輔仁大學
醫學資訊與創新應用學士學位學程
醫療標準及術語
臺北市立聯合醫院仁愛院區家庭醫學科 郭冠良
Kuan-Liang Kuo, M.D., Ph.D.
2022-02-22
個人簡歷
• 學歷
– 國立台灣大學資訊工程研究所博士 – 國立陽明醫學院醫學士
• 現任
– 臺北市立聯合醫院仁愛院區家庭醫學科主任 – 國立陽明大學生醫資訊所兼任助理教授
– 輔仁大學醫資學程兼任助理教授
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課程資料
• http://www.csie.ntu.edu.tw/~d93009/scholar.php
課程進行方式
• Lecture
• Discussion
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成績計算方式
• Class attendance: 20%
• Class participation: 10%
• Midterm exam: 30%
• Final exam: 30%
• Homework: 10%
課程表
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Date Topic Teacher
2/22 Introduction 郭冠良
3/1 Overview of Medical Standard
and Terminologies 邱瑞科
3/8 HL7 邱瑞科
3/15 HL7 邱瑞科
3/22 HL7 邱瑞科
3/29 CDA / FHIR 邱瑞科
4/5 放假
4/12 LOINC 邱瑞科
4/19
Introduction to TMT’s EMR Framework and Structure Case Study Report (By student group)
邱瑞科
4/26 期中考 邱瑞科
課程表
Date Topic Teacher
5/3 EMR 郭冠良
5/10 EMR 郭冠良
5/17 ICD 郭冠良
5/24 CDSS 郭冠良
5/31 CDSS 郭冠良
6/7 CDSS 郭冠良
6/14 W3C standards applicable to
Health Care 郭冠良
6/21 期末考 郭冠良
Electronic Medical Records (EMR)
• Meaningful Use
• MIPS (Merit Based Incentive Payment System)
• Information System Development
• Hospital Information System
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Meaningful Use (2010~)
MIPS (2015~)
• MIPS harmonizes existing CMS quality programs
– Meaningful Use
– Physician Quality Reporting System – Value-Based Payment Modifiers.
• MIPS consolidates multiple, quality programs into a single program to improve quality care
https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use 10
MIPS (2015~)
• The Four Pillars of MIPS Reporting
• Using Certified EHR Technology
Electronic Medical Records (EMR)
• Clinical Document Architecture (CDA)
– XML
• 電子簽章
– 以「非對稱型」密碼技術的數位簽章
• 衛福部已公告六類電子病歷交換單張標準
– 醫療影像及報告 – 出院病摘
– 血液檢驗
– 門診用藥紀錄 – 門診病歷
– 健康檢查報告 (不須上傳)
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廣義的HIS
RIS
LIS
ERP
PACS
CPOE
Clients
HIS
Signature/Verification Principle
Public Key Encryption and Digital Signature: How do they work? 14
2004 by CGI Group Inc.
產生電子病歷
LIS PACS
Gateway:
•XML
•Signature
EEC EMR
Data source 醫療影像及報告
出院病摘 血液檢驗 門診用藥紀錄
門診病歷
International Classification of Diseases (ICD)
• ICD-9
• ICD-10
– Struck By Turtle (W59.22XA) – Fecal Urgency (R15.2)
– Spacecraft collision injuring occupant (V95.43XS)
– Swimming pool of prison as the place of occurrence of the external cause (Y92.146)
– Pecked by chicken, initial encounter (W61.33XA) – Burn due to water-skis on fire, initial encounter
(V91.07XA)
– Art gallery as the place of occurrence of the external cause (Y92.250)
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Clinical Decision Support System (CDSS)
• Provide physicians and other health
professionals with clinical decision support (CDS), that is, assistance with clinical
decision-making tasks
• Link health observations with health
knowledge to influence health choices by clinicians for improved health care
• CDSSs constitute a major topic in artificial
Clinical Decision Process
Gotzsche, Peter.
Rational Diagnosis and Treatment:
Evidence-Based Clinical Decision-
Making. 4th Ed. Willey.
W3C Standard
• W3C standards define an Open Web Platform for application development that has the unprecedented potential to enable developers to build rich interactive experiences, powered by vast data stores, that are
available on any device.
• Although the boundaries of the platform continue to evolve, industry leaders speak nearly in unison about how HTML5 will be the cornerstone for this platform.
But the full strength of the platform relies on many more technologies that W3C and its partners are creating,
including CSS, SVG, WOFF (Web Open Font Format), the Semantic Web stack, XML, and a variety of APIs.
Welcome
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