運用追蹤管理方法建構住院病人的Covid-19資訊科技防疫機制

The utilization of tracer management methodology to construct an information technology (IT) prevention mechanism of COVID–19 infection in admitted patients

2019年12月起，Covid-19造成了全球新興傳染病的嚴重疫情，台灣的防疫表現在此場防疫戰疫中堪稱典範，政府超前部署，並提出一系列的防疫管理措施。資訊科技在防疫管理中扮演關鍵的角色，包含醫療院所及醫療人員的防疫機制。本文運用追蹤管理法確認計畫性住院病人住院流程，針對各個時間點介入人員及資訊防疫管理措施，包含：醫療事務室通知病人辦理住院時口頭詢問TOCC、病人到院時於門口防疫運用資訊系統進行TOCC檢疫、醫院住院病歷系統針對肺炎、咳嗽採取主動監測，同時將陪病者、照顧服務員或是外籍看護等人納入管理，建構出完善的Covid-19防疫機制。在醫療人員防疫機制部分，本院運用數位學習、自主健康管理系統及出國人員雲端管理系統等資訊機制，促使員工能配合相關防疫措施。檢視本院為求防疫機制完善提出的資訊系統，包含：門口資訊防疫（四分格）、TOCC線上篩選問卷（病人/陪病者/訪客）、來院人員登錄系統、外籍看護雲端登錄、數位學習系統、自主健康管理系統及出國人員雲端登錄。雖說透過資訊科技能建置完善的防疫機制，後續仍可思索如何整合資訊內容，例如不同時間點的TOCC資訊連結。期望本文內容及運用的手法能提供所有醫療機構作為參考。

Since December 2019, the outbreak of corona virus disease (COVID-19) has caused a serious pandemic. The epidemic prevention and control implemented in Taiwan has been globally recognized as a role model. The government health authority implemented ultra-early deployment of a series of epidemic prevention strategies. Information technology (IT) played a key role in epidemic prevention, including for all medical institutions and health care personnel. To enhance epidemic prevention in the admission process of our medical institution, tracing management methodology was utilized to confirm that the planned admission process concurred with the epidemic prevention strategy. The admission process is divided into several intervention points: 1) The medical affairs office arranges telephone inquiries about the travel history, occupation, contact history, and cluster information (TOCC) of a patient. 2) When the patient arrives at the hospital entrance, personnel at the epidemic prevention check point use this TOCC data to determine quarantine requirements. 3) The hospital electronic medical records system is used to actively monitor the admitted patient for symptoms and signs of pneumonia. In addition, patient caregivers are included in this management scheme. For epidemic prevention among medical personnel, we implemented IT systems including machine learning, autonomous health management, and cloud computing. These strategies encouraged employees to cooperate with relevant epidemic prevention measures. Thus, a strong COVID-19 epidemic prevention mechanism has been established. However, despite the strengths of this mechanism, additional information content, such as TOCC information links at different time points, has not yet been integrated. The methods described in this article are expected to serve as a reference for other medical institutions.