Introduction
CHANGING has extensive experience and capabilities in system development within the medical industry, with a strong focus on information security. We are committed to supporting the medical industry in transitioning to telemedicine, paperless operations, and the adoption of secure IT infrastructure. The global COVID-19 pandemic in 2020 prompted a reassessment of healthcare models and the need to address cybersecurity risks effectively. The National Development Council has estimated that Taiwan will enter an ultra-aging society by 2025, highlighting the importance of preserving and securely utilizing a large volume of paper medical records as a crucial component of the national health profile.
CHANGING's Clinic Image System (CIS), a robust medical record document repository system, offers comprehensive functionalities designed with cybersecurity regulations and medical laws in mind. It ensures the privacy and integrity of medical records while assisting healthcare institutions in maintaining consistency, improving overall healthcare quality, and promptly adapting to industry trends and recent regulatory adjustments(note 1) As of 2022, our system has already been successfully implemented in 33 medical institutions.
Note 1: Recent Regulatory Adjustments
According to Article 69 of the Medical Act, "Medical institutions may produce and store medical records in electronic format without the need for additional paper copies."
As per Article 17 of the Electronic Medical Record Amendment Act, medical institutions can electronically transcribe specified data and store it as electronic files. The transcribed content should be reviewed for consistency with the original documents and sealed with the institution's digital certificate, thus becoming electronic medical records."
Microsoft discontinued support for the Internet Explorer browser in 2023.
In compliance with medical regulations, medical records should be retained for at least seven years and can be accessed online at any time.
Medical record storage and management scenarios
System architecture
HIS & EMR integration
Features
Scanning tool and Medical Image Management System
including image scanning, management, and retrieval functions, provide a comprehensive digital solution and modular system integration. This significantly reduces maintenance costs, manpower, and time expenses.
The access control mechanism
provides user account authentication using "Healthcare Personnel Card" and "Citizen Digital Certificate" for enhanced security.
Single Sign-On (SSO) integration with the portal is supported.
Patient visit information and medical record images can be integrated and accessed with the Hospital Information System (HIS). They can also be converted into file formats compliant with the Electronic Medical Record Act for integration and access with the Electronic Medical Record system (EMR).
Extensive experience in paper medical record scanning process.
Through requirement interviews, we understand the challenges and pain points faced by healthcare institutions, and we provide real-time solutions for relevant stakeholders to avoid duplicating efforts.
Efficiency and Advantages
Medical institutions can eliminate the various time and cost associated with paper-based storage, transportation, retrieval, archiving, and on-demand access of medical records.
A complete digital solution: scanning, barcode recognition, access control, search and retrieval, and borrowing approval.
Modular system integration: HIS and EMR data integration API.
Function
Scanning workstation
Supports TWAIN-compatible scanning devices.
Supports barcode and QR code recognition.
Provides image insertion and page supplementation functionality.
Inquiry and retrieval
Compatible with browsers such as Chrome, Edge, etc.
Provides keyword search criteria for fields such as medical record number, medical record category, forms, etc.
Version control mechanism for medical record images.
Document/form management
Create and modify document types, including inactive and sensitive records.
Create and modify form types, such as anesthesia record forms and surgical consent forms.
System management
Enables user profile management, including adding, modifying, and deactivating users. It also allows for configuring different permissions for individual accounts.
Provides group management functionality, allowing for system permissions to be set based on unit attributes.
Allows for querying system transaction records as audit controls based on date criteria.
System integration
The system supports integration with HIS and EMR systems, and provides authentication functionality using "Healthcare Personnel Card."
System requirements
Windows Server 2019
IIS 10
.Net Framework 4.8+
Microsoft SQL Server 2019
Not applicable for Microsoft SQL Server Express
Successful case
A total of 33 medical institutions have implemented the system, listed as follows:
(Data collected until December 2023; the classification of medical institutions is based on the Ministry of Health and Welfare, categorized by geographical regions: North, Central, South, and East)
Medical Centers:
Far Eastern Memorial Hospital / National Taiwan University Hospital / National Taiwan University Hospital Hsinchu Branch / National Taiwan University Hospital Yunlin Branch / Tri-Service General Hospital.
Regional Hospitals:
New Taipei City Hospital / Kaohsiung Municipal United Hospital / Koo Foundation Sun Yat-Sen Cancer Center / National Yang Ming Chiao Tung University Hospital / Mennonite Christian Hospital / Luodong Lo-Tung Pohai Hospital / Saint Mary's Hospital Luodong / Cardinal Tien Hospital / Tungs' Taichung MetroHarbor Hospital
Ministry of Health and Welfare:
Keelung Municipal Hospital / Taoyuan General Hospital / Miaoli Hospital / Fongyuan Hospital / Ministry of Health and Welfare Taichung Hospital / Nantou Hospital / Chang Hua Hospital / Hualien Hospital / Xinying Hospital.
Ministry of Health and Welfare:
Taoyuan Psychiatric Center / Tsaotun Psychiatric Center.
District Hospitals:
Yonghe Cardinal Tien Hospital / Fu Jen Catholic University Hospital / Yeezen General Hospital / Catholic Mercy Hospital / Dongshih Farmers' Hospital / St. Martin De Porres Hospital / St. Joseph's Hospital.
Primary Clinics:
Far Eastern Polyclinic.