互通性醫療服務協同合作架構之研究－－以腦中風病患之連續性照護為例

The Design of an Interoperable Collaborative Architecture for Healthcare Services-- A Continuum Care Service Using Stroke Patient as Example

中風是腦血管障礙的總稱。中風是腦部因為血液供應突然中斷，使得腦部缺乏氧氣及養份，導致局部腦細胞受損或死亡而產生各種的神經症狀，令受該腦組織控制的身體機能因而受到影響。腦中風是在全世界致死原因排名的第二位，主要好發族群為中年及老年人。要提供給病患良好的治療，除了的開發新的治療藥物之外，還有其他許多相關的問題存在，例如治療的黃金時刻、相關療程的不完整和破碎性、資訊人員和專業領域之間的代溝。這些阻礙都影響了中風病患的照護及預後。因此，本篇論文架構在IHE上並且應用了標準化資料格式、工作流程、統一化的分析工具去設計出一套整合各項中風預防、急救、治療及復健元件的照護系統。回顧過去的文獻並歸納出中風病患照護的價值鏈，分成：預防，臨床前期、緊急照護、住院照護以及復健，每一個流程都根據建議書的內容提供相關的照護策略給病人最完整的照護。這篇論文的主要目的在於以SOA、ebXML、IHE為基礎來設計整合性的照護平台供分散不同價值鏈中的醫療照護提供者一個協同合作的環境以達成提供中風病人連續性照護的願景。

Stroke, affects the arteries leading to and within the brain, is a type of cardiovascular disease. Globally, stroke is the second leading cause of death. Also, it predominantly occurs in mid-age and older adults. Despite successes in delivering effective new therapies, significant obstacles remain in ensuring that scientific advances are consistently translated into clinical practice. These obstacles include treatment golden time, fragmentation of stroke-related care, effective implementation and the gap between IT and domain. In these cases, we base on IHE to design a collaboration stroke care system with standardize data formats, workflow, and unified analysis tools. We conclude a value chain of stroke care which is divided into five parts: Prevention, Pre-Clinical, Emergency care, Hospital care, and Rehabilitation. Each of the parts has some strategy and control factors with it. Also, the purpose of this study is to provide the methodology of designing a collaborative long term care system by using the concepts of SOA, ebXML, and IHE. Finally, we take the sub-process Emergency Care as example to demonstrate how to modeling the business process. In other words, the purpose of this study is to by strengthening the integration between components in the value chain to provide an efficient care to stroke patients.