以病人及其家庭為中心之智慧型醫療社工資訊系統

Abstract

本篇論文主要是以台大醫院社工室為例，在服務導向架構的健康協定第七層中介軟體架構下發展一個以病人及其家庭為中心的智慧型醫療社工資訊系統。 本系統首先會在整合台大醫院醫療資訊系統下設計快速分派個案的功能，並提供社工員個案管理的功能。 為了達成流程的無紙化與數位化，系統將根據社工室不同的服務內容設計固定格式的電子化病人評估記錄系統，並在日後提供自動輸出某位社工員工作月報表的功能。 本論文接著提出一個新的設計概念：以病人及其家庭為中心的設計，讓社工員可以有效掌握病家全戶的相關資訊，更使其能以病家全戶為考量而提供給病人更適合的服務。此設計包含有以下幾個功能：照會與回覆，家庭成員組成記錄，病人評估記錄，個案服務次數記錄，補助建議，和關鍵的病家個案史功能。 隨著病人評估記錄全面的數位化後，在病人醫療補助的部份，系統將可計算出補助百分比建議值，在此部份，本論文將根據相關的補助規則並利用模糊理論等方法讓系統自動計算出病人的補助百分比以提供給社工員作為參考。

The study is primarily aimed at developing an Intelligent Patient-and-Family- Centered Medical Social Work Information System in the MSW office in NTUH based on the Health Level Seven (HL7) middleware framework of Service-Oriented Architecture (SOA). We will first design the function of Fast Case Assignment integrating with NTUH HIS, and provide the MSW with the function, Case Management. So as to accomplish paperless and digitalized work flow, the system will be designed with Patient Assessment Record in fixed and digitalized format according to the different service contents in the MSW office, and provide the function of automatically outputting each MSW’s monthly working report in the future. In turn, this study proposes a new concept- a Patient-and-Family-Centered Design (PFCD), not merely can the MSW productively get hold of the information on the household, but they can provide patients with further better and more proper services based on the consideration of the patient’s household. The PFCD consists of Consultation and Reply, Family Composition Record, Patient Assessment Record, Case Service Count Record, Suggestion of Subsidy, and the most important and the key function, Patient-and-Family Case History. Subsequent to the comprehensively digitalized Patient Assessment Record, the percentage of subsidy can be calculated by the system. In this part, the study tries to calculate the percentage of subsidy with the methods of some subsidy rules and Fuzzy Theory to provide the reference for the MSW.