轉診醫療資訊管理系統之研究──以HL7及XML為基礎

A Study of Referral Information Management Systems Based on HL7 and XML

行政院衛生署，為了均衡城鄉醫療資源、提升醫療品質、健全醫療服務體系，保障民眾就醫權益和有效運用醫療資源成本，規定實施醫院分級及轉診制度。目前醫療院所的轉診支援，因資訊化實行程度不一 ，大致可分為無轉診系統、有轉診系統未符合HL7 / XML、及有轉診系統已符合HL7 /XML等3種。目前大部份的轉診系統，大多屬於有轉診系統未符合HL7 / XML，並且僅考慮特定的醫療院所而設計，無法支援所有的醫療院所，且無法與醫療院所內部的資訊系統做整合。本研究提出新的轉診醫療資訊管理方法論，此方法論能夠提供從轉診轉出、轉入、回覆到追蹤，支援整個醫療院所轉診病歷交換。並且，在方法論的各步驟中，也將改善目前轉診系統中相對應步驟的問題與缺點。藉由本方法論，以期提供醫療院所一個完整的轉診病歷交換支援 ，確實有效支援醫療院所進行轉診病歷交換，使得能夠迅速取得醫療資訊，共享醫療資訊，避免醫療資源浪費，進而提昇醫療服務品質及管理效率。

For balancing the medical resource between the city and the country, the Department of Health established the rules to classify the hospitals and push the referral system. These actions can increase the quality of the medical service, strengthen the medical systems, assure the right of the public to have enough medical services, and utilize the medical resource efficiently. As for the referral system, the medical organizations can be classified into three kinds according the availability of that system: one is the hospitals having no the referral system, another is the hospitals having the referral system but the system does not conform to the HL7 standard, and the other is the hospitals with the referral system and the system conforms to the HL7 standard. Currently, most of the hospitals are classified as the second one; that is, they have a referral system but it is not compatible with the HL7 standard. Such a system is designed under the consideration of single hospital. The system cannot apply to other hospitals and even cannot integrate with other systems in the same hospital. This paper proposes a new method that can support the referral in / out, replying, tracking, and the interchange of the patient records. In addition, the proposed method can overcome the drawbacks and problems occurring in the referral process. Based on this method, a complete and efficient interchange system for the patient records is designed. With this system, the medical information can be quickly retrieved, the sharing of the resource can be easily achieved, the waste of the resource can be avoided and, in the same time, the quality of service can be increased.