A Study of the Implementation for a High-Secure Cloud-Based Exchange Model of Electronic Medical Records in Conformity with IHE Framework

• Main Authors: WU,CHIEN-HUA, 吳建樺
• Other Authors: CHIU,RUEY-KEI
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/46220834729853202153

博士 === 輔仁大學 === 商學研究所博士班 === 104 === The exchange of electronic medical records can not only reduce the paper of the presentation of medical reports but also the management issues of use. For patients, physicians can quickly access to their medical records for treatment resulting to avoid the waste of medical resources. It has been quite effective so far since the Ministry of Health and Welfare established and implemented the exchange of electronic medical records. To the end of May 2016, the hospitals take the exchange of electronic medical records through EEC gateways over the VPN environment has reached the total number of 405. At present, it may proceed to cross-institutional exchange of electronic medical records that include the exchange services of five leaflets, which are medical images and reports, blood tests, the disease summary of discharge, outpatient medication records and patient medical records. Physicians can use their physician cards and a patient’s national health insurance IC Card to access the patient’s recent electronic medical records within last six months. This study aims to implement a secure but suitable for cloud computing EMR exchange mechanism which is based on the integrated standards of IHE XDS, ATNA, and CT as well as use the TLS security mechanism with the adoption of the framework of RESTFul Service on Windows Communication Foundation. In this study, the digital certificates is used to verify the identity in the server-side and the encryption and decryption of medical records are taken in the process of the the transferring to protect the security of electronic medical records. The study also established a highly secure EHR exchange mechanism on Microsoft Azure cloud computing platformin in conformity with IHE framework. There are four scenerios designed for system simulation and experiment in order to verify the feasibility of the prototyping system. The experimental results show the system can successfully proceed to the upload and retrieval of EMR. The Microsoft Azure is also taken to be the cloud computing platform for the comparison of exchange performance between Web Services and RESTful Services.The results of four experimental scenerios show that RESTful Services (2.612 seconds) are superior to Web Services (5.311 seconds). The results of verification show that the comformity of IHE and the use of RESTful and security mechanism of TLS may effectively enhance the process of existing exchange of electronic medical records as well as may achieve confidentiality, integrity, and verifiability of electronic medical records at the time of the exchange.