数字化影像信息系统在医院的移动应用

The Mobile Application of Digital Imaging Information System in the Hospital

目的:构建全套完整无线数字化影像信息系统,使各科医务人员能够操作该系统在整个医院范围内安全、快速、简便的进行医疗应用。材料和方法:基于医院现有GE Centricity PACS/RIS的企业级架构和WEB技术向临床发布影像的应用,以多台戴尔PowerEdge服务器分别用作PACS服务器、RIS服务器、HIS服务器和PACS-web服务器。网络连接设备使用戴尔Powerconnect交换机和TP-LINK无线宽带路由器。用户终端移动设备使用戴尔Latitude笔记本电脑。首先依托医院现有的有线网络构架,选择具有代表性的科室,如放射科、神经外科、神经内科、预防保健科、质控科,并将无线宽带路由器通过双绞线连接至以太网接口,设置无线宽带路由器指定IP地址、子网掩码,设置路由器工作模式,MAC地址过滤、SSID并且禁用SSID广播、频道和加密属性。建立起集中控制式无线网络。在用户终端设置无线适配器,设置为与路由器相同的SSID、频道和加密属性。测试终端移动设备和服务器之间的连接,并且交给最终用户使用。结果:用户使用终端移动设备进行医疗工作日常操作移动性便携性明显优于原系统。而医疗软件的使用与原系统相同,无须另外培训。神经外科和神经内科的临床医生可以手持终端移动设备在患者床前边查房边做病程记录,并且同时通过浏览器基于IHE规范要求优先调阅关键帧影像,通过TruRez增量传输技术降低对无线网络带宽的要求,以web浏览的形式快速从GE Centricity PACS-web服务器实时调用患者的影像资料。预防保健科和质控科通过HIS和RIS查询进行疾病分类、例数统计,快速生成报表,进行传染病监控和质量控制。放射科医生需要经常从PACS服务器调用大量的DICOM格式文件,由于无线宽带路由器的带宽为54 M,是原有线网络100 M带宽的一半,调用时间有所延长。结论:使用医用无线网络系统的通信交流方式较传统方式更加迅速便捷。各种医务人员使用终端移动设备可以在医疗机构内任意漫游、高速传输影像、报告、病历以及其他电子文档。当影像浏览信息极大丰富时(如扩展对心电信息、电生理、超声、病理等信息),正确的操作者可以在正确的时间、安全的获得正确的、完善的临床诊断应用需要的综合诊断信息。对操作者而言简单明了,能够在所有医疗通信系统中使用而无需考虑制造商的因素。

Objective： To construct a whole entire wireless digital imaging information system operated by doctors, nurses and managers for medical application securely,rapidly, easily in the full hospital. Materials and Mediods： Many Dell PowerEdge servers were used as PACS server, RIS server, HIS server and PACS-web server. Basing on the GE Centricity PACS/RIS structure and web technology images were distributed to all clinical departments. Dell Powerconnet switchers and TP-LINK wireless routers were used as ethemet connection equipments. Dell Latitude notebooks were used as terminal mobile equipments for users. Wireless routers were connected to the ethemet in the hospital basing on the recent network structures. Set up the wireless routers with IP addresses, subnet musks, working modes, MAC address filters, SSIDs, channels and passwords. Thus center control wireless network were constructed. Wireless adapters were set as the same properties as the routers at the terminal mobile equipments. The connections between the terminus and servers were tested, and were handed to the users, Results： The modalities of new mobile digital imaging information system for users to daily operate were better than the original system. No additional training was required because that the usage of medical software was as the same as originals. Surgeries and medical doctors could do the medical records at the bedside of the patients with the terminal mobile equipments, and download the key images from the GE Centricity PACS-web server. Radiologist could download a large amount of DICOM format files from the PACS servers, but the consumed download time was increased a bit due to the 54M bandwidth of the wireless routers. Conclusions： It is more convenient and rapid in the style of medical information communicate using the medical wireless network system instead of the traditional information system. And it also enabled each physician with a mobile terminal equipment to browser and access images, the reports, the medical records and all the other electronic documents at high transmission speed, anytime, anywhere. When the image resources are getting more and more rich （e.g.：enriched by MUSE, EP, cardiovascular, echo and pathology information,etc.）, the right person can get the right information for right diagnosis decision by a safe way at right time, which is so simple that the factors relating to any manufactory can be ignored.