[F21_Telehealth] CHAPTER 5-6

510220433徐國廷 510220158廖建閔

醫療資訊標準
   整個規範大致可分為醫療篇、行政管理篇與基礎建設與醫院相關系統三大區塊,為醫療資訊系統的各系統訂定功能明細與規範,希望未來提供針對資訊系統進行認證核可的機制,進而可讓所由層級的醫院所均可參考這份規範發展完善的醫療資訊系統,以支援醫療的臨床及行政工作。

  在科技與工程業界,因專業細分化,跨企業合作成為了一個無法回逤的趨勢。為此,工業工程業界已經出現了一套相對成熟的解決方案。
 在工業3.0的時代,又稱電子信息化時代,即廣泛應用電子與信息技術,使製造過程自動化控制程度進一步大幅度提高。在此,資料庫系統被廣泛的運用,譬如汽車零件工業,靠著數字設計、總裝、數字製造與分析系統建立資料庫,並在當中進行校正,相比起曾經的工業2.0時代,效率得到了廣泛提升。
 而近年間所稱之工業4.0,則是為智慧製造所出現的大範圍工業躍進運動,包括但不限於大數據分析、智能數據分析、自動化機器人、物聯網感測、甚至包括當中的人因工程技術,都成為了其中的要點。

 清華大學工業工程學系的簡禎富教授,為了讓我國現今許多仍在工業2.0;工廠電子化時代停駐的企業們能夠有效接軌國際,而提出了工業3.5的概念。
 工業3.5藉助AI、大數據及數位決策系統為破壞性創新,結合產學資源,為企業解決需求個人化、產品週期愈來愈短、人力短缺、企業接班等經營難題。並從經營決策、資源管理、人才培育與藍湖策略這四個大方向上,協助企業有效管理資源,優化經營。

未來展望

醫療資訊標準的推動可帶來以下幾個好處

1. 交換性:與不同醫療院所交換資料,且不用修改程式或資料庫

2. 整合性:院內可在相同標準下,選擇在不同階段建置或不同功能的系統下進行整合

3. 獨立性:可做單獨系統之修改或升級,不必擔心影響其他系統

4. 提升國際競爭力:各家廠商可以集中研發能,致力發展特定系統,而不必為了滿足醫院的要求而承包自己不專長的系統,甚至可以與國外廠商媲美,增加競爭利基

5. 節省開發時間及成本

6. 提升臨床研究水準及品質:電子病歷發展成熟,將促進個人化的健康紀錄與精準醫療之發展

醫療資訊資料庫管理系統

   資料庫必須要有一個資料庫管理系統(database management system)來負責管理資料的新增、刪除、更新和查詢等操作,使用者可以不需要知道存放資料的磁碟位置,只要透過此系統就可以操作存放在資料庫的資料。
    在簡教授的著作:「工業3.5:台灣企業邁向智慧製造與數位決策的戰略」與智慧工業等相關著作中,提到了許多針對於舊資訊系統改進與新系統創新的方案,許多亦為醫學資訊業界能做為參考的,在此分析為以下項目:

 1.) 資料庫系統修正

    許多醫院的資料庫系統在建置時,已經是二十年前的事情了。當時的許多資訊環境與今日截然不同,無論是硬體、軟體、網路、甚至是醫療人員的科技認知能力,皆與今日截然不同。
    根據許多業內的朋友所述,現只有地區性醫療中心等相關醫療院所,為了大數據的資料儲備而設計自有的系統,而地區醫院等資料系統則並未完善規劃。
   同時,醫事人員在資料登打上亦需要訓練。現許多,無論大小醫療院所,在資料登打上並未完整規範,而導致在資料整理上並無法導出一份完整的資料規格,造成資料庫上出現不完整性。

 2.) 資料的統一規格化

    現一套完整的醫療資訊系統,皆是由各醫院外包的廠商負責,醫院的資料處理中心大多不具具備如此產能。而個別廠商擁有其自有的資料格式,而廠商間則為了保全自有的利益,而提升了資料轉移的難度。

 3.) 大數據資料準備

   近年大數據科技亦成為醫療資訊產業中隱形的推手,許多資訊中心亦開始招募有關人員,期望能提升醫師在診斷時的效能。
    以本次新冠病毒,中國在大數據下的分析系統為例。我們先將看診分為五個階段,分別為問診、檢查、報告閱讀、判斷、治療方案。利用人工智能系統中的卷積神經網路,導入大量的X光與相關資訊去培訓這套判斷系統。
   這套系統最後能創造出一個能看CT,快速做出判斷的智能系統,能有效率的降低醫師在這兩環節中所花費的時間,節約在大規模疫情中所突然激增的醫師需求。

 4.) 資料傳遞的共同規格

    在現今各大醫療院所時常出現的跨院所診斷及救治中,跨醫療資訊系統的資料傳遞成為了一大困境。以自身經驗為例,之前曾在三總做了套完整的MRI檢查,並被轉診至榮總。
    可能在資訊系統上只要數秒鐘便能完成的事情,卻需要病患親至兩間醫院完成資料傳遞,索取光碟、病例資訊等相關資料,並至另一間醫院由該醫院人員作資料登打,無形中形成了醫療資源的浪費。

 5.) 數位決策系統的大規模導入

   資訊系統大多需要超前部署,因更新一套系統需要耗費大量時間與費用。在設計與規劃系統時,需要考量未來數年、甚至數十年的需求去做規劃。
    以近幾年為例,除了資料傳遞、大數據分析之外,數位決策系統亦成為了資訊系統的重要賣點之一,在醫師產業精細化,與三大科醫師人數降低的狀況下,數位決策系統能完成有效的降低醫師需求的功能。

回應

Thanks for an interesting blog. What else may I get that sort of info written in such a perfect approach? I have an undertaking that I am just now operating on, and I have been on the lookout for such info. 안전놀이터

I definitely enjoying every little bit of it. It is a great website and nice share. I want to thank you. Good job! You guys do a great blog, and have some great contents. Keep up the good work. 토토사이트

That is the excellent mindset, nonetheless is just not help to make every sence whatsoever preaching about that mather. Virtually any method many thanks in addition to i had endeavor to promote your own article in to delicius nevertheless it is apparently a dilemma using your information sites can you please recheck the idea. thanks once more. 토토사이트

I definitely enjoying every little bit of it. It is a great website and nice share. I want to thank you. Good job! You guys do a great blog, and have some great contents. Keep up the good work. 안전놀이터

Wow! Such an amazing and helpful post this is. I really really love it. It's so good and so awesome. I am just amazed. I hope that you continue to do your work like this in the future also 릴게임사이트

Wow, this is really interesting reading. I am glad I found this and got to read it. Great job on this content. I like it. 토토사이트

Thanks for taking the time to discuss this, I feel strongly about it and love learning more on this topic. If possible, as you gain expertise, would you mind updating your blog with extra information? It is extremely helpful for me. 안전놀이터

Wow! Such an amazing and helpful post this is. I really really love it. It's so good and so awesome. I am just amazed. I hope that you continue to do your work like this in the future also 안전놀이터

Pretty nice post. I just stumbled upon your weblog and wanted to say that I have really enjoyed browsing your blog posts. After all I'll be subscribing to your feed and I hope you write again soon! 토토커뮤니티

The article looks magnificent, but it would be beneficial if you can share more about the suchlike subjects in the future. Keep posting. 스포츠중계

Thanks for the blog filled with so many information. Stopping by your blog helped me to get what I was looking for. Now my task has become as easy as ABC. 안전토토사이트

I admire what you have done here. I like the part where you say you are doing this to give back but I would assume by all the comments that this is working for you as well. 안전놀이터

Thanks for the blog filled with so many information. Stopping by your blog helped me to get what I was looking for. Now my task has become as easy as ABC. 토토사이트

I am always looking for some free kinds of stuff over the internet. There are also some companies which give free samples. But after visiting your blog, I do not visit too many blogs. Thanks. 토토커뮤니티

I visit your blog regularly and recommend it to all of those who wanted to enhance their knowledge with ease. The style of writing is excellent and also the content is top-notch. Thanks for that shrewdness you provide the readers! 먹튀검증