NCKU introduces smart medicine to improve clinical quarantine efficiency of COVID-19
成大導入智慧醫療 提升武漢肺炎臨床檢疫效率
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          Video:https://www.youtube.com/watch?v=hg7r14j1_r4
          Video for Students:https://www.youtube.com/watch?v=L0xA5jpJiF4&feature=youtu.be


          In order to combat the severe epidemic of the new type of coronavirus pneumonia (COVID-19), Su Huey-Jen, the president of National Cheng Kung University, led the NCKU and affiliated medical centers to integrate a number of smart medical treatments. They established a "smart medical clinical decision support system" to increase quarantine efficiency by 5 to 6 times. The time required for a high-risk patient to enter quarantine after the physician's diagnosis was originally 2 and a half hours. After smart medicine integration, it can be completed in less than 30 minutes. Smart medicine can also reduce the risk of cross-infection between medical staff, patients and the quarantine staffs. At the same time, the NCKU interdisciplinary team created the home quarantine policy with a "WEN-SHIN(溫心)smart band". Shan Yan-Shen, the dean of the medical college, and Shen Meng-Ru, the president of the NCKU Hospital stated that since the epidemic struck, NCKU and NCKU hospital immediately mobilized for epidemic prevention. The establishment of a smart medical system will make the quarantine work more efficiently with more reliability.

          The Ministry of Science and Technology (MOST) has traditionally supported NCKU's development in the smart medical care field. Xie Da-Bin, the Deputy Minister of Science and Technology, stated that NCKU has grasped and utilized the latest scientific and technological trends.

          The "Smart Medical Clinical Decision Assistance System" includes front-end medical record automation, chest X-ray artificial intelligence to assist in the interpretation of pneumonia, and real-time updated clinical decisions based on the latest daily epidemic development provided by the CDC. This results in greatly improving the decision-making in quarantine and prevention.

          NCKU also adopts intelligent monitoring for students living in school dormitories under home quarantine. The "WEN-SHIN(溫心)smart band" developed by an NCKU interdisciplinary team continuously monitors body temperature and heartrate as predictive symptoms indicators. When the body temperature of the wearer rises, the mobile phone APP can be used to help confirm the abnormal symptoms and remind the student to seek medical treatment. At present, the bands are regularly collected every week, and then management personnel uploads the data to a cloud platform for follow-up. Shan Yan-Shen, the dean of NCKU Medical College, stated that NCKU's home-based quarantine measures are thorough and rigorous and are a model system for Taiwan.

          NCKU Hospital is highly vigilant against the epidemic situation and does not show any slackness due to the Chinese New Year. The director of the hospital, Shen Meng-Ru, started the “Wuhan Pneumonia Clinical Quarantine Station” before Chinese New Year. The first step was to set up 8 high-specification tent quarantine stations outside the emergency room as the front line of epidemic prevention sites. At the same time, modular quarantine house stations were built to improve the anti-epidemic preparedness specifications. Shen Meng-Ru said that the epidemic prevention tent is a “high pressure situation”. The patients are uneasy and the medical staff are under great psychological pressure. Therefore, the hospital is committed to standardizing and speeding up the entire process to prevent the risk of infection.

          In the second step, the research results of the "AI Biomedical Research Center at National Cheng Kung University" and the "Top-notch Integration Project" of the Ministry of Science and Technology were included into the smart medical treatment in large hospitals to automate medical records. , Close contact during traditional paper work filling or verbal inquiry of medical history may increase the risk of infection between medical staff and patients. The automated medical record system allows patients to use tablets to independently fill in travel history, occupation history, contact history, cluster history… etc. Medical record data is uploaded into the electronic medical record system, and medical staff can immediately identify relevant data for clinical decision-making. Each tablet will be disinfected with alcohol after patient use.

          The third step was the introduction of AI-assisted detection of pneumonia. "Chest X-Ray Artificial Intelligence Interpretation of Pneumonia System Model" was developed by the AI and the hospital information teams of NCKU Hospital. The pneumonia image data of NCKU Hospital was uploaded and is currently used to assist 152 patients with suspected COVID-19 screening. The sensitivity and accuracy can be achieve 80% and 90% accuracy.

          The quarantine 3-step project from NCKU Hospital combined with the latest daily epidemic development provided by the CDA, for example the expansion of the epidemic prevention control area, was integrated into a "smart medical clinical decision support system".This system is built into the computer system at the quarantine station so clinical decisions during the epidemic are no longer stressful for medical staff.

          In order to avoid the continuous infection of people with virus, monitoring and forecasting is very important part. NCKU's multi-disciplinary team and the technology manufacturer Pan-Xu Intelligent(盤旭)jointly developed a "WEN-SHIN(溫心)smart band ". The band can continuously monitor the patient's body temperature and heartrate. Before the fever, there is an early rise in body surface temperature. By wearing the band, a patient can be warned of oncoming fever. Real-time temperature change monitoring, real-time alerts to abnormalities, and recommendation to take appropriate actions early. At present, there are more than 130 medical and nursing colleagues in NCKU Hospital voluntarily wearing "WEN-SHIN(溫心)smart bands ". Students currently in quarantine at NCKU who are suspected cases and their household contacts also use the "WEN-SHIN(溫心)smart band" for continuous real-time temperature detection.

          In this epidemic prevention period, the NCKU; hospital, medical college, electrical information college, science college, and management college are a cross-disciplinary, inter-departmentalteam, combining medical resources, using "scientific" and "professional" to prevent epidemics. The "Medical Record Automated System" is led by the director of the Clinical Medical Research Center, Liu Bing-Yan, who directs a team of information engineers from to seamlessly integrate the experience of the precision medical record automated system during the past year.

          The "Chest X-Ray Artificial Intelligence Interpretation of Pneumonia System Model" was developed by Tsai Yi-Shan, a physician in the Department of Imaging Medicine at NCKU Hospital. The automatic AI interpretation model of tuberculosis X-ray film was imported into the pneumonia image data from NCKU hospital. The hospital information team and Professor Sun Yong-Nian's team from the School of Electricity and Energy also actively participated in the development of the AI Biomedical Medical Innovation Research Center.

          The "WEN-SHIN(溫心)smart band" is supported by the Department of Foresight and Innovation Policies of the Ministry of Science and Technology. Ke Nai-Ying, the head of the Nursing Department of NCKU, Ke Wen-Qian, the deputy director of NCKU Hospital, Chen Po-Ling, the deputy director of NCKU Infection Control Center, Chuang Kun-Ta, associate professor of NCKU Information Engineering Department, Gao Hong-Yu, head of NCKU Department of Information Engineering, and Shu Yu-Zheng, associate professor of NCKU Department of Mathematics, all contributed to research and development with technology companies.

          為對抗新型冠狀病毒肺炎(武漢肺炎)嚴峻疫情,成功大學校長蘇慧貞領導大學校本部與附屬醫學中心整合多項智慧醫療,建制「智慧醫療臨床決策輔助系統」,將檢疫效率一舉提高5至6倍。原本高風險病人從踏入檢疫站到醫師做出臨床決策的時間從原本需2個半小時,現在不到30分鐘即可完成,還可有效降低醫護人員和病人交叉感染的風險以及檢疫所需人力。同時,成大跨域團隊也以「溫心智慧手環」協助落實居家檢疫的政策。蘇慧貞期盼在疫情籠罩之下,成大導入智慧醫療能創造30分鐘守護全世界的新可能性。醫學院院長沈延盛與成大醫院院長沈孟儒皆表示,自疫情來襲,成大與成醫即刻動員進行防疫,是項智慧醫療系統的建制將令檢疫工作更為迅速確實。

          科技部向來支持成大發展智慧醫療,科技部次長謝達斌表示,成大掌握最新科技動向且不忘以人為本、落地生根,令使科技產生實質造福社會。

          「智慧醫療臨床決策輔助系統」包括前端的病歷自動化,胸部X光片人工智慧輔助判讀肺炎,還有最後再依疾管署提供的每日最新疫情發展,隨時更新臨床決策,大大提升成大醫院在檢疫、防疫的應變與決策。

          成大對於住在學校宿舍執行居家檢疫的學生也採用智慧化監測,跨領域團隊開發的「溫心智慧手環」能連續監測體溫與心跳,作為預測症狀指標。當配戴者體溫上升時,可以藉由手機APP主動確認異常症狀並提醒主動就醫。目前每個禮拜定期回收手環,再交由管理人員統一上傳數據資料至雲端平台做後續追蹤。成大醫學院院長沈延盛表示,成大在住校居家檢疫的措施周全嚴謹,可謂全台楷模。

          成大醫院對疫情高度警戒,不因過年而有絲毫懈怠,醫院院長沈孟儒過年前即啟動成大醫院「武漢肺炎臨床檢疫站」三部曲。第一部曲是在急診室外設8個高規格野戰帳篷檢疫站,做為最前線的防疫場所,同時興建組合屋式檢疫站,提升防疫戰備規格,為未來可能有社區感染疫情做長期抗戰的準備。沈孟儒說,防疫帳篷其實是一個壓力站,病患不安、醫護人員心理壓力大,所以醫院致力讓整個流程標準化、快速化,以阻絕感染風險。

          第二部曲將科技部「成大AI人工智慧創新研究中心」暨「拔尖整合計畫」的研究成果,結合成大醫院智慧醫療的能量,做到醫療病歷自動化。相較於傳統紙筆填寫或口頭詢問病史,近距離接觸恐增加醫護人員與病患接觸感染風險,醫療病歷自動化系統讓病患使用平板自主填寫旅遊史、職業史、接觸史、群聚史等病歷資料,上傳到電子病歷系統,醫護人員就能立即收到相關資料做臨床決策,每次平板使用過後,就會以酒精消毒,降低交叉感染風險也提升檢疫站時效。

          第三部曲則是導入肺炎AI輔助偵測。「胸部X光人工智慧判讀肺炎系統模型」為成大醫院AI團隊與醫院資訊團隊開發,導入成大醫院的肺炎影像資料,目前用於輔助152例疑似武漢肺炎篩檢,敏感度與準確性可達80%及90%。

          成大醫院檢疫三部曲,最後再結合疾管署提供的每日最新疫情發展,例如防疫管制區的擴大等資訊,整合成的「智慧醫療臨床決策輔助系統」,建構於檢疫站的電腦系統,讓因應疫情變化的臨床決策不再成為醫護人員壓力。病患從進入檢疫站到醫師決定是否需要通報住院隔離或居家檢疫觀察,也得以從2個半小時縮減至不到30分鐘。

          為避免疫情持續擴散,監測與預測也是相當重要的一環,成大跨領域團隊與科技廠商磐旭智能共同開發「溫心智慧手環」。手環能連續監測病患的體溫及心跳,在發燒之前,會有前期的體表溫度上升,透過配戴手環,可以預警發燒。掌握溫度趨勢變化做到隨時監測、及時警覺異常,提醒及早採取適當行動。目前成大醫院有超過130位的醫護同仁自願配戴溫心智慧手環,成大目前居家檢疫中的學生、疑似病例及其家戶接觸者,也以溫心智慧手環進行連續體溫檢測。

          在此次抗疫中,醫院、醫學院、電機資訊學院、理學院、管理學院組成跨領域、跨院系、跨團隊等,結合醫療資源,運用「科學」與「專業」來參與抗疫。「醫療病歷自動化系統」由臨床醫學研究中心主任劉秉彥帶領資訊工程師團隊,將過去一年來在精準醫療病歷自動化系統的經驗做一無縫接軌。

          「胸部X光人工智慧判讀肺炎系統模型」為成大醫院影像醫學部醫師蔡依珊帶領醫院資訊團隊開發,電資學院孫永年教授團隊也積極參與,利用先前AI生技醫療創新研究中心計畫發展的肺結核X光片AI自動判讀模型,導入成大醫院的肺炎影像資料,雙方平行合作,以最快速度完成。

          「溫心智慧手環」是在科技部前瞻司的支持下,由成大護理系主任柯乃熒、成大醫院副院長柯文謙、成大感染管制中心副主任陳柏齡、成大資訊工程學系副教授莊坤達、成大資訊工程學系主任高宏宇及成大數學系副教授舒宇宸,與科技公司共同研究開發。