concentrate on caring for patients, not worry about device connecting, the IEEE 1073 standard had been proposed since 1989, but it does not be widely adopted up to now. One of the reasons is that this standard defines a complete seven layers communication of OSI stacks. The higher cost and difficulty, defer the manufacturers to adopt it in their products. Many hospitals still collect data from their patient monitors by connecting to the RS-232 ports, especially those devices capturing just a few vital signs from connected patient per minute, such as blood pressure monitor. Three important requirements of medical network are: (1) the network should be able to withstand multiple daily reconfiguration due to moving monitor device to other bed. (2) the network should be ‘plug-and-play’, allow clinician to setup the connection by just plugging in a connector. (3) the network should definitely associate the device with specific patient. Without altering the interface design of medical device, an ID box possesses the ‘device ID’ is attached to the RS-232 port of the medical device. In addition, a linking parser is placed between the ID box and CIS as a mediation device. The device ID got from ID box is used by linking parser to load the XML document which describes the packet format, and the vital signs are parsed from packets received from bedside monitors and saved into database in real time. An intra-bed and inter-bed network is established by equipping each bed with a serial device server. Through the association of COM ports of linker parser with bed, and the plug-and-play connecting information, a definite association of device with patient is set up.
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