CAJ | 학술논문

临床文档共享是整合医院内部异构系统、构建临床数据中心和实现信息集成的重要手段.结合HL7 CDA文档架构和国家相关数据标准以及规范,对临床文档的结构和语义进行标准化和本地化定义,支持异构系统之间临床文档的互操作,并基于IHE XDS文档共享模式进一步实现跨系统临床文档交互,提高临床质量.最后对结构化临床文档的数据可用性以及科研检索、数据安全性和保密性等进行初步讨论.
림상문당공향시정합의원내부이구계통、구건림상수거중심화실현신식집성적중요수단.결합HL7 CDA문당가구화국가상관수거표준이급규범,대림상문당적결구화어의진행표준화화본지화정의,지지이구계통지간림상문당적호조작,병기우IHE XDS문당공향모식진일보실현과계통림상문당교호,제고림상질량.최후대결구화림상문당적수거가용성이급과연검색、수거안전성화보밀성등진행초보토론.
Exchange and Sharing of clinical documents is the important means of integrating the heterogeneous information system from internal hospital, constructing the Clinical Data Repository and realizing information integration. We use the HL7 CDA related with the national data standards and specifications, so the structure and semantics of clinical documents can be better defined from the specification of standardization and localization. It can then support the interoperability between clinical documents from heterogeneous systems. At this point in the IHE XDS Model, to further integrate and realize the document sharing, improving medical quality based on the construction method. Finally, we primarily discuss data availability and scientific research retrieval, data security and privacy for structured clinical documents.