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    Title: 電子病歷彙總工具之設計與實作
    Design and Implementation of a Content Aggregator for Electronic Medical Records
    Authors: 林柏維
    Lin, Bo Wei
    Contributors: 陳恭
    Chen, Kung
    林柏維
    Lin, Bo Wei
    Keywords: TMT
    電子病歷
    XML文件產生器
    TMT
    EMR
    XML Document Generator
    Date: 2007
    Issue Date: 2009-09-19 12:11:02 (UTC+8)
    Abstract: 臺灣電子病歷內容基本格式 (Taiwan Electronic Medical Record Template, TMT)是參考國際相關標準之後，專為臺灣本土需求而設計的電子病歷標準。為了進一步評估TMT的實用性與實施上可能遭遇到的問題，衛生署於民國96年推動了「建構以病人為中心之電子病歷跨院資訊交換環境案」，目前已完成參與該專案各醫院的實地測試工作。
    在檢視專案執行的結果後，我們發現TMT資訊系統有三項主要的缺點：一、TMT病歷標準不易閱讀，難以撰寫從醫院醫療資訊系統彙總TMT所需資料的指令集；二、製作TMT系統所須的設定檔程序過於繁複，不但時間攏長而且容易出錯；三、線上實際產生個別病患的TMT資料的時間過長，執行效能有待提昇。有鑑於此，我們設計並實作了一套適用於TMT標準的電子病歷文件產生工具，我們重新設計了規格文件檔及輔助設定檔，並提供了Schema Processor自動化工具產生這些檔案；同時，我們也改進了病歷資料彙總程序，搭配高便利性的設定檔，病歷文件產生工具在執行效能上了有明顯的改善。
    在詳細、完整的規格文件檔協助下，資訊人員能更快的了解病歷標準架構及撰寫病歷資料查詢語法，以利產出正確的電子病歷文件；透過自動化工具的輔助，簡化了設定檔的製作程序，改善了耗時且容易出錯的缺點；相較於目前的TMT系統，我們的工具執行效能提昇了80%以上，產出電子病歷文件的時間只要原來的五分之一。
    The Taiwan Electronic Medical Record Template (TMT) proposed by Taiwan Association for Medical Informatics (TAMI) aims to provide a suite of standard forms that will become the common basis for developing electronic medical record (EMR) systems in Taiwan. It is specified in the XML standard for facilitating data interchange. In order to further assess the usefulness of TMT, in 2007 the Department of Health lauched the project "Building of an Information Exchange Environment for Cross-Hospital Digital Medical Record" to put the TMT to a filed test. There are in total eleven hospitals in the project and they all successfully implemented a significant subset of TMT using their hospital information systems (HIS).<br>However, towards the end of the project, we have identified three major shortcomings of the content aggregator for TMT provided by the TAMI: First, as the TMT Schema is rather complex, it is very difficult for hospital IT staff to prepare the required query instructions to retrieve the data stored in the HIS database. Although there is a XML data mapping tool provided to simplify the mapping process, we found that it did not ease the mapping task as the TAMI staff had expected. Second, the configuration files for preparing a patient’s EMR are too complicated, making the implementation process not only long time but also error-prone. Third, the time required to produce a single sheet of TMT is much longer than planned. There is an urgent need to improve the performance of the content aggregator.<br>Therefore, we propose to re-engineer the content aggregator of TMT for retrieving the required data from the HIS database. Specifically, we redesigned the specification document files and configuration files, and provided a Schema Processor tool to generate these files in a semi-automatically manner. As a result, the IT staff of hospitals can more quickly understand the structure of TMT Schema and prepare the query instructions effectively. Finally, with the powerful configuration files, our TMT document generator runs much faster than the existing one. According to our experimental results, it enhances the performance of generating a TMT sheet more than 80 percent.
    Reference: [1] 行政院衛生署，「醫療院所病歷電子化現況調查」，民國91、94年
    [2] Health Level Seven, The Clinical Document Architecture Release 2.0,
    http://www.hl7.org/library/standards_non1.htm
    [3] 簡文山、徐建業、劉孟純、張博論、溫信財、郝德慧、李友專，制訂及推動電子病歷內容基本格式之研究，醫療資訊雜誌，14(2005)，pp. 1-10.
    [4] 簡文山，建構可攜式資料與資訊透通基礎建設－臺灣電子病歷內容基本格式架構，民國96年
    [5] XML Schema, http://www.w3.org/XML/Schema.html
    [6] 建構以病人為中心之電子病歷跨院資訊交換環境案,
    http://emr.doh.gov.tw/introduce/introduce_1.html
    [7] Altova XMLSpy,
    http://www.altova.com/products/XMLspy/XML_editor.html
    [8] Simple Object Access Protocol, http://www.w3.org/TR/soap/
    [9] XML Document Object Model (DOM)
    http://msdn.microsoft.com/en-us/library/hf9hbf87.aspx
    [10] Document Object Model Level 1 Level 2,
    http://www.w3.org/DOM/DOMTR
    [11] XML Schema Object Model (SOM) ,
    http://msdn.microsoft.com/en-us/library/bs8hh90b.aspx
    [12] RDB to XML Mapping Editor, http://www.ibm.com/developerworks/websphere/techjournal/0204_russell/russell.html
    [13] Altova MapForce,
    http://www.altova.com/products/mapforce/data_mapping.html
    [14] XSLT, http://www.w3.org/TR/xslt
    Description: 碩士
    國立政治大學
    資訊科學學系
    95971013
    96
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0095971013
    Data Type: thesis
    Appears in Collections:[Department of Computer Science ] Theses

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