Agent-Based數位影像醫療資訊整合及交換共通服務閘道－－以轉診系統為例

Agent-Based Common Service Gateway for the Integration and Exchange of digital images-- A Case Study of Referral System

為了提供民眾更周全與持續的醫療服務品質及建立以病人為中心的醫療觀念並避免醫療資源的浪費，醫療機構間醫療資訊交換與資料共享的需求日益提高。醫療資訊的交換除了文字資料之外，醫療影像的交換更顯重要。為有效的來促進此一交換與分享，必需有賴建立一個標準且可行的資訊交換模式來支援。更由於各醫療資訊系統在建置過程中，諸多並未考量整合、延伸性的問題。有鑒於此，本文提出一個醫療資訊整合及交換之共通服務閘道的架構模式及其雛型系統建立。系統架構模式採用HL7與XML為基礎並整合CDA及DIC0M之健康資訊交換標準及軟體代理人的技術來建立。希冀藉此來提升資訊交換及資料分享的效益與效率並進而加速達成我國醫療主管機關推行(1)醫療資源使用最佳化、(2)分級醫療制度、(3)轉診訊息的完整性及(4)醫療院所內相關資訊系統整合的目標。我們將此架構模式提供給我國衛生醫療院所作為未來建置類似系統及及專家學者進行進一步研究發展的基礎，藉此共同來促使我國醫療院所間資訊交換及資料共享的願景得以加速達成。

In order to offer the quality of the people having thorough and persistent medical care services and to establish the medical idea of regarding patient as the centre as well as avoid the waste of resources of medical care, the demand of information exchange and data sharing between healthcare institutions is increasing day by day. In addition to the exchange the text-based medical information, the exchange of medical images becomes increasingly important as well. For the purpose of effectively fostering this exchange and sharing, it is necessary to rely on building a standardized and feasible information exchange model to support. Furthermore, owing to the most of medical information systems in the course of their implementations are not considered the issues of integration and scalability, therefore this paper presents an architectural model with a prototyping system implementation of agent-based common service gateway for the integration and exchange of medical information. The system architectural model is established by adopting the standards of HL7 and XML with integrating the healthcare standards of CDA and DICOM, and employing the technology of software agents to implement. It is anticipated to leverage this model to enhance the effectiveness and efficiency of medical information exchange and sharing. Moreover, to expeditely reach the goals set by our national medical authority to promote and strengthen (1) the optimization of the utilization of medical resources, (2) hierarchical medical treatment system, (3) strengthen the integrity of referral message, and (4) the integration of information systems. The proposal of this architectural model hopefully can provide a reference model for nationwide medical institutions and health care institutions to build similar systems and as a basis for industrial professionals and academic researchers to conduct further research so that the vision of nationwide medical information exchange and sharing can be accelerated to achieve.