以知識工程方法設計與實現語意網架構之電子病歷交換服務

Knowledge Engineering Approach to Design and Implementation of Semantic Web Architecture for EMR Exchange Services

葉慶隆(Ching-Long Yeh)；林國中(Kuo-Chung Lin)；蔡慧貞(Hui-Chen Tsai)；莊茵婷(Yin-Ting Chuang)

知識分享 ； 社會網絡分析法 ； 虛擬社群 ； 論壇 ； knowledge engineering ； semantic web ； emr exchange services

資訊管理學報

24卷3期（2017 / 07 / 31）

273 - 306

繁體中文

衛生署在2009 年推動醫療影像報告、血液檢驗報告、門診用藥紀錄及出院病摘等4 項之電子病歷交換標準，其方法為將分散儲存於各醫院之病歷資料，建置交換中心（EEC）提供跨院區索引集中查詢。但因民眾大都選擇當下方便的且即時的醫院就醫，導致每位病患之病歷項目繁多，醫師在透過健保卡尋找院外電子病歷時，往往出現很多的歷史病歷清單，醫師又得花費許多時間在調閱資料上，才能找到符合自己需求的病歷資料；也因此降低了門診醫師使用EEC 平台的意願。本研究旨在設計推薦調閱系統來解決現行醫師在EEC 平台上調閱所需病歷不易問題。首先，使用CommonKADS 知識工程方法論來找到醫師在問診時的領域知識，並進而設計專屬之問診知識集，作為發展電子病歷交換推薦調閱介面的設計基礎。其次，設計推薦電子病歷交換平台之有效管理系統，來承載大量資料。再來，發展推薦調閱規則之SPAQRL 語言，針對運用現行存在EEC 平台下載之電子病歷XML 檔案，擴大應用各醫院間已簽章之電子病歷資料；最後，運用RDF 相關技術來承載SPAQRL 查詢語言，進而提升EEC 平台查詢調閱之效率與精確度。

Purpose-This study aims to design systems to solve the current recommended access to physicians in the EEC internet access to needed medical difficult problem. Design/methodology/approach-This study used CommonKADS knowledge-engineering methodology to locate the domain of the physician in diagnosed enquiry, and then, design an exclusive enquiring science anthology as a basis of accessing interface to develop, exchange, and recommend the EMR. Secondary, design and recommend an effective managing system of the EMR exchanging platform to carry bulk data, and then, develop and recommend the SPARQL language of the accessing rules, aiming at the existing EEC platform to download the XML file of EMR, so as to broaden the inter-hospital application of the signed EMR Finally, use RDF-related technology to carry SPARQL-enquiring language, and further to enhance the enquiring and accessing efficiency and precision of the EEC platform. Findings-In this study, introducing EHR interoperability through empirical findings, the use of XML files generated by the application in practice to expand the extension of applications, not only can improve the exchange of electronic medical records when physicians willingness to see the doctor, and can increase the accuracy of access to medical records and timeliness, access to external medical physicians no longer need to wait for a long time, saving time outpatient medical records transfer, the more time spent on interrogation, and thus enhance the doctor-patient relationship, but also provides a platform to use existing EEC some sort of relief program on the predicament faced, Research limitations/implications-In this study, access to electronic medical records exchange, Taiwan is currently only implemented EHR environment as an object, and only in line with national health care system, whether or not covered by a health or social limits of national health care systems of the advanced countries of this study; others present Research is currently only physicians access to electronic medical records at the clinic recommended as a reference design that is appropriate for the problem of other medical specialties, is another limitation of this study. Practical implications-Conclusions from the study seen by the results of this study may expand Taiwan's electronic medical records exchange file existing range of applications; future studies will, through a wider range of medical experts in the field of knowledge development, and a combination of these faces with rich semantics of RDF files of Cloud Applications, Taiwan will forward the information to the electronic medical record massive cloud computing, and to develop national health policy, community disease prevention, medication safety and other fields. Originality/value-This study will be converted into electronic medical records XML file RDF Schema agent, not only can effectively address the plight of the operation of the existing EEC, but can be expanded to extend the application of electronic medical records, the development of an effective system of electronic medical records can be recommended to improve doctor-patient relationship

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