物联网时代RFID在医疗系统中的应用

介绍了物联网的关键技术RFID在医疗行业的发展现状及其用于医疗系统的优势,分析了RFID在医疗系统中的应用前景,并对存在问题给出解决方案,以期为我国医疗卫生行业信息化发展提供一定的参考.     

Critical Elements and Lessons Learnt from the Implementation of an RFID-enabled Healthcare Management System in a Medical Organization

Healthcare services are complex and life-critical. One mistake in any procedure may lead to irremediable consequences; numerous researchers, thus, introduce information and communication technology to improve quality of services and enhance patient safety by reducing the medical errors. Radio frequency identification (RFID) is considered as one of the emerging tool assist in meeting the challenges of the present situation. In recent years, RFID has been applied in medical organizations for the purpose of managing and tracking medical equipment, monitoring and identifying patients, ensuring that the right medication is given to the right patient, and preventing the use of counterfeit medicine. However, most of the existing literature focuses on demonstrating how RFID can benefit the healthcare industry, whereas little attention has been given to the management issues involved in constructing an RFID project in medical organizations. In this paper, an exploratory case study is conducted in a medical organization to illustrate the development framework and critical issues that should be taken into consideration in the preparation, implementation and maintenance stage of constructing such a project. All the experiences and results discussed in this paper offer valuable and useful insights to steer those who would like to start their journey using RFID in medical organizations.     

The Adoption and Implementation of RFID Technologies in Healthcare: A Literature Review

Radio Frequency Identification (RFID) technology not only offers tracking capability to locate equipment, supplies and people in real time, but also provides efficient and accurate access to medical data for health professionals. However, the reality of RFID adoption in healthcare is far behind earlier expectation. This study reviews literature on the use of RFID in healthcare/hospitals following a formal innovation-decision framework. We aim to identify the common applications, potential benefits, barriers, and critical success factors. Our study facilitates quick assessment and provides guidance for researchers and practitioners in adopting RFID in medical arenas. Many earlier adopters in healthcare found RFID to be functional and useful in such areas as asset tracking and patient identification. Major barriers to adoption include technological limitations, interference concerns, prohibitive costs, lack of global standards and privacy concerns. Better designed RFID systems with low cost and privacy issues addressed are needed to increase acceptance of RFID in healthcare.     

Redesigning the Medical Office for Improved Efficiency: An Object-Oriented Event-Driven Messaging System

Medical practitioners are under ever increasing pressure to maximize patient care, while minimizing costs. One productivity area that has not previously undergone thorough investigation is the efficient utilization of time for intra-office communication. Medical office personnel typically need to communicate patient information and resource requests, as well as personal messages. An intra-office communication system is designed that reduces time-waste typically incurred in medical office environments. Redesigning medical offices with intra-office communication systems provides time savings of several man hours per day. The subsequent increase in time efficiency enables higher quality of patient care and larger patient loads to be managed by existing medical staff.     

Application of Portable CDA for Secure Clinical-document Exchange

Health Level Seven (HL7) organization published the Clinical Document Architecture (CDA) for exchanging documents among heterogeneous systems and improving medical quality based on the design method in CDA. In practice, although the HL7 organization tried to make medical messages exchangeable, it is still hard to exchange medical messages. There are many issues when two hospitals want to exchange clinical documents, such as patient privacy, network security, budget, and the strategies of the hospital. In this article, we propose a method for the exchange and sharing of clinical documents in an offline model based on the CDA—the Portable CDA. This allows the physician to retrieve the patient’s medical record stored in a portal device, but not through the Internet in real time. The security and privacy of CDA data will also be considered.     

基于数字水印和数字签名技术的医学影像存储与传输系统安全机制研究

针对目前未引入安全机制的医学影像存储与传输系统,提出基于数字水印和数字签名技术的安全机制方案。数字水印技术对医学图像进行有效的版权等信息认证,数字签名技术对医学图像的发送方与接收方进行身份等信息的认证,为远程医疗的发展提供支持。     

Development of an Ease-of-Use Remote Healthcare System Architecture Using RFID and Networking Technologies

The study aims to provide an ease-of-use approach for senior patients to utilize remote healthcare systems. An ease-of-use remote healthcare system (RHS) architecture using RFID (Radio Frequency Identification) and networking technologies is developed. Specifically, the codes in RFID tags are used for authenticating the patients' ID to secure and ease the login process. The patient needs only to take one action, i.e. placing a RFID tag onto the reader, to automatically login and start the RHS and then acquire automatic medical services. An ease-of-use emergency monitoring and reporting mechanism is developed as well to monitor and protect the safety of the senior patients who have to be left alone at home. By just pressing a single button, the RHS can automatically report the patient's emergency information to the clinic side so that the responsible medical personnel can take proper urgent actions for the patient. Besides, Web services technology is used to build the Internet communication scheme of the RHS so that the interoperability and data transmission security between the home server and the clinical server can be enhanced. A prototype RHS is constructed to validate the effectiveness of our designs. Testing results show that the proposed RHS architecture possesses the characteristics of ease to use, simplicity to operate, promptness in login, and no need to preserve identity information. The proposed RHS architecture can effectively increase the willingness of senior patients who act slowly or are unfamiliar with computer operations to use the RHS. The research results can be used as an add-on for developing future remote healthcare systems.     

A Provably Secure RFID Authentication Protocol Based on Elliptic Curve for Healthcare Environments

To enhance the quality of healthcare in the management of chronic disease, telecare medical information systems have increasingly been used. Very recently, Zhang and Qi (J. Med. Syst. 38(5):47, 32), and Zhao (J. Med. Syst. 38(5):46, 33) separately proposed two authentication schemes for telecare medical information systems using radio frequency identification (RFID) technology. They claimed that their protocols achieve all security requirements including forward secrecy. However, this paper demonstrates that both Zhang and Qi’s scheme, and Zhao’s scheme could not provide forward secrecy. To augment the security, we propose an efficient RFID authentication scheme using elliptic curves for healthcare environments. The proposed RFID scheme is secure under common random oracle model.     

A Review of Tags Anti-collision and Localization Protocols in RFID Networks

Radio Frequency IDentification (RFID) has allowed the realization of ubiquitous tracking and monitoring of physical objects wirelessly with minimum human interactions. It plays a key role in a wide range of applications including asset tracking, contactless payment, access control, transportation and logistics, and other industrial applications. On the other side, RFID systems face several technical challenges that need to be overcome in order to achieve their potential benefits; tags collisions and localization of tagged objects are two important challenges. Numerous anti-collision and localization protocols have been proposed to address these challenges. This paper reviews the state-of-art tags?? anti-collision and localization protocols, and provides a deep insight into technical issues of these protocols. The probabilistic and deterministic anti-collision protocols are critically studied and compared in terms of different parameters. We further review distance estimation, scene analysis, and proximity localization schemes and provide useful suggestions. We also introduce a new hybrid direction that utilizes power control to spatially partition the interrogation range of a reader for more efficient anti-collision and localization. Finally, we present the applications of RFID systems in healthcare sectors.     

TAP.NET: A Windows Messaging Service for Nursing Staff

Nurses are the foundation of any healthcare system. It is essential to alert nurses on time so that they can offer care and comfort without any delay. Pager messages (short messages) represent an important part of the overall hospital communication network. These short messages are sent through data paging systems to direct nurses to patients. Telocator Alphanumeric Protocol (TAP) is used for submitting short messages to these data paging systems. In this paper, a windows messaging service (TAP.NET) is designed to connect to a data paging system using the TAP protocol. A Web application is also proposed that uses remote technology to transmit page requests to this messaging service. With this overall design, pager messages can be sent from any computer that has an Internet connection on the hospital network. A logging scheme is also introduced to assess the performance of the TAP.NET.     

国内外医患关系现状的比较与分析

我国的医患关系现状一直是社会关注的焦点。笔者利用文献法、比较法和社会调查等方法,分析和比较了国内外医患关系现状,可以发现国内外医疗保障制度的差异,医疗监督、风险管理制度的不同,医疗行业的定位不明确和医生待遇低,双方沟通不够,缺少信任等都使得医患关系状况差别很大。这是我们在研究医患纠纷处理机制时必须考虑的。     

Deployment of RFID in Healthcare Facilities—Experimental Design in MRI Department

Patient safety has become an important issue due to medical errors. Some health care systems use Radio Frequency Identification (RFID) to identify patients during medical procedures. However, the RFID data readability especially depends upon the environment, an investigation of data reliability and signal loss is essential to making an effective deployment plan. The operation of Magnetic Resonance Imaging (MRI) is the major source of electromagnetic interference in the hospital. Therefore, this research conducts an experimental design of reading performance considering various notable factors in the MRI department. In addition to the readability experiment, this paper also measures the efficiency and reliability of implementing RFID technology in the MRI department using a simulation approach and helps hospitals by providing the measured outcomes.     

Utilize Common Criteria Methodology for Secure Ubiquitous Healthcare Environment

RFID technology is widely used in healthcare environments to ensure patient safety. Therefore, the testing of RFID tags, such as performance tests and security evaluations, is necessary to ensure inter-operational functional compatibility with standards. A survey of the literature shows that while standards that are around RFID performance tests have been addressed, but the same is not true for security evaluations. Therefore, in this paper, we introduce the Common Criteria security evaluation methodology, also known as ISO/IEC 15408, for the security evaluation of RFID tags and propose a framework as a minimal requirement for RFID tags to improve security assurance.     

A RFID Grouping Proof Protocol for Medication Safety of Inpatient

In order to provide enhanced medication safety for inpatients, the medical mechanism which adopts the modified grouping proof protocol is proposed in this paper. By using the grouping proof protocol, the medical staffs could confirm the authentication and integrity of a group of Radio-Frequency Identification (RFID) tags which are embedded on inpatient bracelets and the containers of drugs. This mechanism is designed to be compatible with EPCglobal Class-1 Generation-2 standard which is the most popular specification of RFID tags. Due to the light-weight computational capacity of passive tags, only the pseudo-random number generator (PRNG) and cyclic redundancy code (CRC) are allowed to be used in the communication protocol. Furthermore, a practical scenario of using this proposed mechanism in hospital to examine the medication safety is also presented.     

Secure Communication of Medical Information Using Mobile Agents

Recently several efficient schemes are proposed to provide security of e-medicine systems. Almost all of these schemes have tried to achieve the highest security level in transmission of patients' medical information to medical institutions through a heterogeneous network like Internet. In this paper, we explain the insecurity of these schemes against "man-in-the-middle" attack. Furthermore, a dynamic mobile agent system based on hybrid cryptosystem is proposed that is both secure and also efficient in computation cost. Analyzing the security criteria confirms suitability of the proposed scheme for e-medicine systems.     

医疗数据隐私保护研究综述

随着医疗数据的迅速电子化,数据的存储变得越来越方便,与此同时,医疗数据的隐私性、安全性问题也随之而来,特别是当这些数据需要发布在网上供二次使用的时候。研究了医疗数据隐私保护的意义、研究进展以及面临的威胁,最后针对中国医疗信息化现状对医疗数据隐私保护提出了几点建议。     

基于物联网的医学实验室信息管理系统

主要阐述使用RFID技术、ASP．NET技术等构建医学实验室信息管理系统。系统在具备传统实验室信息管理系统所具有的仪器管理、试验管理等常见功能外,还具有远程访问、RFID智能信息获取及检索等功能。使用RFID技术进行设备、药品等的管理,使获取、处理仪器、药材等的信息更加高效、便捷和智能,同时减少了对信息的人为操作,保证信息的安全性和准确性。远程访问功能将实验室管理人员行使管理职能和获取实验室信息的范围从实验室内部扩大到互联网覆盖的任何区域。     

Realizing Digital Signatures for Medical Imaging and Reporting in a PACS Environment

According to Taiwan’s legislation pertaining to the protection of electronic data, the creators of electronic medical records (EMR) are solely responsible for the security of EMR. However, actual implementations that fulfill the security standards and requirements for electronic medical record systems are still lacking. Most EMR created from picture archive and communication system are not considered secure, as security protection mechanisms have not yet been granted legal status. This paper describes the details of establishing a digital signature system using Taiwan health professional cards. A digital signature system has been included to ensure quality assurance (QA) operations are controlled by technicians, and reporting capabilities have been provided for radiologist. Six imaging modalities and eight types of radiology reports have also been included in the system. Results indicate that the process of creating QA signatures does not have an adverse effect on the workflow of the facility, requiring less time for the signing and verification of radiology reports. This system has already been used routinely online in a real clinical setting for more than 2 years.     

Low Cost RFID Real Lightweight Binding Proof Protocol for Medication Errors and Patient Safety

An Institute of Medicine Report stated there are 98,000 people annually who die due to medication related errors in the United States, and hospitals and other medical institutions are thus being pressed to use technologies to reduce such errors. One approach is to provide a suitable protocol that can cooperate with low cost RFID tags in order to identify patients. However, existing low cost RFID tags lack computational power and it is almost impossible to equip them with security functions, such as keyed hash function. To address this issue, a so a real lightweight binding proof protocol is proposed in this paper. The proposed protocol uses only logic gates (e.g. AND, XOR, ADD) to achieve the goal of proving that two tags exist in the field simultaneously, without the need for any complicated security algorithms. In addition, various scenarios are provider to explain the process of adopting this binding proof protocol with regard to guarding patient safety and preventing medication errors.