CN102760206A - System and method for sharing cross-regional medical image information - Google Patents
- ️Wed Oct 31 2012
CN102760206A - System and method for sharing cross-regional medical image information - Google Patents
System and method for sharing cross-regional medical image information Download PDFInfo
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- CN102760206A CN102760206A CN2012101950996A CN201210195099A CN102760206A CN 102760206 A CN102760206 A CN 102760206A CN 2012101950996 A CN2012101950996 A CN 2012101950996A CN 201210195099 A CN201210195099 A CN 201210195099A CN 102760206 A CN102760206 A CN 102760206A Authority
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Abstract
The invention discloses a system and method for sharing cross-regional medical image information. The system is mainly composed of three major components as follows: a regional medical image sharing platform, a short message authentication system and a medical image information storage device, wherein the regional medical image information sharing platform is composed of a document registration library, a distributed document storage library, a patient cross-indexing manager, an audit trail and node verification manager and a current medical mechanism PACS (Picture Archiving and Communication System) all of which are built in a special network; and an agent server is used for the calling outside the region. The medical image information storage device mainly comprises shared document submission collections, shared documents, key images, a shared document editor, a digital certificate and an image browsing software. The short message authentication system is used for guaranteeing legality of reading the medical image information outside the region. The system and method for sharing cross-regional medical image information, disclosed by the invention, have the advantages of avoiding printing of check reports and photographic films, saving examination cost for patients and avoiding repeated examination as the medical image information can be carried by a patient per se to be used in other medical mechanisms.
Description
Technical field
The present invention relates to a kind of trans-regional medical imaging information sharing method and system, belong to the information-based field of medical imaging.
Background technology
Medical industry development at present is unbalanced; Medical resource distributes and is structural disequilibrium; 80% high-quality medical resource concentrates on the big city large hospital; Checkout facilities such as high-end checkout facility such as high-end CT, nuclear magnetic resonance all concentrate on large hospital, so the medical imaging information sharing becomes the emphasis of China's health information construction development.Perfect medical imaging information sharing system can improve whole level of medical and health, and balance high-quality medical resource skewness solves and to see all over ugly all over expensive difficult problems such as rechecking.
The construction of trans-regional medical imaging information sharing platform is mainly proceeded in two phases, and the first step is to realize the collection of medical imaging information in the zone, storage, shared; Second step was the medical imaging message exchange between the trans-regional medical institutions of realization and shared.It is to confirm medical imaging message exchange standard that the first step realizes not having basically technical bottleneck, key, solves the standard and the unitarity of distinct device data transformation interface.Present most of area medical image information shared platform all adopts the IHE standard to build, and employing 100M or above bandwidth realize regional interior medical imaging exchange and shared.Second step built owing to be that central database in different aspects carries out data transmission and shares, and therefore mainly had following difficult point: 1, network bandwidth limitations.2, along with the checkout facility upgrading, medical imaging is often very big, and the trans-regional image of having access to can be very long in the transmission over networks time, and causing having access to speed can not satisfy the demands.3, the medical imaging shared platform is built and handling cost, and the medical imaging shared platform is often very big on the input of hardware and software, and for remote districts and low developed area financially is a very big expenditure.
Summary of the invention
The objective of the invention is to deficiency, a kind of trans-regional medical imaging information sharing system and method are provided to prior art.
The present invention adopts the IHE standard as medical imaging information sharing and exchange standard.IHE (Integrating The Healthcare Enterprise: medical treatment & health information integration standard); It is an international organization that forms by the medical and health industry expert; Be intended to through merging all kinds of HIT standards, realize that medical information is shared, the raising medical level.Since 1999 set up, form a plurality of IHE technological frames, solved (like radiology, angiocardiology, IT infrastructure) concrete compatibility issue in the every profession and trade.The integrated standard in IHE IT Infrastructure field that the present invention relates to mainly comprises: XDS (Cross-Enterprise Document Sharing) strides mechanism's document sharing; XDS-i (Cross-Enterprise Document Sharing for Imaging) strides mechanism's image documents and shares; PIX (Patient Identifier Cross-referencing) patient identifies cross-index; ATNA (Audit Trial and Node Authentication) audit-trail and node verification.
For the medical imaging information sharing in the zone, this method uses Web service to realize through making up systems such as document registration storehouse, distribution type file thesaurus, patient's cross-index manager, audit-trail and node verification manager; For extra-regional medical imaging information sharing; This method uses the XML form to encode medical imaging information sharing document based on the IHE standard; Export in the common storage medium together with shared document, crucial image, digital certificate, shared document editing machine, browsing image software etc.; Carried voluntarily and taken care of by the patient, the patient can use the note authentication code after the authentication legitimacy, to have access to audit report and crucial image in extra-regional medical institutions.For general diagnosis; Consult audit report and crucial image just can satisfy diagnostic requirements; For the particular diagnostic demand,, obtain shared document through acting server inquiry document registration storehouse and patient's cross-index manager and submit collection to through obtaining the medical imaging information in the shared document; According to submitting to collection information from the distributed storage storehouse, to obtain shared document, use WADO to have access to image then from the PACS system of medical institutions of correspondence.
System involved in the present invention comprises:
The medical imaging information-storing device; Be used to store shared document and submit collection, shared document, crucial image, shared document editing machine, browsing image software and digital certificate to; Adopt common storage; This device is carried voluntarily and is taken care of by the patient, and the patient offers the clinician and uses when medical institutions carry out diagnosis and treatment outside the zone; Described shared document editing machine; Be used for generating, browse, import, derive shared document and submit collection and shared document to; Can use this editing machine to resolve and browse shared document simultaneously at doctor's clinical position station and submit collection and shared document to; And document is obtained in inquiry from document registration storehouse and repositories of documents, needs to submit to collection and shared document to import in other systems that support the IHE standard document if having.
The document registration storehouse is used for safeguarding the metadata of registered document comprising the register documents metadata, concerns between file and the document; Also be used for inquiring about the information of patient's register documents simultaneously.
The distribution type file thesaurus is responsible for the permanent shared document of preserving, and file structure can be simple text information, formatted document, image, structurized document and vocabulary coding clinical information document.
The note Verification System for the medical imaging information sharing in the zone, uses medical insurance card or citizen's card to carry out authorization identifying; Have access to for medical imaging information outside the zone; System is after patient's cell-phone number is extracted in the concentrated parsing of shared document submission; The note Verification System is sent 6 authentication codes to patient's mobile phone, and the doctor comes through authorizing through the input authentication sign indicating number, and authentication code effective time is within 5 minutes; If exceed 5 minutes, system resends authentication code and carries out authentication.
Patient's cross-index manager; Mainly be used for obtaining cross-index patient ID tabulation; When needs obtain the medical imaging information of patient in other ID territories, need from patient's cross-index manager, obtain patient ID tabulation, in order to from document registration storehouse and thesaurus, inquiring about and obtain document.
Audit-trail and node verification manager; Main with generating the audit-trail record; Use relevant incident all will go on record to all and protected medical data, and be transferred to the central data store storehouse, these record data can be monitored to find unlawful practice; Can also be used to verifying the node communication simultaneously, all PHI related datas are authorized to and through the node of checking to be transferred to only, thereby guarantee the user responsibility recordability.
Sharing the method concrete steps based on said system is:
1) system authentication judges according to the information that medical insurance card, Nong Baoka provide whether the patient belongs to particular patient ID territory, if patient ID belongs to particular patient ID territory; Then patient ID is sent to and go to carry out authentication in patient's cross-index manager; If belong to the overseas patient ID of patient ID, then from document properties, extract patient's cell-phone number, send the note authentication code to patient's mobile phone through the note Verification System; Authentication code is 6, and the term of validity is 5 minutes.
2) through after the authentication, use medical imaging information sharing document editor, opening document is submitted collection and document entry to.The doctor can browse collection information and the document entry information submitted in this locality; According to actual diagnostic requirements; If the information of having access to has been stored in the medical imaging information-storing device, then directly use document editor and browsing image software to have access to image information and image; Obtain the outer relevant medical imaging information in zone if desired, then forward step 3) to.
3) send patient ID and send to the patient and intersect used manager, inquiry obtains the patient ID in other patient ID territories according to patient ID.
The patient ID inquiry document registration storehouse of 4) using inquiry to obtain the registered document of this patient ID and submits collection to.
5) the thesaurus ID in the extraction register documents obtains document through acting server from repositories of documents.
6) browse and share the medical imaging information document, obtain image through WADO and in browsing image software, open according to actual diagnostic requirements.
7) for implementing area medical image information shared platform zone, the shared platform that shared document imports to the one's respective area is prepared against follow-up having access to through the shared document editing machine.
Beneficial effect of the present invention:
1. use the medical imaging information-storing device can avoid audit report and film printing, saved the patient expense, the patient can be carried to other medical institutions' uses voluntarily simultaneously, has avoided rechecking.This device uses common storage such as USB flash disk or CD to preserve, and does not need special read-write equipment, and is cheap, is easy to carry about with one, and has very strong generalization.
2. can generate the shared document of IHE standard, these documents can directly be used for carrying out exchanges data with other medical institutions, can directly import to the system that supports the IHE standard for extra-regional medical institutions.
Directly with crucial image store in storage medium, avoided image information share to need to carry shared document editing machine and browsing image software simultaneously through Network Transmission, can on any clinical position station, browse image.
4. use medical insurance card and the authentication of citizen's card in the zone, use the note authentication outside the zone, guarantee the legitimacy of video calling, use digital certificate to carry out the HTTPS communication simultaneously, guaranteed the security of data in transmission over networks.
5. adopt Web Service technology to realize the medical imaging share service, as communication standard, support to carry out cross-platform calling, can be applied to other medical information systems with SOAP.
6. realize the trans-regional medical imaging information of calling, enlarged the use value of the area medical image information shared platform of having implemented.
Description of drawings
Fig. 1 is the general frame synoptic diagram.
Fig. 2 is data model figure.
Fig. 3 has access to process flow diagram for trans-regional medical imaging information.
Fig. 4 is audit message structure figure.
Embodiment
Below in conjunction with accompanying drawing the present invention is described further.
As shown in Figure 1; The present invention uses jumbo memory device that medical imaging is imported in the storage; Document resolver that use carries and image viewing software are had access to; Simultaneously use Web service to have access under special circumstances, thereby promoted the value of area medical image information shared platform, solved the difficult problem that trans-regional medical imaging is shared for indivedual images.
A kind of trans-regional medical imaging information sharing system mainly is made up of three parts: area medical image shared platform, note Verification System, medical imaging information-storing device.Wherein area medical image information shared platform is employed in document registration storehouse, distribution type file thesaurus, patient's cross-index manager, audit-trail and node verification manager, PACS system of the existing medical institutions composition of setting up in the dedicated network, carries out through acting server to extra-regional calling then.The medical imaging information-storing device mainly comprises shared document submission collection, shared document, crucial image, shared document editing machine, digital certificate, browsing image software composition.The note Verification System is used for guaranteeing the legitimacy that the outer medical imaging information in zone is had access to.
Sharing the method concrete steps based on said system is:
1) system authentication judges according to the information that medical insurance card, Nong Baoka provide whether the patient belongs to particular patient ID territory, if patient ID belongs to particular patient ID territory; Then patient ID is sent to and go to carry out authentication in patient's cross-index manager; If belong to the overseas patient ID of patient ID, then from document properties, extract patient's cell-phone number, send the note authentication code to patient's mobile phone through the note Verification System; Authentication code is 6, and the term of validity is 5 minutes.
2) through after the authentication, use medical imaging information sharing document editor, opening document is submitted collection and document entry to.The doctor can browse collection information and the document entry information submitted in this locality; According to actual diagnostic requirements; If the information of having access to has been stored in the medical imaging information-storing device, then directly use document editor and browsing image software to have access to image information and image; Obtain the outer relevant medical imaging information in zone if desired, then forward step 3) to.
3) send patient ID and send to the patient and intersect used manager, inquiry obtains the patient ID in other patient ID territories according to patient ID.
The patient ID inquiry document registration storehouse of 4) using inquiry to obtain the registered document of this patient ID and submits collection to.
5) the thesaurus ID in the extraction register documents obtains document through acting server from repositories of documents.
6) browse and share the medical imaging information document, obtain image through WADO and in browsing image software, open according to actual diagnostic requirements.
7) for implementing area medical image information shared platform zone, the shared platform that shared document imports to the one's respective area is prepared against follow-up having access to through the shared document editing machine.
Implementation step of the present invention is following:
1, use the shared document editing machine, with the audit report that needs are shared, contents such as crucial image tabulation generate shared document and submit collection and shared document to.Submit to the collection data model to see Fig. 2, model has used following entity:
Document is submitted collection to: submit to collection to comprise 0 or a plurality of new XDS document and quote registered XDS document for one, submit to collection can also comprise 0 multifile folder for one simultaneously.Document submits to the collection determinant attribute to comprise that mainly establishment mechanism, founder, establishment specialty, note, content type, patient ID, source ID, submission time, submission collect unique ID etc.; While is had access to legitimacy in order to guarantee document sharing outside the zone; Document submits to set attribute will force to have defined patient's cell-phone number, has access to authentication so that send authentication code through the note Verification System.
Document entry: by the information entity of document registration Role Management, it comprises a metadata set of describing XDS document principal character, follows the document links that also has of this data set, and the document of storing in the repositories of documents is pointed in this link.Comprise mainly that for its determinant attribute of document entry patient ID, service startup and stand-by time, shared document rise time, shared document classification coding and display Name, execution are provided with coding and display Name, medical institutions' type coding and display Name, effective status, patient's cell-phone number, the unique Id of shared document, the related medical image documents is searched through these determinant attributes by system.Wherein shared document classification coding, execution is provided with coding, medical institutions' type coding belongs to coded set, the coded set numeral between 10-100, thereby guarantee fairly simple locating function.In order to retrieve specified documents; System definition additional querying attributes realize that secondary selects, these attributes comprise the event code tabulation, document author and the associated mechanisms that can be used as keyword and use, document relationships that management substitutes addendum and various changes, security classification, speech encoding etc.
Document: be stored in the byte stream in the repositories of documents, have a document entry to point to this document.In the medical imaging information-storing device; The shared document editing machine can import in the medical imaging information-storing device from repositories of documents, extracting shared document; Can from medical image information memory storage, directly open when outside the zone, browsing shared document; Having avoided medical imaging information to have access to needs only when the particular diagnosis demand need be called the specific medical image information, just to obtain from repositories of documents through network through Network Transmission.
File: a logic container, can one or more document entry be divided into groups with the mode of any one demand.File provides the method for file organization, and a document entry possibly belong to one or more files.The file determinant attribute comprises code table, code table display Name, note, final updating time, patient ID, the unique ID of file.
Document relationships: document is set up with previous document through three kinds of methods and is got in touch replacement (RPLC), addendum (APND), conversion (XFRM).Replacement is meant with new release documentation and covers the document that has existed that old document is not deleted, but is labeled as upstate " discarded ".Addendum has been meant new document reference previous document has expanded and has changed the observations in the previous document.Conversion is meant that document is undertaken being produced after the mechanical translation by the document of extended formatting, and for example DICOM structured report (SR) is converted into the CDA document or is converted into certain format file to a report.
2. use the shared document editing machine; With together importing in the medical imaging information-storing device after the document submission collection, shared document, crucial image file, digital certificate and the browsing image software cryptography that generate; Recording events Operation Log in audit-trail and node verification manager is prepared against follow-up monitoring simultaneously.
3. have access to medical imaging information sharing document, see Fig. 3, mainly contain following step:
1) system authentication judges according to the information that medical insurance card, citizen's card etc. provides whether the patient belongs to current patient ID territory, if patient ID belongs to current patient ID territory, then patient ID is sent to and goes to carry out authentication in patient's cross-index manager; If patient ID does not belong to current patient ID territory, then submit to and extract patient's cell-phone number the set attribute from document, send the note authentication code to patient's mobile phone through the note Verification System, authentication code is 6, the term of validity is 5 minutes.
2) through after the authentication, use the shared document editing machine, opening document is submitted collection and document entry to.The doctor can browse collection information and the document entry information submitted in this locality; Have access to document and browsing image files according to diagnostic requirements, if having access to presentation content in memory storage then directly use document editor and browsing image software to have access to image information and image; If have access to presentation content not in memory storage, then need outside the zone, obtain the related medical image information, forward step 3) to.
3) send patient ID to patient's cross-index manager, inquiry obtains the patient ID of patient in other patient ID territories according to patient ID.
4) use the patient ID that obtains from the inquiry of patient's cross-index manager to inquire about the document registration storehouse, obtain the registered document of this patient ID and submit collection to.
5) extract document and submit the repositories of documents ID that concentrates to, obtain repositories of documents Web service address, from repositories of documents, obtain document then through mapping relations.
6) browse medical imaging information sharing document, from existing PACS system of hospital, obtain image through WADO and in browsing image software, open according to actual diagnostic requirements.
For implementing area medical image information shared platform zone, the shared platform that shared document imports to the one's respective area is prepared against follow-up having access to through the shared document editing machine.
Private in order to guarantee patient information, data integrity, and user responsibility recordability, the Action Events of above step all will produce the audit-trail record, in the concurrent meter thesaurus of submitting to a higher level for approval or revision.Audit message is made up of event recognition (Event Identification), activation participant (Active Participant), audit source identification (Audit Source Identification), participant's object identification (Participant Object Identification), and concrete structure is seen shown in Figure 4.
Claims (2)
1. a trans-regional medical imaging information sharing system is characterized in that: comprise
The medical imaging information-storing device; Be used to store shared document and submit collection, shared document, crucial image, shared document editing machine, browsing image software and digital certificate to; Adopt common storage; This device is carried voluntarily and is taken care of by the patient, and the patient offers the clinician and uses when medical institutions carry out diagnosis and treatment outside the zone; Described shared document editing machine; Be used for generating, browse, import, derive shared document and submit collection and shared document to; Can use this editing machine to resolve and browse shared document simultaneously at doctor's clinical position station and submit collection and shared document to; And document is obtained in inquiry from document registration storehouse and repositories of documents, needs to submit to collection and shared document to import in other systems that support the IHE standard document if having;
The document registration storehouse is used for safeguarding the metadata of registered document comprising the register documents metadata, concerns between file and the document; Also be used for inquiring about the information of patient's register documents simultaneously;
The distribution type file thesaurus is responsible for the permanent shared document of preserving, and file structure can be simple text information, formatted document, image, structurized document and vocabulary coding clinical information document;
The note Verification System for the medical imaging information sharing in the zone, uses medical insurance card or citizen's card to carry out authorization identifying; Have access to for medical imaging information outside the zone; System is after patient's cell-phone number is extracted in the concentrated parsing of shared document submission; The note Verification System is sent 6 authentication codes to patient's mobile phone, and the doctor comes through authorizing through the input authentication sign indicating number, and authentication code effective time is within 5 minutes; If exceed 5 minutes, system resends authentication code and carries out authentication;
Patient's cross-index manager; Mainly be used for obtaining cross-index patient ID tabulation; When needs obtain the medical imaging information of patient in other ID territories, need from patient's cross-index manager, obtain patient ID tabulation, in order to from document registration storehouse and thesaurus, inquiring about and obtain document;
Audit-trail and node verification manager; Main with generating the audit-trail record; Use relevant incident all will go on record to all and protected medical data, and be transferred to the central data store storehouse, these record data can be monitored to find unlawful practice; Can also be used to verifying the node communication simultaneously, all PHI related datas are authorized to and through the node of checking to be transferred to only, thereby guarantee the user responsibility recordability.
2. trans-regional medical imaging information sharing method is characterized in that:
1) system authentication judges according to the information that medical insurance card, Nong Baoka provide whether the patient belongs to particular patient ID territory, if patient ID belongs to particular patient ID territory; Then patient ID is sent to and go to carry out authentication in patient's cross-index manager; If belong to the overseas patient ID of patient ID, then from document properties, extract patient's cell-phone number, send the note authentication code to patient's mobile phone through the note Verification System; Authentication code is 6, and the term of validity is 5 minutes;
2) through after the authentication, use medical imaging information sharing document editor, opening document is submitted collection and document entry to; The doctor can browse collection information and the document entry information submitted in this locality; According to actual diagnostic requirements; If the information of having access to has been stored in the medical imaging information-storing device, then directly use document editor and browsing image software to have access to image information and image; Obtain the outer relevant medical imaging information in zone if desired, then forward step 3) to;
3) send patient ID and send to the patient and intersect used manager, inquiry obtains the patient ID in other patient ID territories according to patient ID;
The patient ID inquiry document registration storehouse of 4) using inquiry to obtain the registered document of this patient ID and submits collection to;
5) the thesaurus ID in the extraction register documents obtains document through acting server from repositories of documents;
6) browse and share the medical imaging information document, obtain image through WADO and in browsing image software, open according to actual diagnostic requirements;
7) for implementing area medical image information shared platform zone, the shared platform that shared document imports to the one's respective area is prepared against follow-up having access to through the shared document editing machine.
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