健保碼與LOINC碼對應輔助網路系統

A Web-based Assistant for Mapping NHI Laboratory Codes to LOINC

李定洋(Lee Ding Yang)

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(2006年)

摘要

檢驗資料的處理一直是醫院中極為重要的部分之一。在現行的架構下，各醫院為了健保申報，均各自訂定了本身院內使用的院內碼和健保碼的對應項目表。然而，各醫院在進行檢驗時多採用本身制訂之院內碼系統來進行檢驗。這種方式在實施上雖然沒有不妥當之處，但是當資料需要進行交換的時候，各醫院間不同的編碼標準除了造成資料溝通的困難外，也使各醫院的臨床診斷和檢驗結果的比對產生極大的困難，這對整體來說是一個浪費許多人力物力的情況。 由於建構新的系統需要花費大量的人力和物力，因此能夠直接將現有使用的檢驗碼轉換為LOINC碼作為標準，將是較佳的選擇。本研究的目的，並不在於建構一個可以取代國外目前現行的RELMA的系統，而是在建構一個適合國內醫療院所和檢驗中心使用的查詢平台，使各醫療院所能夠在自己較熟悉的環境中進行檢驗碼轉換的工作。對國內各醫院來說，最為熟悉的就是健保碼和院內碼。因此，架構一個可以利用健保碼和院內碼檢驗名稱查詢到相關LOINC碼的檢驗名詞系統，是本研究最主要的工作。 本系統透過Taiwan-LOINC知識庫，建構一個Web-based的線上輔助查詢系統，提供使用者單筆健保碼、健保碼分類和利用檢驗名詞來進行查詢。利用收集到的檢驗名詞Term加以重整後建立的Keyword-LOINC對應資料，讓檢驗人員能夠以自身所掌握的知識來進行查詢，進而找到正確的LOINC碼，完成院內碼對應的工作。當各醫院的院內碼-LOINC碼對照表都建立的時候，即可讓各院能夠透過檢驗代碼的交換，使不同的檢驗系統能彼此溝通、交換和分析的目的，進而使健保能夠達成節省成本的目的。

關鍵字

檢驗名詞 ； 檢驗資訊系統

並列摘要

Handling to the medical examination data is an important issue in the hospital. Under current administrative structure, each hospital has its own local codes to perform the examinations and management the laboratory data. These codes may suit for internal use, but may cause the great difficulties in data communication, clinical diagnosis, and comparison of the examination data between hospitals. Thus this system caused a serious waste, in global situation. To construct a new communication system for exchange the laboratory data between hospitals will cost large amount resources. An alternative choice is setting the logical observation identifier names and codes (LOINC) as standard, and directly converting the local code to LOINC. The main purpose of this study is to construct an information inquiry platform which is suitable for domestic hospital and examination center to communicate with each other using their familiar internal-used code, but not to construct a new system to replace the Regenstrief LOINC Mapping Assistant (RELMA) system which is widely-used in foreign area. The most familiar coding systems for the domestic hospital are their local code and national health insurance (NHI) standard code. Each hospital already established corresponding sheet between local examination code and the NHI standard code to declare the NHI payment. Thus, the main work in this study is concentrating to construct a platform which can directly inquire the LOINC information using local laboratory name or NHI laboratory name. This system will construct a web-based mapping assist system. Using Taiwan-LOINC knowledgebase, user can inquire the information with single NHI standard code, category of the NHI standard codes, and examination term. After arrange the collected examination term, a keyword-LOINC database has been build up. The user can also inquire the LOINC code by these keywords which are not standard keywords in LONIC but are familiar to the laboratory technician. When the corresponding sheet between local codes and LOINC code has been established in each hospital, the different coding system in different hospital can be easily communicated, and data can also be easily exchanged and analyzed. Thus, the cost of NHI can be reduced.

並列關鍵字

LOINC ； Term ； Keyword

參考文獻

[4] 臺北醫學大學醫學資訊研究所碩士論文; 研究生:呂新傑撰;建構 Taiwan-LOINC 知識庫。

[6] 臺北醫學大學醫學資訊研究所碩士論文; 研究生:黃崇益撰; 建構健保藥品給付規定本體論知識庫之研究-以降血脂用藥為例。

[5] 臺北醫學大學醫學資訊研究所碩士論文; 研究生:陸偉輝撰; Building Knowledge bases and Mapping Framework for Taiwan LOINC. June，2002。

[8] Matney S, Bakken S, Huff SM. Representing nursing assessments in clinical information systems using the logical observation identifiers, names, and codes database. J Biomed Inform. 2003 Oct;36(4-5):287-93.

[9] Logical Observation Identifier Names and Codes (LOINC?) (2005). Users' Guide Updated. Regenstrief Institute and the Logical Observation Identifiers Names and Codes Committee.p.1-70。