摘要
本论文针对医疗工作者和异地疑难重症患者对医疗信息系统提出的新需要,即迫切希望能够出现医院与医院之间病人信息共享、远程护理、远程医疗培训、远程交互治疗、远程会诊等多功能的远程医疗平台。针对这个需求本课题旨在研究基于客户端/服务器端(Client/Server)和浏览器/服务器端(Browser/Server)结构的远程医疗类系统。医院可以通过宽带或窄带和远端的专家或医院之间实现信息交互、数据采集、文件共享、远程会诊等综合功能,同时也在探索和研究远程医疗与计算机方面技术结合的最佳途径。
本论文针对国内部分医院的需求,就远程临床会诊、远程影像会诊、撰写报告、医疗费用计算、文件传输的远程医疗系统,就病例采集、数据上传到远程数据服务中心、病例统计的远程病例采集和统计系统,进行详细的介绍。前者主要是针对于医院与医院之间的医疗服务,旨在医院之间建立起一个虚拟的网络联合平台,医院可以向会诊中心申请影像会诊和临床会诊,并可以查看诊断报告,有利于资源共享,同时也提高了医院看病效率。后者主要针对医院与医院之间科研用途,进行病例的采集和统计,方便医生进行病例汇总和分析研究,减少了医疗风险,提高了医院的医学研究水平。
本论文中的C/S模式远程医疗系统的开发,用到了面向对象开发工具Delphi、FTP协议以及大中型企业所使用的数据库Oracle。B/S模式的远程病例采集和统计系统用到J2EE技术、面向对象的开发语言Java、Struts框架、开发Web系统所使用的开发模型和语言,并且还有后台数据库Oracle。
本课题的贡献在于设计并实现了基于C/S架构远程医疗系统的文件断点传输部分、合同模块、系统中费用模块等。此外设计并实现了基于B/S架构的远程病例采集和统计系统的颈动脉狭窄病例采集。前者系统中具有稳定的远程文件续传功能；能够实现完善而清晰的远程会诊工作流程,提高工作效率；费用部分配合合同部分,能够准确而及时的进行费用信息反馈；后者系统中实现了复杂信息病例的采集,其界面功能具有综合性、友好性以及条理性,使得用户可以在交互界面下完成复杂的病种信息填写。
Medical workers and severe patients in long distance propose the new demand about medical information system. They wish that multi-functional remote medical care platform is to be born, and its function includes sharing patient information between one hospital and another hospital, remote care, remote medical training, remote mutual curing, remote consulting, and so on. For this demand, the research aim of the project is the kind of Telemedicine system mainly based on Client/Server and Brower/Server. So, the local hospital connects the remote hospitals or doctors by broadband or narrowband to achieve information interaction, gathering data, sharing information, remote consulting, etc. The project is also exploring and making research in the best integrated way of telemedicine and computer technique.
The paper integrates the above demand with the functions of the popular Telemedicine system to realize Telemedicine System whose functions have remote clinical consultation, remote image consultation and remote training and so on, and the Remote Gathering and Statistical System of Medical Records whose functions contain delivering medical records, uploading the medical data to data service center, and medical records statistics. The paper will introduce the two systems in detail. The first one mainly applies in building virtual network platform between hospitals for medical services. The medical services allow member hospitals to apply for image diagnosis and checking through the diagnosing records, which is beneficial to sharing resources, treating severe cases and promoting the working efficiency. The last one is aimed at medical researching between hospitals. The remote collection and statistics of medical records is an ideal method to gather and analyze medical records for most of doctors, which advances the alliance between hospitals, declines medical risks and elevates medical research level of the hospital.
The Telemedicine system based on C/S Mode and the Remote Gathering and Statistical System of Medical Records based on B/S Mode are discussed in the paper. The first one uses Delphi tool, FTP protocol, and so on. The second one makes use of J2EE technique, Java language, Struts structure, and Web developing modules. The two systems all use the Oracle database.
The contribution of the project lies in designing and realizing file resuming module, contract module, and expense module in The Telemedicine system based on C/S Mode. Besides, collecting carotid artery stenosis in the remote gathering and statistical system of medical records based on B/S mode is realized. The former system has the possession of stable function of the remote file transfer and accomplishing the all workflow of remote consultation, which is good for improving working efficiency. Also, it returns the accurate and timely expense information by combining expense module with contract module. The latter system accomplishes the collection of medical records with MVC mode and factory mode, which holds many advantages. For example, friendly interface, interactive operation, clear function, easy operation.
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