建構新一代的防疫資訊交換平台

Design and Implementation of an Innovation Epidemic Information Exchange Platform

疾病管制署負責疫情監控，為了能夠迅速收集和分析醫院間通報的相關資訊，在2007年就開始建立防疫資訊交換平台，以分散式系統架構，在各醫療院所端安裝一部個人電腦作為閘道器，負責將各醫院的資料轉換成健康資訊交換第七層協定(HL7)的標準訊息，再傳送到疾病管制署的主機分析處理。近年來，政府積極推動以臨床文件架構(CDA)作為跨機構間電子病歷交換的標準文件，另外，資訊及通訊科技也有很大的進步，防疫資訊交換平台將有很大的改善空間。本研究以專家訪談的方式，了解現有防疫資訊交換平台運作情形及新的需求，規劃新的資料交換格式及防疫資訊系統的架構，提出以雲端運算架構及簡化的CDA交換格式的改善建議，並以實作系統雛形的方式，開發設計和分析實際應用的可行性，醫院資訊系統的資料，可以透過程式創新的服務系統進行編碼、解碼及驗證，並且轉換成為CDA或是Green CDA的標準格式。未來準備配合國家防疫雲計畫實際推廣應用，相信對於防疫資訊交換及疫情防治會有所幫助。

The Center for Disease Control (CDC) constantly controls and monitors the infectious diseases. In order to quickly collect and analyze epidemic information among hospitals, The CDC has built an epidemic information exchange platform since 2007. The platform is a distributed architecture with a personal computer installed in each hospital as data exchange gateway that may transfer relevant information into HL7 standard messages and then send it to the server in the CDC for further processing. In recent years, the government encourages different institutions to exchange electronic medical records in Clinical Document Architecture (CDA) as a standard format to replace the traditional HL7 messages. In addition, the information and commimication technologies progress rapidly and the hardware in each hospital is quickly outdated. The epidemic information exchange platform has a large room for improvement. In this study, we visited domain experts to understand the operation situation and new requirements of the epidemic information exchange platform. We also made recommendations of applying cloud computing architecture and using the simplified CDA as data exchange format for improvement. We have implemented a prototyping system to analyze the feasibility of practical applications. The reporting data of hospital information system can be encoded, decoded and validated through this innovation services system and transferred into CDA or Green-CDA standard format. We hope that the research results can be widely promoted in epidemic reporting environment, and believe that the quality and efficiency of epidemic prevention and control will be greatly improved.