[醫(yī)療信息化][DICOM教程]開(kāi)篇介紹，新冠肺炎為醫(yī)療保健信息產(chǎn)業(yè)帶來(lái)新的的緊迫性

COVID brings a Renewed Urgency for the Healthcare Informatics Industry

新冠肺炎為醫(yī)療保健信息產(chǎn)業(yè)帶來(lái)新的的緊迫性

The ongoing COVID-19 pandemic and the tragedies that have occured (and still occuring) have helped highlight the need for more timely exchange of critical healthcare related information for governments, health agencies, care providers and patients around the world. For many decades, the healthcare community has been at the forefront of standardization efforts for information exchange through the use of communication protocols such as HL7 and DICOM, and has worked hard to promote the use of these standards worldwide. However, the recent experience only highlights the fact that more opportunities exist to help achieve even more synergies and efficiencies in the information exchange processes that need to occur between various systems involved in the overall process of planning, administering, receiving and monitoring of all healthcare-related activities that are operationalized at any moment.

持續(xù)發(fā)生的COVID-19大流行以及已經(jīng)發(fā)生（和仍在發(fā)生）的悲劇，凸顯了需要為世界各地的政府，衛(wèi)生機(jī)構(gòu)，護(hù)理提供者和患者更及時(shí)地交流重要的醫(yī)療保健相關(guān)信息。 數(shù)十年來(lái)，醫(yī)療保健界一直在通過(guò)使用諸如HL7和DICOM之類的通信協(xié)議進(jìn)行信息交換的標(biāo)準(zhǔn)化工作中走在前列，并且一直在努力促進(jìn)在全球范圍內(nèi)使用這些標(biāo)準(zhǔn)。 但是，最近的經(jīng)驗(yàn)僅凸顯了這樣一個(gè)事實(shí)，即存在更多的機(jī)會(huì)來(lái)幫助實(shí)現(xiàn)信息交換過(guò)程中更多的協(xié)同作用和效率，而信息交換過(guò)程需要在涉及所有醫(yī)療保健的計(jì)劃，管理，接收和監(jiān)視的整個(gè)過(guò)程中進(jìn)行的各個(gè)系統(tǒng)之間進(jìn)行。 隨時(shí)可進(jìn)行的相關(guān)活動(dòng)。

“Where, after all, do universal human rights begin? In small places, close to home – so close and so small that they cannot be seen on any maps of the world. … Unless these rights have meaning there, they have little meaning anywhere. Without concerned citizen action to uphold them close to home, we shall look in vain for progress in the larger world” ~ Eleanor Roosevelt

“畢竟，普遍人權(quán)從哪里開(kāi)始？ 在離家不遠(yuǎn)的小地方-太小太小以至于它們?cè)谑澜缛魏蔚貓D上都看不到。 …除非這些權(quán)利在那里具有意義，否則它們?cè)谌魏蔚胤蕉紱](méi)有意義。 沒(méi)有關(guān)心的公民采取行動(dòng)在自己家附近維護(hù)他們，我們將徒勞地尋求更大世界的進(jìn)步”?埃莉諾·羅斯福（Eleanor Roosevelt）

Although I have been blogging about these standards from a software development perspective for many years, I feel that a higher level of urgency is needed now to help increase awareness of healthcare information standards for software developers and others in the IT community who are either getting started in the field or simply curious. I hope those of you that stumble across these articles on my site find them useful in some way to get started or perhaps sharpen your skills in areas that you may have had some exposure to already. With more brains collectively working on the many challenges and the opportunities for improvement that still exist in the healthcare informatics area from around the world, we can hopefully look past the sufferings, learn from any mistakes made, and dream of safer and healthier societies in the future for ourselves as well as others like the elderly and our young ones.

盡管多年來(lái)我一直從軟件開(kāi)發(fā)的角度來(lái)撰寫這些標(biāo)準(zhǔn)的博客，但我認(rèn)為現(xiàn)在需要更高的緊迫性，以幫助軟件開(kāi)發(fā)人員和IT社區(qū)中的其他入門人員提高醫(yī)療保健信息標(biāo)準(zhǔn)的意識(shí)。 在野外還是只是好奇。 我希望那些偶然發(fā)現(xiàn)我網(wǎng)站上這些文章的人能從某種程度上幫助他們?nèi)腴T，或者提高您可能已經(jīng)接觸過(guò)的領(lǐng)域的技能。 隨著越來(lái)越多的人集體努力應(yīng)對(duì)來(lái)自世界各地的醫(yī)療信息學(xué)領(lǐng)域仍然存在的許多挑戰(zhàn)和改進(jìn)機(jī)會(huì)，我們有望克服痛苦，從犯下的錯(cuò)誤中吸取教訓(xùn)，并夢(mèng)想著建立一個(gè)更安全，更健康的社會(huì)。 自己以及其他老年人和年輕人的未來(lái)。

Background and Information on Articles

文章的背景和信息

My DICOM and HL7 programming tutorials on this site (see links below) are aimed at beginners starting in this area covering examples of implementation using both C# and Java programming languages using some open source libraries available on the Internet. As the use and popularity of some of the libraries that I have used in these pages have changed over the years (and will likely continue to change), I try to keep them updated when I can. Whenever or wherever that is not the case, I hope these examples still manage to convey the "theoretical minimum" and the core concepts of these standards for one to get started in this area as the standards don't change drastically too often. With that said, let us look at what thee tutorials are about.

我在此站點(diǎn)上的DICOM和HL7編程教程（請(qǐng)參見(jiàn)下面的鏈接）是針對(duì)該領(lǐng)域的初學(xué)者的，它們涵蓋了使用C＃和Java編程語(yǔ)言以及Internet上一些開(kāi)放源代碼庫(kù)的實(shí)現(xiàn)示例。 多年來(lái)，由于我在這些頁(yè)面中使用的某些庫(kù)的使用和流行度發(fā)生了變化（并且可能會(huì)繼續(xù)發(fā)生變化），因此，我會(huì)盡可能地對(duì)它們進(jìn)行更新。 無(wú)論何時(shí)何地，無(wú)論如何，我希望這些示例仍然能夠傳達(dá)“最低標(biāo)準(zhǔn)”和這些標(biāo)準(zhǔn)的核心概念，以便人們開(kāi)始在這一領(lǐng)域工作，因?yàn)檫@些標(biāo)準(zhǔn)不會(huì)發(fā)生太大的變化。 話雖如此，讓我們看看您的教程是關(guān)于什么的。

My HL7 Tutorials

HL7 is a family of cooperating standards which collectively help provide a set of organizational frameworks and guidelines to help in the design, implementation, administration and operationalization of systems that perform healthcare-related information exchange in an electronic format. The various standards contained within the larger HL7 umbrella (such as V2, V3, FHIR, CDA, etc) help define how patient care and any care provider-related information is communicated between the various parties involved. Kmowledge of these standards is vital to enable these disparate parties to exchange timely and critical healthcare data using standardized data types and a structured vocabulary set needed to achieve seamless integration between the various electronic health systems involved. My HL7 Tutorials should take someone with a background in any object-oriented language (C# or Java is preferrable) and illustrate how the static as well as runtime behavior of systems built using the HL7 standard will look like. Please note that some articles are still in progress, and I have been working through them slowly over the years.

HL7是一系列合作標(biāo)準(zhǔn)，共同幫助提供了一組組織框架和指南，以幫助設(shè)計(jì)，實(shí)施，管理和操作以電子格式執(zhí)行與醫(yī)療保健相關(guān)的信息交換的系統(tǒng)。更大的HL7保護(hù)傘中包含的各種標(biāo)準(zhǔn)（例如V2，V3，F(xiàn)HIR，CDA等）有助于定義如何在相關(guān)各方之間傳達(dá)患者護(hù)理和任何與護(hù)理提供者相關(guān)的信息。這些標(biāo)準(zhǔn)的知識(shí)對(duì)于使這些不同的各方能夠使用標(biāo)準(zhǔn)化的數(shù)據(jù)類型和結(jié)構(gòu)化的詞匯表集，以實(shí)現(xiàn)所涉及的各種電子醫(yī)療系統(tǒng)之間的無(wú)縫集成，及時(shí)而重要地交換醫(yī)療數(shù)據(jù)至關(guān)重要。我的HL7教程應(yīng)該讓具有任何面向?qū)ο笳Z(yǔ)言（最好使用C＃或Java）的背景知識(shí)的人，并說(shuō)明使用HL7標(biāo)準(zhǔn)構(gòu)建的系統(tǒng)的靜態(tài)和運(yùn)行時(shí)行為如何。請(qǐng)注意，有些文章仍在進(jìn)行中，多年來(lái)，我一直在緩慢地研究它們。

My DICOM Tutorials

DICOM is a healthcare standard responsible for governing nearly all aspects of medical imaging such as image transmission, image interpretation, print management, procedure management and off-line storage, and is used in nearly all healthcare-related imaging “modalities” such as magnetic resonance, nuclear medicine, computed tomography and ultrasound. Nearly all clinical imaging workflows around the world are based on the DICOM standard. Learning this standard is vital if you work or want to work in the healthcare informatics industry.

DICOM是一種醫(yī)療保健標(biāo)準(zhǔn)，負(fù)責(zé)管理醫(yī)學(xué)成像的幾乎所有方面，例如圖像傳輸，圖像解釋，打印管理，程序管理和離線存儲(chǔ)，并且?guī)缀跤糜谂c醫(yī)療保健相關(guān)的所有成像“模態(tài)”，例如磁共振 ，核醫(yī)學(xué)，計(jì)算機(jī)斷層掃描和超聲檢查。 全世界幾乎所有的臨床成像工作流程都基于DICOM標(biāo)準(zhǔn)。 如果您在醫(yī)療信息學(xué)行業(yè)工作或想要工作，那么學(xué)習(xí)此標(biāo)準(zhǔn)至關(guān)重要。

“Live in the present and shape the future, do not be casting lingering looks to the distant past for the past has passed away, never again to return.” ~ Subramanya Bharathi

“活在當(dāng)下，塑造未來(lái)，不要為遙遠(yuǎn)的過(guò)去投下?lián)]之不去的過(guò)去，因?yàn)檫^(guò)去已經(jīng)過(guò)去，再也不會(huì)回來(lái)。” ?Subramanya Bharathi

My DICOM Tutorials are a series of short and focused articles aimed at someone who is starting with DICOM and wants to understand the theory by relating to some practical code examples. DICOM is an extremely large standard (some 6000 pages and growing each day) and is intimidating even to those who work with it on a daily basis. My tutorials are an attempt to provide a "digest version" of the many areas in the standard. These articles do not require any prior healthcare background or knowledge from the readers. Only a background in any object-oriented programming language such as C#, Java or C++ is required. Like my HL7 tutorials, some articles are still not complete and I have been working on them slowly over the years, learning those parts of the standard deeply as I go on a journey myself.

我的DICOM教程是一系列簡(jiǎn)短而集中的文章，專門針對(duì)那些剛開(kāi)始使用DICOM并希望通過(guò)與一些實(shí)際代碼示例相關(guān)的知識(shí)來(lái)理解該理論的人。 DICOM是一個(gè)非常大的標(biāo)準(zhǔn)（每天約有6000頁(yè)，并且每天都在增長(zhǎng)），甚至對(duì)于每天使用它的人來(lái)說(shuō)都是令人恐懼的。 我的教程試圖提供標(biāo)準(zhǔn)中許多領(lǐng)域的“摘要版本”。 這些文章不需要任何醫(yī)療背景或讀者的知識(shí)。 僅需要任何面向?qū)ο蟮木幊陶Z(yǔ)言（例如C＃，Java或C ++）的背景知識(shí)。 像我的HL7教程一樣，有些文章仍未完成，這些年來(lái)我一直在緩慢地研究它們，在我自己旅途中深入學(xué)習(xí)標(biāo)準(zhǔn)的那些部分。

Read Before Getting Started

開(kāi)始之前請(qǐng)閱讀

I want to make a disclaimer about these articles and the information contained within them. I do not serve on either the HL7 or DICOM standards committee. You must ultimately refer to the standards themselves and their latest recommendations before starting any project involving these standards. Wrongly interpreting these standards can lead to serious health consequences for the patients, reputational risks and financial liabilities for any care givers and organizations involved. For more information about the DICOM standard, you can visit its main site here. The HL7 group's main site or your local HL7 chapters located around the world should help you obtain more information regarding the HL7 standard.

我想對(duì)這些文章及其中包含的信息免責(zé)。 我不在HL7或DICOM標(biāo)準(zhǔn)委員會(huì)中任職。 在開(kāi)始涉及這些標(biāo)準(zhǔn)的任何項(xiàng)目之前，您必須最終參考這些標(biāo)準(zhǔn)及其最新建議。 錯(cuò)誤地解釋這些標(biāo)準(zhǔn)會(huì)給患者帶來(lái)嚴(yán)重的健康后果，聲譽(yù)風(fēng)險(xiǎn)以及所涉及的任何護(hù)理人員和組織的經(jīng)濟(jì)責(zé)任。 有關(guān)DICOM標(biāo)準(zhǔn)的更多信息，您可以在這里訪問(wèn)其主要站點(diǎn)。 HL7組的主要站點(diǎn)或您在世界各地的HL7本地分會(huì)應(yīng)幫助您獲得有關(guān)HL7標(biāo)準(zhǔn)的更多信息。