Electronic medical records, in addition contributing to a hospital¡¦s overall electronic development and moving towards a paperless environment, also allow hospitals to share electronic medical information. To solve the problem of different medical information systems that hamper information sharing, the Executive Yuan Heath Department Commission has requested the assistance of the Taiwan Association for Medical Information to establish a standard Electronic Medical Record Template, in hopes that there is a national unified Electronic Medical Record Template that also uses the international medical information standard, so that all hospital¡¦s information is accessible, allowing for easy sharing of electronic medical records. The administration department also supports in recommending and creating related steps of incentive, to encourage professional electronic medical record researchers making up a standard internet medical information exchange mechanism, with a goal of achieving national medical information exchange. Though the Executive Yuan Heath Department Commission had a nice scheme, but the standard Electronic Medical Record Template established by Taiwan Association for Medical Information is nothing more than a Form Structure Diagram what is far from the software architecture discipline. This research aims to re-define the electronic medical record system, adopting a software architecture modeling approach. Through Structure Element Diagram, Structure Element Service Diagram, Structure Behavior Coalescence Diagram, and Sequence Diagram as four gold rules, we are able to build up any electronic medical record system architecture. Besides providing medical information personnel a more definite electronic medical record system, this research aids hospitals quickly attain an effective electronic medical record system.

付記する学位プログラム名: デザイン学大学院連携プログラム / 京都大学 / 0048 / 新制・課程博士 / 博士(情報学) / 甲第22097号 / 情博第707号 / 新制||情||121(附属図書館) / 京都大学大学院情報学研究科社会情報学専攻 / (主査)教授 黒田 知宏, 教授 吉川 正俊, 教授 矢守 克也 / 学位規則第4条第1項該当 / Doctor of Informatics / Kyoto University / DFAM

Personalen som triagerar och placerar patienter på Södersjukhusets akutmottagning använder det digitala patientjournalsystemet TakeCare. TakeCare är ett hyllat journalsystem som används i hela Region Stockholm sedan 2013. Sjuksköterskorna som använder programmet upplever dock att det kan förbättras, särskilt när det gäller användargränssnittet för placeringen av nya patienter. Det nuvarande programmet saknar en tydlig överblick över akutmottagningens olika moduler och vårdlag, vilket försvårar sjuksköterskornas beslut om patientplacering. De behöver gå igenom varje modul för sig för att få en uppfattning om vårdbelastningen i varje modul. En prototyp för en beslutsstödjande webbapplikation med översiktlig information om belastning på varje modul skulle potentiellt kunna integreras i TakeCare och underlätta sjuksköterskornas process för placering av patienter. I denna studie skapades en webbapplikation som kan utvecklas vidare och eventuellt användas av sjukvårdspersonalen. Denna rapport bevisar att det finns förbättringspotential hos det nuvarande patientjournalsystemet och att ett beslutsstöd för placering av patienter skulle underlätta processen och förbättra vårdflödet. / The triage nurses that are responsible for the placement of patients at Södersjukhuset’s emergency department in Stockholm, Sweden, use the digital medical record system TakeCare. TakeCare is a renowned record system that has been used in Region Stockholm since 2013. However, the nurses using the system experience some difficulty, especially when it comes to the user interface when placing new patients. The current system lacks a clear overview of the emergency departments' many modules and healthcare teams, which makes it difficult to make decisions regarding the placement of incoming patients. The nurses are therefore forced to go through each module one by one to see the current strain in each team. A prototype for a decision-supporting web application with a clear overview of each module could potentially be integrated into the current medical record system and thus facilitate an easier placement process. A web application was made in this study and can eventually be used by the health care staff after further development. This report proves that there is potential for improvement for the current system and that a decision-making tool would improve the flow in the ED.