以影像識別為基礎之藥錠比對方法與裝置之研發

Development of an Intelligent Drug Identification Method and Device Based on Digital Image Recognition

呂全斌(Chuan-Pin Lu)；黃霨(Wei Huang)

藥錠辨識 ； 影像處理 ； 醫療照護 ； 藥錠影像檢測系統 ； Drug Identification ； Digital Image Processing ； Health Care ； Drug Image IdentificationSystem

美和學報

33卷2期（2014 / 11 / 01）

29 - 61

繁體中文

近幾年，社會出現護理人力嚴重不足的問題，而護理人力不足也導致病人受護品質降低與死亡風險的提高；以給藥為例，“給藥錯誤”事件在世界各國的醫療不良事件中皆高居首位，一旦遇到藥發錯，護理人員很容易造成醫療糾紛而身陷囹圄。過去僅有少數文獻進行藥物影像辨識研究，未見有針對此應用的研究被提出；為此，本研究進行一項以藥錠核對為目的之藥錠影像比對方法與裝置的研發，期望透過此裝置協助護理人員於給藥前進行藥綻核對，達到降低人為疏失，提高病人用藥安全的目的。為了要做到藥錠辨識自動化功能，本研究以電腦視覺技術為基礎，設計所需的裝置與影像處理演算法。方法上則使用藥錠形狀、顏色與壓印等影像特徵資訊來做為辨識依據；其中，演算法包含使用簽名特徵來描述形狀、色彩量他估算藥錠顏色、光學字元辨識來識別壓印與自行設計之影像處理方法，本研究所使用的方法，僅以形狀或顏色來進行辨識，準確度高達100%，壓印文字辨識率的部分則維持在88%左右，在文章實驗的部分展現本研究所開發的演算法與裝置的可行性。

In the recent years, there has been an impact on the quality of patients' care due to human negligence, especially in care institution. Nursing human resourcesare directly related to patient safety. For example, nurses need to be individually checked drugs and distributing drugs to multiple patients. For medical purposes, most hospitals introduce a large number of drugs, which nurses cannot remember completely. In some units of hospital, such as intensive care unit, drug identification is performed just by naked-eye examination. It is difficult for even a well-trained and experienced nurse to perfectly identify various drugs without the assistant of equipments. Many literatures examining the application of technology in the medical industry conclude that the quality of medical care would be enhanced significantly through the application of technology like automated machines. Therefore, the intelligent drug identification algorithms and a device based on digital image recognition will be developed to assist nurses in drug identification in this study. The device is based on digital image processing. The algorithms include color feature extraction (color quantization), shape feature extraction (signature), and imprint feature extraction (optical character recognition). Using the proposed automatic drug identification device, nurses can enhance the simplicity and the safety of nursing care in addition to increasing convenience and reducing human error.

1. Yang, K. P.(2003).Relationships between nurse staffing and patient outcomes.The Journal of Nursing Research,11,149-158.
   連結：
2. 夏君誠、鄭亦真(2012年05月12日)、SNG，512護士節上街頭不滿超時工作衛署抗議。中天新聞。線上檢索日期：2012年05月12日。網址：http://www.ctitv.com.tw/news_video_c14v82048.html.
3. 連昭慈、李宇承(2012年05月07日)。白色巨塔血汗工廠？。華視新聞雜誌。線上檢索日期：2012年05月07日。網址：http://news.cts.com.tw/cts/life/201205/201205080997292.html.
4. 陳廣瑞、陳雨柔(2012年05月11日)，直擊！護士過勞爆離職潮急診室忙翻天。中天新聞。線上檢索日期：2012年05月11日。網址：http://www.ctitv.com.tw/news_video_c16v81997.html.
5. 行政院衛生署國民健康局，老化海嘯襲臺灣，2011.07.11, 網址：http://health99.doh.gov.tw/Hot_News/h_NewsDetailN.aspx?TopIcNo=6260
6. 盧孳艷(2011年04月27日)。衛生署騙很大。自由時報。線上檢索日期：2011年04月27日。網址：http://www.libertytimes.com.tw/2011/new/apr/27/today-o8.htm, 2011.
7. Aiken, L. H.,Clarke, S. P.,Sloane, D. M.,Sochalski, J.,Silber, J. H.(2002).Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.Journal of American Medicine Association,288,1987-1993.
8. Benner, P.,Sheets, V.,Uris, P.,Malloch, K.,Schwed, K.,Jamison, D.(2002).Individual, practice, and system causes of errors in nursing: a taxonomy.Journal of Nursing Administration,32(10),509-523.
9. Chen, M.,Ding, X.(1999).A robust skew detection algorithm for grayscale document image.Document Analysis and Recognition
10. Gonzalez, Rafael C.,Woods, Richard E.(2002).Digital Image Processing.Prentice-Hall.
11. Hall, McGills L.,Doran, D.,Pink, G. H.(2004).Nurse staffing models, nursing hours, and patient safety outcomes.Journal of Nursing Administration,34,41-45.
12. He, L.,Chao, Y.,Suzuki, K.,Wu, K.(2009).Fast connected-component labeling.Pattern Recognition,42,1977-1987.
13. Heckbert, P. S.(1982).Color image quantization for frame buffer display.Comput Graphics,16(3),297-307.
14. Hong, Y.(1993).Skew correction of document images using interline cross-correlation.Graphical Models and Image Processing,55,538-543.
15. Hu, M.-K.(1962).Visual pattern recognition by moment invariants.IEEE Trans. Inform. Theor.,8(2),179-187.
16. Huang, H.-L.,Chang, Y.-M.,Li, M.-C.,Tang, S.-Y.,Lee, T.-T.(2011).Information technology in nursing: using the decision-making support system in the opd nursing instruction information system.The Journal of Nursing,58(1),79-84.
17. Lang, T. A.,Hodge, M.,Olson, V.,Romano, P. S.,Kravitz, R. L.(2004).Nurse-patient ratios: a systematic review on the effects of nurse staffing on patient.Nurse Employee, and Hospital Outcomes,34,326-337.
18. Lee, Y.-B.,Park, U.,Jain, A. K.,Lee, S.-W.(2012).Pill-ID: matching and retrieval of drug pill images.Pattern Recognition Letters,33,904-910.
19. Li, Z.,Park, U.,Jain, A. K.(2011).Discriminative model for age invariant face recognition.IEEE Transactions on Information Forensics and Security,6(3),1028-1037.
20. Linda, Q. T.,Jeanne, S.(2009).Informatics and nursing: competencies and applications.Lippincott Williams & Wilkins.
21. Lowe, D.(2004).Distinctive image features from scale-invariant key points.Internat. J. Comput. Vision,60(2),91-110.
22. Marion, J. B.,Kathryn, J. H.,Susan, K. N.,Judith, V. D.(2000).Nursing informatics: where caring and technology meet (health informatics).Springer.
23. Morimoto, M.,Fujii, K.(2011).A visual inspection system for drug tablets.2011 IEEE International Conference on Systems, Man, and Cybernetics (SMC)
24. Needleman, J.,Buerhaus, P.,Mattke, S.,Stewart, M.,Zelevinsky, K.(2002).Nurse-staffing levels and the quality of care in hospitals.The New England Journal of Medicine,346,1715-1722.
25. Ojala, T.,Pietikainen, M.,Maenpaa, T.(2002).Multiresolution gray-scale and rotation invariant texture classification with local binary patterns.IEEE Trans. Pattern Anal. Machine Intell.,24(7),971-987.
26. Ozdemir, D,Akarun, L(2002).A fuzzy algorithm for color quantization of images.Pattern Recognition,35,1785-1791.
27. Royle, J. A.,Blythe, J.,DiCenso, A.,Boblin-Cummings, S.,Deber, R.,Hayward, R.(2000).Evaluation of a system for providing information resources to nurses.Health Informatics Journal,6(2),100-109.
28. Topal, C.,Akinlar, C.(2012).Edge Drawing: A combined real-time edge and segment detector.Journal of Visual Communication and Image Representation,23,862-872.
29. Yu, C.-C.,Wen, C.-Y.,Lu, C.-P.,Chen, Y.-F.(2012).The drug tablet image retrieval system based on content-based image retrieval.International Journal of Innovative Computing, Information and Control,8(7),4479-4508.
30. 石崇良(2004)。醫療錯誤之流行病學。台灣醫學，8(4)，510-520。
31. 何世杰、阮祺文、林月招、周志中、侯秀慧、許維尹(2001)。病人安全指標之建置。台灣醫學，8(4)，535-541。
32. 吳祥鳳、于漱、藍雅慧、唐福瑩(2012)。給藥錯誤事件綜論─急診室、加護中心、兒科病房。護理雜誌，59，92-97。
33. 林秋芬、陳玉枝、張文英、高靖秋、林月桂、盧美秀(2005)。醫療照護疏失原因之探討。長庚護理，16(1)，23-24。
34. 林綽娟、呂桂雲、李素華(2005)。行政院衛生署委託研究計畫成果報告行政院衛生署委託研究計畫成果報告,台北:行政院衛生署。
35. 邱曉彥、陳靜敏(2010)。資訊科技與社區護理之結合：遠距護理的興起。源遠護理，4(2)，5-10。
36. 張念中、陳聰富(2011)。用法律觀點看醫療不良事件之風險管理。醫療品質雜誌，4，70-73。
37. 張黎露、曹澤源、鄭春秋、陳明琪(2006)。運用資訊科技提昇病人安全─以某癌症專科醫院為例。醫保研究雜誌，2(1)，1-8。
38. 郭素娥、姚銘忠、楊鎮嘉、黃梅芬(2008)。以資訊科技建構病人安全事件通報系統─以某區域醫院為例。健康管理學刊，6，1-16。
39. 陳玉枝(2007)。病人安全與護理。醫療品質雜誌，1(1)，58-62。