基于第三方病历管理的电子病案浏览系统的研究与设计
摘要
电子病历(EMR)作为数字化医院中“含金量”最高的部分，目前已经引起国际上越来越多的厂商和专家的重视。在发达国家，象美国、日本，许多大学、研究机构、厂商纷纷投入这一领域的研究工作。与此相关，也成立了各种民间的和政府的标准化机构开展这方面的标准制订工作。政府部门也积极参与到这一进程中来，采取各种行动推动电子病历的发展。由于电子病历涉及医院信息化的方方面面，具有高度复杂性，对电子病历也缺乏完整统一的认识，所以，尽管在不同的方面均取得了各种进展，但完整的电子病历系统尚没有建立起来。在国内，越来越多的人开始认识到电子病历的重要性。
本课题主要是结合HL7标准、DICOM标准，构架B／S架构的电子病历浏览器，以医学影像为例说明如何将非文本病历信息与文本式病历信息相融合为用户提供阅览功能。并针对当前的法律法规等现实问题，提出一个为第三方病历管理机构用来为病人建立一个终生的电子病案的设计思路。另外，本课题还由国际标准与我国国情之间的矛盾，提出要想更好的利用国际标准，必须将国际标准本地化。
本课题是以．NET作为平台，以XML文件作为数据源来实现的。
As a most important role in the digitalized hospitals, the Electronic Medical Record (EMR) now has been getting more and more attentions of the international manufacturers and experts.
In the developed country, such as US and Japan, many universities, research institute and the manufacturers are all devoting into the research work.
Correlatively, there also have been established standardization organizations both of government and non-government to establish the standards in this field.
The governmental department also participates positively in this course, taking various actions to promote the development of the electronic medical record.
Because the electronic medical record involves all aspects of the hospital information and itself has highly complexity and also there isn't any common understanding of the electronic medical record, although progress has been made in the different aspects, the integrated electronic medical record system has not established yet.
In domestic, more and more people have realized the importance of the electronic medical record.
This paper mainly explains how to integrate the non-text medical record information with the text medical record information and provides the reading functions to the users, which unifies the HL7 standard, the DICOM standard, trusses electronic medical record browser of B/S construction, and takes the medicine images as the example.
And it also proposed a designing method for the third party medical record management institute to establish a life-long EMR aiming at the practical issues such as current laws and regulations.
In addition, this paper also discussed the conflict between the international standard and our national situation. And table a proposal that if we want to utilize the international standard better, we should make it localization.
This paper takes .NET as the platform and the XML document as the data source.
本课题主要是结合HL7标准、DICOM标准，构架B／S架构的电子病历浏览器，以医学影像为例说明如何将非文本病历信息与文本式病历信息相融合为用户提供阅览功能。并针对当前的法律法规等现实问题，提出一个为第三方病历管理机构用来为病人建立一个终生的电子病案的设计思路。另外，本课题还由国际标准与我国国情之间的矛盾，提出要想更好的利用国际标准，必须将国际标准本地化。
本课题是以．NET作为平台，以XML文件作为数据源来实现的。
As a most important role in the digitalized hospitals, the Electronic Medical Record (EMR) now has been getting more and more attentions of the international manufacturers and experts.
In the developed country, such as US and Japan, many universities, research institute and the manufacturers are all devoting into the research work.
Correlatively, there also have been established standardization organizations both of government and non-government to establish the standards in this field.
The governmental department also participates positively in this course, taking various actions to promote the development of the electronic medical record.
Because the electronic medical record involves all aspects of the hospital information and itself has highly complexity and also there isn't any common understanding of the electronic medical record, although progress has been made in the different aspects, the integrated electronic medical record system has not established yet.
In domestic, more and more people have realized the importance of the electronic medical record.
This paper mainly explains how to integrate the non-text medical record information with the text medical record information and provides the reading functions to the users, which unifies the HL7 standard, the DICOM standard, trusses electronic medical record browser of B/S construction, and takes the medicine images as the example.
And it also proposed a designing method for the third party medical record management institute to establish a life-long EMR aiming at the practical issues such as current laws and regulations.
In addition, this paper also discussed the conflict between the international standard and our national situation. And table a proposal that if we want to utilize the international standard better, we should make it localization.
This paper takes .NET as the platform and the XML document as the data source.
引文
1．朱海城，陈泽雄，简守维：“医疗资讯系统之前瞻性—以电子病历为例”(http://www.itis.org.tw/forum/content3/01if28d.htm)。
2．秦笃烈：“数字化医院国际发展状况扫描”。计算机世界报第25期C15、C16。
3．林国红，舒权：“谈我国医院数字化建设”，医药与计算机2001年第2—3期。
4．陈啸宏：“加强领导，明确目标，加快卫生信息化建设步伐，为卫生改革与发展服务”，2002年10月25日在全国卫生信息化工作会议上的工作报告。
5. Extensible Markup Language(XML)1.0(Second Edition)。
6．李包罗，夏京辉：“医学信息标准化：在热潮中冷静思考”，中国计算机用户——赛迪网。
7．DICOM PS3.0版本
8．HL7 V2.3.1版本
9. CDA. Release Two. ClevelandDraft. April23. 2003
10. Michio Kimura, Kazuhiko Ohe, Hiroyuki Yoshihara, et al., 51(1998)59-68, "MERIT-9: a patient information exchange guideling using MML, HL7 and DICOM", International Journal of Medical Informatics。
11．《电子病案—21世纪医疗的变革》。原著者：(日)里村洋一等。译者：李恩生、徐国桓等。
12．《医学信息学》。主编：J．H．Van Bemmel(荷兰)、M．A．Musen(美国)。译者：包含飞、郑学侃。
13．何斌，金永杰：“DICOM医学图像文件格式”，世界医疗器械，2001年1月。
14．张凯，吕扬生：“DICOM标准及应用讲座”，世界医疗器械。
15．陈浩，王敏，刘彤：“新技术在电子病历中的应用”，第九届全国医药信息学大会CMIA'02论文集。
16. Vishal Wanchoo, Charles Parisot: "What does IHE do for ME?", Kadiographics magazine, the July, 2002。
17．彭文波：“文档电子签名全接触”，微电脑世界，2002年第2期。
18．孙一民，柴军英：“电子病历加密技术探讨”，医学信息2002年12
月第15卷第12期。
19．程渝荣教授：“后关系型数据库技术”。http://www.pcworld.com.cn/2001/back issues/2012/1231.asp。
20．中华人民共和国卫生部《医院信息系统基本功能规范》。
2．秦笃烈：“数字化医院国际发展状况扫描”。计算机世界报第25期C15、C16。
3．林国红，舒权：“谈我国医院数字化建设”，医药与计算机2001年第2—3期。
4．陈啸宏：“加强领导，明确目标，加快卫生信息化建设步伐，为卫生改革与发展服务”，2002年10月25日在全国卫生信息化工作会议上的工作报告。
5. Extensible Markup Language(XML)1.0(Second Edition)。
6．李包罗，夏京辉：“医学信息标准化：在热潮中冷静思考”，中国计算机用户——赛迪网。
7．DICOM PS3.0版本
8．HL7 V2.3.1版本
9. CDA. Release Two. ClevelandDraft. April23. 2003
10. Michio Kimura, Kazuhiko Ohe, Hiroyuki Yoshihara, et al., 51(1998)59-68, "MERIT-9: a patient information exchange guideling using MML, HL7 and DICOM", International Journal of Medical Informatics。
11．《电子病案—21世纪医疗的变革》。原著者：(日)里村洋一等。译者：李恩生、徐国桓等。
12．《医学信息学》。主编：J．H．Van Bemmel(荷兰)、M．A．Musen(美国)。译者：包含飞、郑学侃。
13．何斌，金永杰：“DICOM医学图像文件格式”，世界医疗器械，2001年1月。
14．张凯，吕扬生：“DICOM标准及应用讲座”，世界医疗器械。
15．陈浩，王敏，刘彤：“新技术在电子病历中的应用”，第九届全国医药信息学大会CMIA'02论文集。
16. Vishal Wanchoo, Charles Parisot: "What does IHE do for ME?", Kadiographics magazine, the July, 2002。
17．彭文波：“文档电子签名全接触”，微电脑世界，2002年第2期。
18．孙一民，柴军英：“电子病历加密技术探讨”，医学信息2002年12
月第15卷第12期。
19．程渝荣教授：“后关系型数据库技术”。http://www.pcworld.com.cn/2001/back issues/2012/1231.asp。
20．中华人民共和国卫生部《医院信息系统基本功能规范》。