基于HL7标准的电子健康档案研究与实现
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摘要
随着社会经济的发展,生活水平的提高,人民群众对医疗卫生服务提出更高要求[1]。我国新的医疗改革方案以创建一个实用的、共享的医疗健康信息平台为目标。卫生信息化建设遇到了千载难逢的发展机遇,构建以电子健康档案为核心的区域卫生信息系统成为卫生信息化的重要方向。
在此背景下,本文构建了基于HL7标准的电子健康档案系统。电子健康档案系统不仅能为居民提供完整的个人健康信息,而且也能为医务人员提供丰富的临床数据源[2]。HL7标准的引入,使得系统可以和外部机构如医疗保险系统、医疗业务系统之间进行数据传输,为进一步扩展为区域范围的医疗信息平台提供基础。
本论文通过对国内外电子健康档案的研究现状的分析,归纳总结了居民电子健康档案系统的主要功能和需求,设计了居民电子健康档案系统核心的业务流程；基于MVC模式和J2EE平台下,对电子健康档案系统进行了详细设计与实现。同时介绍了HL7(Health Level7)标准的基本原理；通过分析HL7规范文档,利用HL7RIM模型描述系统中建档信息,建立了一套可行的HL7消息构建和解析的实现模型,并且运用Web Services技术构建了HL7引擎应用于系统子模块中。
With the development of social economic development and living standards, the people make higher demands on health services [1]. Chinese new medical reform program is to create a practical, shared medical and health information platform. It is an unprecedented opportunity for the construction of health information, and to build regional health information system with electronic health record as a core is an important direction for health information.
Based on this background, the paper builds the electronic health record system which is based on the HL7standard. Electronic health record system can not only provide residents with complete personal health information, but also provides a wealth of clinical data source for medical personnel [2]. The introduction of the HL7standard not only make the system exchange data with external agencies,such as the medical insurance system, medical business systems, and so on, but also provide a basis for health information platform to further expand the regional extent.
After analyzing the state of the field of electronic health record at home and abroad, this paper summarizes the main features and requirements of the electronic health record system, designs the business processes of this system, paper makes detailed design and implementation of electronic health record system using MVC model and J2EE platform. At the same time, this paper introduces the basic principles of the HL7(Health Level7) standard, describes the archiving information of this system using the HL7RIM model through analysis of the HL7specification documents, establishes an implementing model of constructing and parsing a feasible set of HL7message, and builds HL7engine applied in the sub module of the system after using Web Services technology.
在此背景下,本文构建了基于HL7标准的电子健康档案系统。电子健康档案系统不仅能为居民提供完整的个人健康信息,而且也能为医务人员提供丰富的临床数据源[2]。HL7标准的引入,使得系统可以和外部机构如医疗保险系统、医疗业务系统之间进行数据传输,为进一步扩展为区域范围的医疗信息平台提供基础。
本论文通过对国内外电子健康档案的研究现状的分析,归纳总结了居民电子健康档案系统的主要功能和需求,设计了居民电子健康档案系统核心的业务流程；基于MVC模式和J2EE平台下,对电子健康档案系统进行了详细设计与实现。同时介绍了HL7(Health Level7)标准的基本原理；通过分析HL7规范文档,利用HL7RIM模型描述系统中建档信息,建立了一套可行的HL7消息构建和解析的实现模型,并且运用Web Services技术构建了HL7引擎应用于系统子模块中。
With the development of social economic development and living standards, the people make higher demands on health services [1]. Chinese new medical reform program is to create a practical, shared medical and health information platform. It is an unprecedented opportunity for the construction of health information, and to build regional health information system with electronic health record as a core is an important direction for health information.
Based on this background, the paper builds the electronic health record system which is based on the HL7standard. Electronic health record system can not only provide residents with complete personal health information, but also provides a wealth of clinical data source for medical personnel [2]. The introduction of the HL7standard not only make the system exchange data with external agencies,such as the medical insurance system, medical business systems, and so on, but also provide a basis for health information platform to further expand the regional extent.
After analyzing the state of the field of electronic health record at home and abroad, this paper summarizes the main features and requirements of the electronic health record system, designs the business processes of this system, paper makes detailed design and implementation of electronic health record system using MVC model and J2EE platform. At the same time, this paper introduces the basic principles of the HL7(Health Level7) standard, describes the archiving information of this system using the HL7RIM model through analysis of the HL7specification documents, establishes an implementing model of constructing and parsing a feasible set of HL7message, and builds HL7engine applied in the sub module of the system after using Web Services technology.
引文
[1]李庆颖.健康信息云服务中心的设计与实现研究[硕士论文].广州：华南理工大学.2011.
[2]张修研.国内外健康档案研究境况[J].信息研究.2012.34(3)：236-238.
[3]吴思静,郭清.国内外电子健康档案的应用现状与发展困境[J].社区卫生工作平台.2011.14(1B)226-228.
[4]李新伟,黄薇,郭珉江.我国电子健康档案发展现状及对策研究[J].中国医院管理2011.10(30)：26-27.
[5]李君,郭幽燕.基于HL7标准的居民健康档案研究[J].北京生物医学工程.2011,30(5)：516-520.
[6]HL7 V3 [DB/OL]. http://www.hl7.org/.
[7]HL7中国委员会[DB/OL].http://www.h17china.com.cn/.
[8]李祥.基于Web的网络文件管理系统的研究与实现[硕士论文].兰州：兰州大学.2010.
[9]刘思彤.基于MVC架构新闻门户网站设计与实现[硕士论文].长春：吉林大学.2011.
[10]马文泉.社区卫生服务信息系统的设计与实现[硕士论文].济南：山东大学.2009.
[11]豆豆网.什么是SSH[DB/OL].http://www.ddvip.com/mc/server/5094.html
[12]师成虎.XML在电子病历中的应用[J].中华现代医院管理杂志.2007.5(4)：40-42.
[13]EDI/HL7 Security including XML Security Solutions [DB/OL]. http://www.hl7.de/veranstahtungen/kongress/iajm2000/bhobeh. pdf.
[14]宇文姝丽,郑兴辉,杨小平.基于HL7的电子病历开发研究[J].中国数字医学.2011.6(5)：24-26.
[15]刘玉兵.基于HL7标准的电子病历信息数据交换研究[J].信息与电脑.2010.(10)：124-125.
[16]R.SNELICK,P.RONTEY,L.GEBASE,et al. Towards interoperable healthcare information systems:The HL7 conformance profile approach [DB/OL]. http://www.itl.nist.gov/div897/ctg/messagemaker/papers/IESA2007.rsnelick.pdf.
[17]Lopez Diego M.,Blobel Bernd G.M.E.development framework for semantically interoperable health information sy stems [J]. International Journal of Medical Informatics,2009,78(2):83-103.
[18]Yun Ji Hyun, Kim Kon.Processing HL7-CDA entry for semantic interoperability[A].2nd International Conference on Convergent Information Technology,ICCIT 07[C].United States: Inst.of Elec.and Elec.Eng.Computer Society,2007:1939-1944
[19]蒋巍巍,王海舜,汪齐舜.面向健康体检信息共享的HL7接口引擎设计[J].医学信息.2009.22(9)：1701-1703.
[20]刘刚,吴翔虎,曲明成,陈超,郝晶晶.HL7在HIS系统中的应用研究[J].医院数字化.2011.26(2)：43-48.
[21]Mehmood Yasir,Javed Muhammad Younus.Afzal Muhammad,et al.Efficient metadata loading algorithm for generation and parsing of health level 7 version 3 messages[A].2009 International Conference on Emerging Technologies,ICET 2009[C].Pakistan:IEEE Computer Society,2009:315-320.
[22]刘英.基于Axis和Java的Web服务在EAI中的应用研究[硕士论文].兰州：西北师范大学.2007.
[23]郑楠.基于SOA的Web服务在B2B中的应用与研究[硕士论文].大连：大连海事大学.2008.
[24]Web Service Architecture(2004-2011)[DB/OL].from http://www.w3.org/TR/ws-arch.
[25]徐宏发,王卫平,郑建煌,温才学.基于HL7和Web Services的区域医疗机构间信息交换平台研究[J].计算机应用与软件.2007.24(3)：88-90.
[26]中华人民共和国卫生部.基于健康档案的区域卫生信息平台建设指南(试行).卫办发(2009]46号.2011.
[27]宿希龙.潍坊市新型农村合作医疗信息系统的设计与实现[硕士论文].山东：山东大学.2008.
[28]Best Design Practice for HL7 Interfaces [DB/OL]. http://www. interfaceware.com/manual/design. html.
[29]董启明.医院信息系统的设计与实现[硕士论文].济南：山东大学.2010.
[30]胡永辉.基于HL7的医疗信息系统研究[硕士论文].西安：西安电子科技大学.2006.
[31]Health Level Seven Security Services Framework [DB/OL]. http://www.h17.org/library/committees/secure/HL7_Sec. html.
[32]陈文斌.基于HL7引擎的远程医疗系统的设计与实现[硕士论文].上海：复旦大学.2011.
[33]Janjua Naeem Khalid,Hussain Maqbool Afzal.et al.Digital health care ecosystem:SOA compliant HL7 based health care information interchange[A].2009 3rd IEEE International Conference on Digital Ecosystems and Technologies,DEST'09[C].United States:IEEE Computer Society,2009:329-334.
[34]Cheng P.H.,Yang C.H.,Chen H.S.,et al.Application of HL7 in a collaborative healthcare information system[A].Conference Proceedings-26th Annual international Conference of the IEEE Engineering in Medicine and Biology Society,EMBC 2004[C].United States:institute of Electrical and Electronics Engineers Inc,2004:3354-3357.
[35]Thompson, S. M. and Dean, M. D.2009. Advancing information technology in health care. Commun. ACM 52,6 (Jun.2009),118-121.
[36]ISO/HL7 27931:2009,Data Exchange Standards--Health Level Seven Version 2.5-an application protocol for electronic data exchange in healthcare environments[S].
[37]Boqiang LIU,Xiaomei LI,Zhongguo LIU,et al.Design and Implementation of information exchange between HIS and PACS Based on HL7 standard[A].The 5th International Conference on Information Technology and Application in Biomedicine[C].United States:Inst.of Elec.and Elec.Eng.Computer Society,2008,552-555.
[38]Syckle DEV,Gaeta JM.Successful integration between information systems and imaging systems-integrating the healthcare enterprise(IHE)[A].Proceedings of case 2000[C].San Francisco:Lemke HU.2000:377-382.
[39]贾玮.基于HL7标准的医疗信息交换关键技术研究[硕士论文].广州：南方医科大学.2009.
[40]刘颖慧,郑建立,谢秀秀,廖芸,张君玲.HL7引擎设计及实现方案[J].微计算机信息.2010.26(11-1)：185-187.
[2]张修研.国内外健康档案研究境况[J].信息研究.2012.34(3)：236-238.
[3]吴思静,郭清.国内外电子健康档案的应用现状与发展困境[J].社区卫生工作平台.2011.14(1B)226-228.
[4]李新伟,黄薇,郭珉江.我国电子健康档案发展现状及对策研究[J].中国医院管理2011.10(30)：26-27.
[5]李君,郭幽燕.基于HL7标准的居民健康档案研究[J].北京生物医学工程.2011,30(5)：516-520.
[6]HL7 V3 [DB/OL]. http://www.hl7.org/.
[7]HL7中国委员会[DB/OL].http://www.h17china.com.cn/.
[8]李祥.基于Web的网络文件管理系统的研究与实现[硕士论文].兰州：兰州大学.2010.
[9]刘思彤.基于MVC架构新闻门户网站设计与实现[硕士论文].长春：吉林大学.2011.
[10]马文泉.社区卫生服务信息系统的设计与实现[硕士论文].济南：山东大学.2009.
[11]豆豆网.什么是SSH[DB/OL].http://www.ddvip.com/mc/server/5094.html
[12]师成虎.XML在电子病历中的应用[J].中华现代医院管理杂志.2007.5(4)：40-42.
[13]EDI/HL7 Security including XML Security Solutions [DB/OL]. http://www.hl7.de/veranstahtungen/kongress/iajm2000/bhobeh. pdf.
[14]宇文姝丽,郑兴辉,杨小平.基于HL7的电子病历开发研究[J].中国数字医学.2011.6(5)：24-26.
[15]刘玉兵.基于HL7标准的电子病历信息数据交换研究[J].信息与电脑.2010.(10)：124-125.
[16]R.SNELICK,P.RONTEY,L.GEBASE,et al. Towards interoperable healthcare information systems:The HL7 conformance profile approach [DB/OL]. http://www.itl.nist.gov/div897/ctg/messagemaker/papers/IESA2007.rsnelick.pdf.
[17]Lopez Diego M.,Blobel Bernd G.M.E.development framework for semantically interoperable health information sy stems [J]. International Journal of Medical Informatics,2009,78(2):83-103.
[18]Yun Ji Hyun, Kim Kon.Processing HL7-CDA entry for semantic interoperability[A].2nd International Conference on Convergent Information Technology,ICCIT 07[C].United States: Inst.of Elec.and Elec.Eng.Computer Society,2007:1939-1944
[19]蒋巍巍,王海舜,汪齐舜.面向健康体检信息共享的HL7接口引擎设计[J].医学信息.2009.22(9)：1701-1703.
[20]刘刚,吴翔虎,曲明成,陈超,郝晶晶.HL7在HIS系统中的应用研究[J].医院数字化.2011.26(2)：43-48.
[21]Mehmood Yasir,Javed Muhammad Younus.Afzal Muhammad,et al.Efficient metadata loading algorithm for generation and parsing of health level 7 version 3 messages[A].2009 International Conference on Emerging Technologies,ICET 2009[C].Pakistan:IEEE Computer Society,2009:315-320.
[22]刘英.基于Axis和Java的Web服务在EAI中的应用研究[硕士论文].兰州：西北师范大学.2007.
[23]郑楠.基于SOA的Web服务在B2B中的应用与研究[硕士论文].大连：大连海事大学.2008.
[24]Web Service Architecture(2004-2011)[DB/OL].from http://www.w3.org/TR/ws-arch.
[25]徐宏发,王卫平,郑建煌,温才学.基于HL7和Web Services的区域医疗机构间信息交换平台研究[J].计算机应用与软件.2007.24(3)：88-90.
[26]中华人民共和国卫生部.基于健康档案的区域卫生信息平台建设指南(试行).卫办发(2009]46号.2011.
[27]宿希龙.潍坊市新型农村合作医疗信息系统的设计与实现[硕士论文].山东：山东大学.2008.
[28]Best Design Practice for HL7 Interfaces [DB/OL]. http://www. interfaceware.com/manual/design. html.
[29]董启明.医院信息系统的设计与实现[硕士论文].济南：山东大学.2010.
[30]胡永辉.基于HL7的医疗信息系统研究[硕士论文].西安：西安电子科技大学.2006.
[31]Health Level Seven Security Services Framework [DB/OL]. http://www.h17.org/library/committees/secure/HL7_Sec. html.
[32]陈文斌.基于HL7引擎的远程医疗系统的设计与实现[硕士论文].上海：复旦大学.2011.
[33]Janjua Naeem Khalid,Hussain Maqbool Afzal.et al.Digital health care ecosystem:SOA compliant HL7 based health care information interchange[A].2009 3rd IEEE International Conference on Digital Ecosystems and Technologies,DEST'09[C].United States:IEEE Computer Society,2009:329-334.
[34]Cheng P.H.,Yang C.H.,Chen H.S.,et al.Application of HL7 in a collaborative healthcare information system[A].Conference Proceedings-26th Annual international Conference of the IEEE Engineering in Medicine and Biology Society,EMBC 2004[C].United States:institute of Electrical and Electronics Engineers Inc,2004:3354-3357.
[35]Thompson, S. M. and Dean, M. D.2009. Advancing information technology in health care. Commun. ACM 52,6 (Jun.2009),118-121.
[36]ISO/HL7 27931:2009,Data Exchange Standards--Health Level Seven Version 2.5-an application protocol for electronic data exchange in healthcare environments[S].
[37]Boqiang LIU,Xiaomei LI,Zhongguo LIU,et al.Design and Implementation of information exchange between HIS and PACS Based on HL7 standard[A].The 5th International Conference on Information Technology and Application in Biomedicine[C].United States:Inst.of Elec.and Elec.Eng.Computer Society,2008,552-555.
[38]Syckle DEV,Gaeta JM.Successful integration between information systems and imaging systems-integrating the healthcare enterprise(IHE)[A].Proceedings of case 2000[C].San Francisco:Lemke HU.2000:377-382.
[39]贾玮.基于HL7标准的医疗信息交换关键技术研究[硕士论文].广州：南方医科大学.2009.
[40]刘颖慧,郑建立,谢秀秀,廖芸,张君玲.HL7引擎设计及实现方案[J].微计算机信息.2010.26(11-1)：185-187.