門診中心醫療資訊系統計畫

門診中心醫療資訊系統

Sistema de Informação Hospitalar

陳煥杰醫師

摘要

背景：聖多美普林西比是我國在西非的邦交國，自1998年起即有常駐醫療團支援醫療業務。除了教育訓練、硬體建設外，醫療團也協助建立藥局、病歷等管理制度。隨著醫療業務成長，紙本病歷的缺點也逐漸浮現，諸如儲存空間不夠、紙張成本過高、手寫辨識困難、病歷調閱費時…等等。醫療資訊系統是解決的辦法，但是與台灣迥異的醫療環境造成了實行的困難。
目標：根據當地醫院的需求提出可行的解決方案，建立經濟實用，易於維護的系統。
材料與方法：以首都門診中心為試辦對象，從2013年六月開始試行。使用Filemaker資料庫軟體架構包含掛號，看診，處方，批價功能的系統，以無線區域網路串聯掛號、批價處，診間與藥局。
結果：對電腦不熟悉的當地掛號行政人員，在練習後可以輕易上手。當地院長與行政主管表達高度興趣，同意醫療團於首都門診中心繼續試行。
結論：操作簡單，架構經濟的系統符合當地的醫療需求。雖然醫療資訊系統的效益仍需時間驗證，這套系統已為改善聖多美普林西比的醫療環境邁出了第一步。

Abstract

Background: São Tomé and Príncipe is one of our allies in West Africa, and the Taiwan Medical Mission has been there since 1998. Despite helping medical education and the construction of facilities, the Taiwan Medical Mission also helped the management of hospital for years. However, as medical service grows, the healthcare providers face the drawbacks of paper-based records, such as lack of storage space, the cost of paper, difficulty in recognition of hand-written contents, and time consuming in collating records. Hospital information system may be the solution, but it is not easy to apply in an environment that is much different from Taiwan. 
Objective: To propose applicable solutions according to the local needs and to build a system which is economic and easy to maintain. 
Materials and methods: The task was conducted in the Centro Policlínico since June 2013. The database software Filemaker was adopted to design a system containing basic operating functions. Registration, billing office, the clinics and the pharmacy are connected via wireless network. 
Result: The system is easy for healthcare providers to learn and use. The president and the administrator of Centro Policlínico are highly interested and agree further implementation of the system. 
Conclusion: An easy operating and low cost system meets the need of local healthcare providers. Although the efficacy of the system still awaits time to prove, it is a good start to improve the quality of care in São Tomé and Príncipe.

系統可在iPad上運行，實現偏鄉行動醫療。

聖多美第一張使用醫療資訊系統列印的處方箋

系統首頁。預設畫面為首頁，在其他畫面按左上角Home圖示可回到首頁。首頁的病患清單可依姓名，病歷號及身分證號排序及查詢。點選病患後可選擇上方功能列的功能: Lista(掛號清單)，Analise(檢驗報告查詢)，Exame(檢查報告查詢)，Ficha(歷次門診病歷)，Marcar(掛號)，Fatura(批價)

掛號頁面。點選畫面上方功能列的Marcar進入掛號畫面，選擇日期(Data)，時間(Horas)及醫師(Doutor)後點選Marcar完成掛號。點選Procurar可鍵入病歷號或身分證字號查找其他病患。

掛號清單。點選畫面上方功能列的Lista進入所有掛號清單，選擇日期(Data)，時間(Horas)及醫師(Doutor)查詢各別醫師病患清單。點選Nova開啓空白門診病歷，點選Ultima查看最後一筆門診病歷，點選Passa查詢過去歷次門診病歷。

檢驗查詢畫面。

檢查查詢畫面。

X光檢視畫面。

門診病歷輸入畫面。

掛號處作業實況。