應用Web Services建置符合HL7標準的電子病歷交換系統架構之研究

The study on Web Services based Health Level Seven for Electronic Health Record exchange system

HL7為國際醫療資訊交換的標準，廣泛採用勢必是未來發展的重要趨勢，目前國內使用HL7訊息並不普遍，究其原因在於大部分醫療院所都沒有開發HL7編碼與解碼程式的能力，而某些醫療資訊廠商所開發的HL7軟體價格昂貴外也未能完全合乎標準，導致醫療資訊無法做全面性交換，所以本研究希望能夠藉由系統的發展並遵循自由軟體的精神將程式共享，促使各醫療院所在建置本身系統時的參考及使用。本研究目標是以「病患轉診單」與「疾病通報單」的電子健康記錄為主，建置發展以病患為中心的醫療資訊架構交換平台，整體系統架構大致分成五個部分：(1)資料庫管理子系統──提供HL7訊息修改、刪除及索引等功能；(2)資料介面轉換子系統──提供資料新增及擷取轉換至介面資料庫；(3)HL7訊息產生子系統──提供HL7訊息編碼與解碼等功能；(4)動態資料交換子系統──以Web Services機制來達成不同醫療機構間訊息傳送及接收；(5)訊息驗證測試子系統──主要驗證HL7訊息內容的正確性。透過這個架構的設計希望能跨出個別醫院或機構的區隔，進一步實現醫療資訊相互流通目標，並冀望對於提升醫療品質能有所助益。

HL7 is a standard of medical information exchange. It will become an important trend for developing hospital information system in the future. However, this standard has not been widely used because most medical institutes are unable to encode and decode HL7 messages. Some products developed by medical information providers are very expensive and do not conform to the standard. This research applies the web services technology to develop the HL7 encoding and decoding software and provides all medical organizations using the open source through the Internet. In this paper, we will discuss the architecture and share our developing experience of the system. We have designed computer programs for implemented prototyping systems including (1) Database Management Subsystem (2) Data Interface Transformation Subsystem (3) HL7 Messages Generation Subsystem (4) Dynamic Services Exchange Subsystem, and (5) HL7 Messages Validation Subsystem. At present, the purpose of using HL7 information is mainly to notify the patient referral and disease report, and then hoping to offer the exchange of medical information, reducing the waste of medical resources, and promoting the quality of medical service.