近年來，隨著國民所得與生活水準的提昇，民眾對於醫療品質的要求也越來越高，在許多西醫無法根治的慢性疾病上，有越來越多的病患轉而求助於中醫。因此，對於中醫院所而言，為了應付日益龐大的門診量並兼顧診療的品質，建立一個電子化病歷系統是相當急切的。而隨著中醫診斷方式的現代化，中醫診療紀錄的資料類型也更趨多元化，除了文字資料以外，還包含患者的舌診影像及語音紀錄等多媒體資訊，傳統的紙本病歷已不敷使用。因此惟有藉著電腦在處理與儲存多媒體資訊上的優勢，才能解決這個問題。

本研究的主要目的為建構一個高效率的電子化診療助理系統，以配合中醫病歷電子化及輔助中醫師進行診療作業。研究範圍則偏重於診療助理系統介面之設計，以物件導向的觀點來規劃多媒體中醫診療助理系統的架構、功能、使用案例及運作流程，並使用統一化模式語言（UML）為工具輔助系統分析與設計。

實作上則以網路與資料庫為基礎，配合多媒體技術提供友善的病歷存取介面，在資料交換方面則利用 XML文件做為交換格式，並透過ActiveX/控制項和網頁技術的配合，達成軟體安裝和更新自動化的目的，減輕醫院資訊人員和使用者的工作負擔。希望本研究能做為中醫院所建置相關系統時之參考。

With the raise of national income and quality of life, people have more demands on the medical treatment. More and more patients with chronic diseases ask for the treatment of traditional Chinese medicine since that of Western medicine is unable to cure their diseases completely. Therefore, in order to handle large number of outpatient and enhance quality of medical treatment, it is imperative for traditional Chinese medical hospitals to construct an electronic patient record system. As the modernization of traditional Chinese medicine diagnosis, its patient record data type becomes more diverse with multimedia information including text data, tongue image and speaking voice. Thus, the traditional paper-based patient record can not satisfy the requirements. The best solution is to utilize the modern computer with the advantage of high speed data processing and storing huge information.

The primary goal of this study is to provide an effective electronic consultation agent system. It can assist the development of the electronic patient record in traditional Chinese medicine and help the doctor to make diagnoses. The scope of designing interface for the consultation agent system is emphasized. Its main architecture, functions, uses cases and workflow are planned from the viewpoint of object oriented approaches. Also, we use UML (Unified Modeling Language) as the CASE (Computer Aided Software Engineering) tool in system analysis and design.

The system is based on the network and database, it provides a friendly access interface for multimedia patient record. We uses XML(eXtensible Markup Language) document for the medium format of electronic data interchange. In order to reach the goal of installing and updating software automatically, the ActiveX/Controls is introduced to embed in web pages for operating easily and reducing the workload of information technology professionals. The consultation agent model in this system is expected to be a valuable reference for those who need to implement relative system in the future.

[1]井口圭子,“舌診影像擷取環境控制之研究,”中國醫藥學院中國醫學研究所碩士論文, 2001.

[2]台北榮民總醫院, 工業技術研究院生醫工程中心,“多媒體電子病歷系統與臨床資料庫系統發表會,” 2000.

[3]行政院衛生署,“二代全國醫療資訊網計劃,” http://www.doh.gov.tw/90-info/lane/lane-1.htm, 2000.

[4]行政院衛生署,“施政目標與重點,” http://www.doh.gov.tw/newverprog/proclaim/content.asp?class_no=3800&doc_no=21178, 2001.

[5]呂世明,“外感在寸部脈波表現之探討,”中國醫藥學院中國醫學研究所碩士論文, 2002.

[6]吳孟雄,劉志文,“人工智能在醫學領域的應用進展,”第九屆全國醫藥訊息學大會, pp.605-607, 2002.

[7]李賢輝,“運用HL7介面導入隨身醫囑之研究,”成功大學工程科學研究所碩士論文, 2002.

[8]洪國鋒,“舌診影像系統在疾病辨識之應用,”中原大學醫學工程研究所碩士論文, 2000.

[9]洪宗貝,吳有龍,姚政佑,鄭國宏,王榮志,侯坤志,王建清,顏良安,楊宗龍,“ XML架構下的線上多媒體電子病歷建構,”2002電子商務與數位生活研討會, pp.32-44, 2002.

[10]翁清松,張恩豪,鄭振鴻,“中風中醫證型診斷配藥專家系統之建立,”八十八年度醫學工程科技研討會, pp.327-328, 1999.

[11]張景岳,“景岳全書,”台灣商務印書館, 1990.

[12]張璐,“張氏醫通,”自由出版社, 1993.

[13]張永賢,“中醫四診現代化思路與研究,”1998工程科技與中西醫學應用研討會, pp.9-12, 1998.

[14]張裕益,“ UML理論與實作,”博碩文化, 2000.

[15]陳世達,“應用音中仙中文聽寫機之全球資訊網語音輸入查詢系統,”成功大學電機工程研究所碩士論文, 1997.

[16]陳逸光,“網際網路中醫藥典籍文獻動態資料庫研究,”中醫藥雜誌第十一卷第一期, pp.43-50, 2000.

[17]陳楚杰,“醫院組織與管理,”宏翰文化事業有限公司, pp.267- 270, 2001.

[18]陳錦城,“以CORBA為基礎之元件化醫療資訊安全機制,”台北醫學院醫學資訊研究所碩士論文, 2002.

[19]陳逸光,“ SQL Server 2000 XML 結構描述在類證治裁網際網路化資料統合之應用,” 中醫藥雜誌第十四卷第一期, pp.47-58, 2003.

[20]黃章銘,楊晴雯,溫嘉憲,“榮民醫療資訊網計畫：Thin Client / Server 醫療資訊系統架構,”臺中榮總資訊室未出版技術報告, 2000.

[21]黃耀德,“語音訊號應用於中醫過敏性鼻炎病患之研究,”中原大學醫學工程研究所碩士論文, 2002.

[22]游隆權,“慢性胃炎中醫療法,”中國中醫臨床醫學雜誌第八卷第一期, pp.67-68, 2002.

[23]楊愛年, 王棟, 成方, 宋羿星, 楊逸帆, 張永強, 李瑛,“中醫專家智囊軟件集成與應用展望,” 第九屆全國醫藥訊息學大會, pp.608-614, 2002.

[24]鄧鐵濤,“中醫診斷學,”知音出版社, 1989.

[25]蘇奕彰,李燊銘,吳文祥,“中醫血虛證型分群在系統性紅斑狼瘡患者的統計分析,”中國統計學報第十三卷第四期, pp.563-580, 1999.

[26]Adam, D.,“ActiveX Controls Insides Out,” Microsoft Press, 1997.

[27]Dan, Q. and Dudeck, J., “ Some problems related with probabilistic interpretations for certainty factors,” Fifth Annual IEEE Symposium on Computer-Based Medical Systems, pp.538-545, 1992.

[28]David, J.M.,“HL/7 in the 21st Century,” Healthcare Information, 2000.

[29]Etzioni, O. and Weld, D.S., “Intelligent Agents on the Internet: Fact, Fiction, and Forecast,” IEEE Expert Volume 10 Issue 4, pp.44-49, August 1995.

[30]Hongmei, G., Biqing, H., Wenhuang, L., Shouju, R., and Yu, L.,“An agent-based approach for workflow management, ” IEEE International Conference on Systems, Man and Cybernetics, pp.292-297, 2000.

[31]Kyriacou, E., Pavlopoulos, S., Koutsouris, D., Andreou, A.S., Pattichis, C. and Schizas, C.,“Multipurpose health care telemedicine system,” Proceedings of the 23rd Annual International Conference of the IEEE Volume 4, pp.3544-3547, 2001.

[32]Laforest F. and Flory A., “Medical Records and Electronic Documents:A Proposal,” Tenth World Congress on Health and Medical Informatics, pp.633-637, 2001.

[33]Magedanx, T., Rothermel, K., and Krause, S., “Intelligent Agents: An Emerging Technology for Next Generation Telecommunication?,” Proceedings of IEEE INFOCOM96, pp.464-472, 1996.

[34]Microsoft Web Development,“Microsoft XML SDK 4.0 Documentation,” http://msdn.microsoft.com/xml.

[35]San, M., “Intelligent agents on the Internet and Web,” TENCON’98 IEEE Region 10 International Conference on Global Connectivity in Energy, Computer, Communication and Control, Volume 1, pp.97-102, 1998.

[36]Sharma, A. and Capretz, M.A.M.,“Application maintenance using software agents,” First IEEE International Workshop on Source Code Analysis and Manipulation, pp.55-64, 2001.

[37]Shortliffe, E.H., Perreault, L.E., Wiederhold, G. and Fagan L.M.,“Medical Informatics--Computer Application in Health Care,” Addison—Wesley Publishing Company, 1990.

[38]Sinan S.A.,“UML in a Nutshell,” O'Reilly & Associates Inc., 1999.