傳染病管理系統

Epidemic Prevention and Control-Infectious Disease Management System

疾病管制署「防疫雲」子計畫──運用醫療資訊系統進行自動化傳染病通報，介接醫院端醫療資訊系統，帶入疾管署通報系統進行資料交換，大幅改善感染管制人員耗時費力手工作業，進行轉歸通報，藉此健全通報系統，提升整體防疫效能。然而2017年研究報告發現，僅有醫學中心全和少數中小型醫院，建構自動介接通報傳染病。本研究分享某醫學中心運用流程分析，設計系統架構等開發過程，及系統效能。在2021年5月新冠病毒疫情高峰時通報瞬間爆量，單日通報量達639人次，藉由本系統簡單操作、資料交換達成通報、檢體送驗的任務。實測人工作業和使用資料介接自動通報、送驗每一個案所花費時間，在疾管署網頁人工登打「通報」所花費的時間平均17.3±3.6分鐘，程式資料交換3.5±1.0分鐘；人工登打「送驗」花費平均4.7±0.5分鐘；程式資料交換花費1.9±0.6分鐘。開發過程雖然費心耗時，一旦建置成功，不僅省時、精準，省下來的人時讓感染管制人員能發揮專業，在疫情期間避免疫病於院區交叉散播，並持續兼顧推動組合式照顧降低醫療照護相關感染。總結，醫院開發具有資料交換功能、行政管理的傳染病通報系統，有助於防疫，也間接提升了臨床照護品質及病人安全。

“Electronic Medical Record Auto-reporting Project”, a sub-project of the National Epidemic Cloud Project sponsored by Taiwan Centers for Disease Control (CDC), bridging the Healthcare Information System of hospitals with CDC Infectious Disease Reporting System, established and upgraded a web-based notification system in order to improve efficiency of surveillance of healthcare-associated, endemic, and epidemic infections. However, only a minor proportion of hospitals established a web-based system for notifiable infectious diseases according to a national survey released in 2017. Thus, this study describes a medical center’s experience regarding development of an automatic data exchange system complementary to a web-based notification system. This involved process analysis, data architecture design and performance evaluation. At the peak of the COVID-19 epidemic in May 2021, the number of notifiable cases of COVID-19 at this hospital was up to 639 cases a day. We upgraded this system in order to overcome the overwhelming burden of reporting task, support personnel quickly learn to use this system for data exchange. We measured and compared the time for traditional notifications performed by infection control personnel and those performed through this upgraded system. For notification step it took 17.3±3.6 minutes versus 3.5±1.0 minutes, respectively. For laboratory specimen login step it took 4.7±0.5 minutes versus 1.9±0.6 minutes, respectively. In conclusion, the development process required multidisciplinary collaboration and time. Nevertheless, once successful implementation of the system, it saves person-hours and provides precise timely reporting or data exchange. In addition, infection control personnel may provide their professionalism and more focus on promoting bundle care and other prevention measures against healthcare-associated infections or cross transmission of epidemiologically pathogens. All these efforts contribute to epidemic control, quality of care, patient and occupation safety.