資訊傳輸標(biāo)準(zhǔn)—健康資訊交換第七層協(xié)定（Health Level Seven，HL7）作為國(guó)內(nèi)醫(yī)療資訊交換標(biāo)準(zhǔn)。
本研究為配合國(guó)防部軍醫(yī)局建立國(guó)軍醫(yī)療資訊交換標(biāo)準(zhǔn)，以國(guó)軍軍官年度健康檢查為範(fàn)例，以HL7/XML為標(biāo)準(zhǔn)格式，建置國(guó)軍軍官健檢資料傳輸標(biāo)準(zhǔn)，結(jié)合國(guó)防醫(yī)學(xué)中心祝年豐副教授所主持之國(guó)防研究計(jì)畫「建立國(guó)軍軍官健康資料庫(kù)」，並實(shí)際咦黛秶?guó)窚It學(xué)院、三軍總醫(yī)院以及國(guó)軍臺(tái)中總醫(yī)院之間，未來(lái)俟咦髑樾兄鴆酵普怪羾?guó)軍高雄總醫(yī)院、國(guó)軍桃園總醫(yī)院、國(guó)軍花蓮總醫(yī)院、國(guó)軍左營(yíng)醫(yī)院、國(guó)軍松山醫(yī)院等五家區(qū)域醫(yī)院。
考量國(guó)軍軍官健檢資料於網(wǎng)際網(wǎng)路傳送過(guò)程中之資訊安全，本研究另結(jié)合行政院衛(wèi)生署「醫(yī)療憑證管理中心」（Healthcare Certificate Authority，HCA）網(wǎng)路安全機(jī)制，強(qiáng)化資訊傳輸之隱私性（Privacy）、完整性（Integrity）、鑑定性（Authentication）及不可否認(rèn)性（Non- repudiation），建立安全之院際資訊交換平臺(tái)。
未來(lái)配合國(guó)軍醫(yī)療網(wǎng)之規(guī)劃，結(jié)合電子病歷以及各項(xiàng)醫(yī)療行政資訊交換等。建立完整而持續(xù)之醫(yī)療照護(hù)體系，提高對(duì)國(guó)軍官兵、眷屬及民眾之醫(yī)療品質(zhì)與服務(wù)效率，達(dá)成醫(yī)療資源共享之目的。
關(guān)鍵字：全國(guó)醫(yī)療網(wǎng)、區(qū)域資訊中心、電子病歷、醫(yī)療資訊系統(tǒng)、健康資訊交換第七層協(xié)定、醫(yī)療憑證管理中心
Abstract
Since 1987, Department of Health (DOH) has planned and constructed the first generation of national Health Information Network (HIN V1) to establish the infrastructure of electric healthcare systems. In this project, the region centers (RC) organized in Taipei, Taichung, and Kaohsiung, etc. to support around of nationwide health administrative information service and electronic health claim service. In order to enhance the public systems, create operating environment (including the regulation and standards, health insurance), and make the patient record transparent. In 1999, DOH started to implement the second generation of Health Information Network (HIN V2). According to the plans, HIN V2 will be done in 2005. HIN V2 could make it easier to exchange healthcare information between medical units and healthcare administration department, so as to improve the performance and quality of healthcare.
Due to the variety of infrastructure for healthcare information systems (HIS), there is no standardized interface for information exchange, which will increase the difficulty of exchanging electronic medical records (EMR) among hospitals. To solve the present situation, DOH has adopted Health Level Seven (HL7) as the nation standard for healthcare information exchange protocol in Taiwan in 2001.
This research is proposes a pilot project of health information exchange standard for National Defense Medical Bureau. With the model of annual physical checkup for military officers and the data exchange standard format of HL7/XML, which will be integrated with “military officers health information database” that built by Prof. N.F. Chu of National Defense Medical Center. In this research will practice among National Defense Medical Center, Tri-Service General Hospital and Armed Force Taichung General Hospital. Furthermore, the system will be extended to Armed Force Kaohsiung General Hospital, Armed Force Taoyuan General Hospital, Armed Force Hualien General Hospital, Armed Force Zuoying Hospital, and Armed Force Songsan Hospital in the coming future.
Considering the information security of data exchange with the military officers’ health information over the Internet, this research will not only link up with the Healthcare Certificate Authority (HCA) of DOH but enhance privacy, integrity, authentication and non-repudiation of data exchange. The goal lies in providing a secure inter-hospital information exchange platform.
To accompany with the plan of Military Healthcare Information Network in the future, this research establish a platform to consolidate with electronic medical record and healthcare administration resource exchange to develop a completed and continuous health care system for military, family dependants and the public. Finally, this research will promote the purpose for sharing of healthcare resource.
Keywords：Health Information Network (HIN), Region Center (RC), Electronic Medical Records (EMR), Healthcare Informatics System (HIS), Health Level Seven (HL7), Health Certificate Authority (HCA)
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