- 學位論文
基於 HL7 FHIR 實現數位心電圖索引系統
Using HL7 FHIR to Achieve the Index System of the Digital ECGs
摘要
為了讓連續性生理訊號能夠在醫療院所間互通，需要依據醫療資訊標準統一儀器輸出的檔案格式。新興的Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) 標準近年來被大量探討與使用。然而FHIR官方網站提供的範例是以Observation Resource模組來儲存連續性生理訊號。此模組規定必須以文字儲存十進制的數值，因此一個1.85 MB的二進位檔案會變為5.2 MB的Observation Resource資料，進而導致資料量龐大與數據難以處理與分析。本研究以心電訊號為例，改良了FHIR 標準儲存連續性生理訊號的方式，並設計了一個心電圖索引系統。而為了讓不同格式的心電圖檔案能在醫療院所間互通，該系統利用FHIR標準中的DocumentReference Resource模組將檔案連結與檔案相關資料建構成檔案索引，並傳到交換中心儲存。此時其他醫療院所就能用另一個心電圖索引系統到交換中心搜尋與取得檔案索引。系統能根據檔案索引中的檔案連結取得檔案，再根據檔案格式顯示心電圖。本研究的解決方案僅需約1.1 KB的額外空間建構檔案索引，就能基於FHIR標準使心電圖檔案互通。此相較於FHIR提供的範例儲存方式，有效降低了互通所需承擔的儲存成本。而且若此解決方案應用於各種連續性生理訊號，就能實現遠距醫療與智慧醫療。
並列摘要
In order to exchange the continuous physiological signal between medical institutions, we need to follow the medical informatic standard to unify the files’ formats from different devices. The new standard, called Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR), has been widely discussed and used in recent years. However, the example on the FHIR website uses Observation Resource to save the continuous physiological signal and saves decimal values with spaces in string format. Hence, an ECG data with a 1.85 MB binary file becomes a 5.2 MB Observation Resource. This would lead to a huge storage burden and increase processing time. This research takes the ECG signal as an example and develops a storage method and yet, still follows the FHIR standard to resolve the problem above. An ECG index system is implemented by facilitating this method to verify its applicability. In order to exchange different formats of ECG files between medical institutions, the system uses DocumentReference Resource model in the FHIR standard to record the file link and the file format as the index of the file and sends the index to the Exchange Center for storage. Then, the practitioner in the different medical institution can use another system to search on the Exchange Center and selects the index he/she wants. The system would follow the file link and the file format to get and read it. This solution in this research only needs 1.1 KB additional storage spaces to save the index and can make ECG files in every file format be exchanged between medical institutions. Compared with the way of the example on the FHIR website, this solution saves spending on storage spaces. Also, this solution can apply to another continuous physiological signal, and then can implement Telemedicine and eHealth.