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

Det finns ett behov av användarvänliga, anpassningsbara och tillgängliga journalsystem inom en variation av branscher. Befintliga system har visat sig vara bristfälliga inom dessa tre aspekter. Bristerna bottnar i att systemen sällan är anpassade för det specifika ändamålet, vilket i många fall grundar sig i att slutanvändarna inte varit med i utvecklingsprocessen. När användare har implementerat befintliga journalsystem inom sina verksamheter har även bristfälligheter gällande tillgänglighet påvisats. På den utvecklade journalsystemprototypen som arbetet resulterade i, utfördes ett antal tester av uppdragsgivarens anställda. Dessa tester påvisade att prototypens användarvänlighet, anpassningsbarhet och tillgänglighet uppnådde de krav som företaget hade på ett journalsystem. Prototypen har, trots det positiva resultatet, fortfarande utvecklingspotential och områden att förbättra. / There is a need for user-friendly, customizable and accessible record systems in a variety of industries. Existing systems have proven to be deficient in these three aspects. The shortcomings are due to the fact that the systems are seldom adapted for the specific purpose, which in many cases is a consequence of the end users not being involved in the development process. When users have implemented existing journal systems within their operations, deficiencies regarding accessibility have also been identified. On the developed record system prototype that the work resulted in, a number of tests were performed by the client's employees. These tests showed that the user-friendliness, adaptability and availability of the prototype met the requirements of the company for a record system. Despite the positive result, the prototype still has development potential and areas for improvement.

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.

Com a rápida evolução tecnológica e o crescimento da aplicação de novas tecnologias digitais na educação - em especial em cursos a distância - o mais importante tem sido a criação de novos ambientes de aprendizagem que estimulam a interatividade, desenvolvem a capacidade de formular, de resolver questões e, acima de tudo, possibilitam a participação de forma colaborativa, embora estando fisicamente distante. A idéia de uma escola \"expandida\" visa atender a diversas áreas de ensino, entre elas a necessidade de treinamentos no setor corporativo para os profissionais que já estão no mercado de trabalho, a formação escolar para jovens e adultos que enfrentam dificuldades pela distância ou indisponibilidade de horário, ou mesmo a qualificação docente em grande demanda por aperfeiçoamento. Para atingir um nível bom de participação em encontros virtuais, faz-se necessário contar com tecnologias de comunicação e informação que medeiam a interação entre os envolvidos no processo de ensino. Afinal, a aprendizagem, que não é apenas individual mas coletiva, se baseia na convivência entre os participantes, na troca de informações entre eles. Quando um conteúdo é ministrado a distância, por meio da Internet, em videoconferência, permite-se criar um espaço ideal para uma colaboração distribuída. Por conta dessa necessidade, este trabalho apresenta um ambiente que oferece a comunicação por vídeo, voz e texto, para aulas ao vivo entre vários participantes, cuja participação é controlada pelo moderador, ao mesmo tempo em que conta com um sistema de registro de atividades para interação assíncrona. Além do ambiente desenvolvido, o trabalho introduz um breve estudo de conceitos envolvidos na videoconferência, as tecnologias disponíveis, bem como as utilizadas para o desenvolvimento deste projeto. Alguns resultados foram obtidos após realização de testes e utilização do ambiente, tal como a análise de desempenho a partir dos recursos disponíveis na rede. / With the fast technological evolution and the growth of the new digital technologies application in the education, in special in long-distance education courses is observed that the majority of these courses has favored great parcel of people. The most important it has been the creation of new learning environment that stimulates the participation, developing the capacity to formulate, to decide questions and all above of everything participating in a collaborative way. The idea of a expanded school aims at to take care of diverse areas of education, between them the necessity of training in the corporative sector for the professionals who already are in the work market, the formation pertaining to school for young and adult that faces difficulties for the distance or non-availability of schedule or the teaching qualification in great demand for perfectioning. A learning that is not only individual, but collective, is basead on the relationship between the participants, in the exchange of information between them. Therefore, in the long-distance education makes necessary the communication technologies and information that measured the interaction between the involved education process. When a content is given in the distance, by means of the Internet, video conferencing and video lessons, is allowed to create an ideal space for the distributed contribution. For this necessity, this work show an environment for lessons live between some participants, that offers the communication by video, voice and text. The participation is controlled by moderator, being able to be a professor or the person that give a lecture. Contains also a system of register of activities for asynchronous interaction. Beyond the developed environment, the work introduces a briefing study of involved concepts in the video conferencing, the available technologies, as well as the used ones for the development of this project. Some results had been gotten after accomplishment of tests, allowing to verify different performances depending on the available resources in the net.

Com a rápida evolução tecnológica e o crescimento da aplicação de novas tecnologias digitais na educação - em especial em cursos a distância - o mais importante tem sido a criação de novos ambientes de aprendizagem que estimulam a interatividade, desenvolvem a capacidade de formular, de resolver questões e, acima de tudo, possibilitam a participação de forma colaborativa, embora estando fisicamente distante. A idéia de uma escola \"expandida\" visa atender a diversas áreas de ensino, entre elas a necessidade de treinamentos no setor corporativo para os profissionais que já estão no mercado de trabalho, a formação escolar para jovens e adultos que enfrentam dificuldades pela distância ou indisponibilidade de horário, ou mesmo a qualificação docente em grande demanda por aperfeiçoamento. Para atingir um nível bom de participação em encontros virtuais, faz-se necessário contar com tecnologias de comunicação e informação que medeiam a interação entre os envolvidos no processo de ensino. Afinal, a aprendizagem, que não é apenas individual mas coletiva, se baseia na convivência entre os participantes, na troca de informações entre eles. Quando um conteúdo é ministrado a distância, por meio da Internet, em videoconferência, permite-se criar um espaço ideal para uma colaboração distribuída. Por conta dessa necessidade, este trabalho apresenta um ambiente que oferece a comunicação por vídeo, voz e texto, para aulas ao vivo entre vários participantes, cuja participação é controlada pelo moderador, ao mesmo tempo em que conta com um sistema de registro de atividades para interação assíncrona. Além do ambiente desenvolvido, o trabalho introduz um breve estudo de conceitos envolvidos na videoconferência, as tecnologias disponíveis, bem como as utilizadas para o desenvolvimento deste projeto. Alguns resultados foram obtidos após realização de testes e utilização do ambiente, tal como a análise de desempenho a partir dos recursos disponíveis na rede. / With the fast technological evolution and the growth of the new digital technologies application in the education, in special in long-distance education courses is observed that the majority of these courses has favored great parcel of people. The most important it has been the creation of new learning environment that stimulates the participation, developing the capacity to formulate, to decide questions and all above of everything participating in a collaborative way. The idea of a expanded school aims at to take care of diverse areas of education, between them the necessity of training in the corporative sector for the professionals who already are in the work market, the formation pertaining to school for young and adult that faces difficulties for the distance or non-availability of schedule or the teaching qualification in great demand for perfectioning. A learning that is not only individual, but collective, is basead on the relationship between the participants, in the exchange of information between them. Therefore, in the long-distance education makes necessary the communication technologies and information that measured the interaction between the involved education process. When a content is given in the distance, by means of the Internet, video conferencing and video lessons, is allowed to create an ideal space for the distributed contribution. For this necessity, this work show an environment for lessons live between some participants, that offers the communication by video, voice and text. The participation is controlled by moderator, being able to be a professor or the person that give a lecture. Contains also a system of register of activities for asynchronous interaction. Beyond the developed environment, the work introduces a briefing study of involved concepts in the video conferencing, the available technologies, as well as the used ones for the development of this project. Some results had been gotten after accomplishment of tests, allowing to verify different performances depending on the available resources in the net.

M. Tech. (Department of Process Control and Computer System, Faculty of Engineering and Technology), Vaal University of Technology. / Personal health record system (PHRS) is a tool that is used in maintaining the health and wellness of an individual as well as helping with illness of an individual. PHRS gives the individual access to a wide range of credible health information, data, and knowledge. Individuals can use that access to improve their health and manage their diseases. Patients with chronic illness can track and manage their health in conjunction with their health provider, this will promote early intervention when they encounter an abnormality or complications. Continuous monitoring and storing of health information has been a challenge for patients and health providers. Personal health data monitoring and retrieval system for health providers was designed and implemented. The main aim of this study was to develop an accurate, secure and flexible personal health data monitoring and retrieval system for health providers (PHRS). This was achieved. The research showed that when a patient health information (Electrocardiogram (ECG) and temperature) was monitored, the heartbeat (ECG) sensor output the value as an analog value to the signal processing (NodeMCU) which was then converted to a digital value. The temperature sensor used in this research is a digital sensor which lowers the amount of ADC conversion that was done. The digital values are displayed on LCD, its send to a personal health data storage system which was designed for health information storage purposes. It also sends the value to a retrieval system which is an android application that is connected to the data storage system to display health information to the health providers from a remote location. Personal health data storage and the retrieval system are secure due to the Message queuing telemetry transport (MQTT) protocol used in the application layer. The MQTT protocol is secure due to the secure socket layer (SSL) which is an encryption based on presentation layer embedded inside the MQTT protocol. After the comparison of the software simulation and the prototype test, the differences in the value for the heartbeat and temperature sensor indicate 0.04 BPM and 0.04 oC which shows the accuracy of the sensing circuit. Personal health data monitoring and retrieval system developed is applicable and useful to multiple entities in and around South Africa such as; Ministry of health, hospitals, sport and recreations.