Chia-Hung Hsiao

Tzu Chi University, Hua-lien, Taiwan, Taiwan

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Publications (16)16.08 Total impact

  • Chung-Yueh Lien · Tsung-Lung Yang · Chia-Hung Hsiao · Tsair Kao
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    ABSTRACT: 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.
    No preview · Article · Feb 2013 · Journal of Medical Systems
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    ABSTRACT: The proliferation of communication and mobile computing devices and local-area wireless networks has cultivated a growing interest in location-aware systems and services. An essential problem in location-aware computing is the determination of physical locations. RFID technologies are gaining much attention, as they are attractive solutions to indoor localization in many healthcare applications. In this paper, we propose a new indoor localization methodology that aims to deploying RFID technologies in achieving accurate location-aware undertakings with real-time computation. The proposed algorithm introduces means to improve the accuracy of the received RF signals. Optimal settings for the parameters in terms of reader and reference tag properties were investigated through simulations and experiments. The experimental results indicate that our indoor localization methodology is promising in applications that require fast installation, low cost and high accuracy. Copyright © 2009 John Wiley & Sons, Ltd.
    No preview · Article · Jun 2011 · Wireless Communications and Mobile Computing
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    ABSTRACT: Browser with Rich Internet Application (RIA) Web pages could be a powerful user interface for handling sophisticated data and applications. Then the RIA solutions would be a potential method for viewing and manipulating the most data generated in clinical processes, which can accomplish the main functionalities as general picture archiving and communication system (PACS) viewing systems. The aim of this study is to apply the RIA technology to present medical images. Both Digital Imaging and Communications in Medicine (DICOM) and non-DICOM data can be handled by our RIA solutions. Some clinical data that are especially difficult to present using PACS viewing systems, such as ECG waveform, pathology virtual slide microscopic image, and radiotherapy plan, are as well demonstrated. Consequently, clinicians can use browser as a unique interface for acquiring all the clinical data located in different departments and information systems. And the data could be presented appropriately and processed freely by adopting the RIA technologies.
    Full-text · Article · Mar 2011 · Journal of Digital Imaging
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    ABSTRACT: The objective of this study was to develop a method to hide information in a portable electronic health record (PEHR). In compliance with HIPAA guidelines, a hiding function for personal identifiers in a PEHR was implemented by recognizing and hiding techniques. The method emphasizes the feasibility of embedding a hiding function in a PEHR. The hiding function could be executed to hide identifiers in offline mode. The present study showed that embedding the hiding function in a PEHR is a practical way not only satisfies data confidentiability needs, but also meets patient's personal privacy requirements. The effects of executing the hiding function would be the same as through de-identification or anonymization process.
    Full-text · Article · Jun 2010 · Journal of Medical Systems
  • Chung-Yueh Lien · Chia-Hung Hsiao · Tsung-Lung Yang · Tsair Kao
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    ABSTRACT: In this paper, we evaluated the implementation of a digital signature for medical imaging quality assurance and control (QA/C) by a technician in accordance with the Digital Image and Communication in Medicine (DICOM). After QA/C, a set of DICOM images were collected into a DICOM Key Object Selection (KOS) document with digital signatures. The digital signature was implemented by RSA public-key cryptography combined with a public-key health certificate and health professional card (HPC) to digitally sign a series of DICOM images. Our method includes the DICOM Modality Performed Procedure Steps (MPPS) mechanism that assures the image transmission completeness and accuracy in an image examination workflow. The results show that the method is more efficient and requires less loading time to create the technician's signature in an imaging examination workflow.
    No preview · Conference Paper · Jan 2010
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    Chung-Yueh Lien · Tsair Kao · Chia-Hung Hsiao · Chung-I Keng
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    ABSTRACT: The cost of digital dental X-ray equipment is still too high for many clinical dental departments. When considering the balance of cost and effectiveness for clinical dental departments, using a scanner to scan traditional X-ray film to acquire secondary capture (SC) images appears to be an acceptable solution. Unfortunately, there is no effective way of preventing the creation of fraudulent SC images. The implementation of medical SC images has to conform to security regulations, such as prevention of data modification and authentication of identity, by law. In this paper, we suggest a method, called software-embedded digital signature, to ensure the integrity and authentication of Digital Imaging and Communications in Medicine (DICOM) of SC image scanned from X-ray film and captured in digital form. During the scanning process, the image is converted into DICOM format and the digital signature was added. The scanning, converting and signing processes are locked with a scanner controller, digital signature module, and patient-identifiable data, and all of these are processed in the scanning system before saving the digital image onto a computer.
    Full-text · Article · Jan 2010 · Journal of Medical and Biological Engineering
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    ABSTRACT: As patients face the possibility of copying and keeping their electronic health records (EHRs) through portable storage media, they will encounter new risks to the protection of their private information. In this study, we propose a method to preserve the privacy and security of patients' portable medical records in portable storage media to avoid any inappropriate or unintentional disclosure. Following HIPAA guidelines, the method is designed to protect, recover and verify patient's identifiers in portable EHRs. The results of this study show that our methods are effective in ensuring both information security and privacy preservation for patients through portable storage medium.
    No preview · Article · Oct 2009 · Computers in Biology and Medicine
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    Chung-Yueh Lien · Chia-Hung Hsiao · Lu-Chou Huang · Tsair Kao
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    ABSTRACT: In this paper, we demonstrate how to digitally sign a content manifest of a presentable clinical document that contains multiple clinical data with presentations. Only one signature is needed for an entire clinical document with multiple data resources, which can reduce the computation time during signing and verifying processes. In the radiology field, a report may contain text descriptions, images, and annotations that are stored separately in different data resources. The manifest signature would be a proper means for integrity checking for all the clinical data within the manifest. The manifest signature can be extended with a trusted third party to add a digital time signature for long-term verifiability. The performance of the manifest signing compared with that of a traditional digital signing was evaluated. The new manifest signature can be used for signing different types of presentable clinical documents, such HL7 CDA documents and DICOM image reports.
    Full-text · Article · Apr 2009 · Journal of Digital Imaging
  • Chung Yueh Lien · Tsung-Lung Yang · Chia-Hung Hsiao · Tsair Kao
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    ABSTRACT: PURPOSE To design and implement the Integrating the Health Enterprise Cross-enterprise Document Media Interchange (IHE XDM) platform in Kaohsiung Veterans General Hospital (VGHKS) in Taiwan. METHOD AND MATERIALS The XDM-compliant document which is integrated with multimedia data (such as: DICOM, medical summaries, report, and ECG) are exported from the various systems in VGHKS. Under the public key infrastructure (PKI), A health organization certificate card (HOC) issued by the Taiwan Health Certificate Authority (HCA) was used for the digital official seal of the XDM-compliant document exported from the VGHKS. We adopted the W3C advance XML digital signature (XAdES) to realize the authenticity and integrity of the XDM-compliant document. RESULTS We will demonstrate the usage of the secure XDM-compliant document which is compliant with DICOMDIR and multimedia stored on portable data storage media (CDs/DVDs, diskettes, flash drives) in real practice. The receiver can use both XDM and DICOMDIR ways to import the DICOM images to other systems. CONCLUSION We will demonstrate the usage of the portable EHR is XDM-compatible and secure for exchange in healthcare environment in Taiwan. CLINICAL RELEVANCE/APPLICATION To implement the portable EHR by XDM way is more suitable than other ways. It is necessary to identify the minimal requirements of XDM in different area should be identified.
    No preview · Conference Paper · Nov 2008
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    ABSTRACT: This paper demonstrates a pure web-based solution enabling the presentation of scanned pathologic microscopic images on the web. For each slide, an entire specimen is scanned, and a high-resolution digital image (in the order of giga-pixels) is reconstructed. These huge images are then tiled into many 256 x 256-pixel blocks with different resolutions, and information about the blocks of each scanned slide is included in an extensible markup language metafile. Based on the data, a virtual microscopy system is created for viewing the scanned pathologic slides on web. The functionalities (changing viewing resolution, location adjustment, and multimedia annotation presentation) of our virtual slide viewing system are accomplished using pure hypertext markup language (HTML) and JavaScript. We show that there is no need to add plug-in components to browsers in order to handle virtual slides on the web. In a heterogeneous healthcare environment, methods using pure HTML and JavaScript to deal with pathologic content are more appropriate than using proprietary technologies supported only by specific browsers.
    Full-text · Article · Jul 2008 · Journal of Digital Imaging
  • Chung-Yueh Lien · Chia-Hung Hsiao · Lu-Chou Huang · Tsair Kao
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    ABSTRACT: In this paper, we proposed a method to secure an electronic health record stored on a portable data storage media (CDs/DVDs, diskettes, flash drives). We applied cryptography to realize the authenticity and integrity of the portable health record. A manifest signature mechanism was used to reduce the computation time of the signing and verifying processes. A DICOM DIR consists of 166 DICOM MR images was tested as an example of a portable medical record. The performance of this method is faster than the regular digital signature mechanism.
    No preview · Conference Paper · Jan 2008
  • K. Chu · L. Wang · L. Chao · D. Huang · C. Hsiao · K. Yeh · Y. Lee · S. Yen · M. Chao
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    ABSTRACT: Purpose: The surgical operation to remove the tumor is the premier treatment method for rectal cancer, and the radiation therapy is an auxiliary but important way. The radiation treatments for rectal cancer include preoperative irradiation and postoperative irradiation. The purpose of this study is to compare different treatment planning techniques for preoperative pelvic irradiation of rectal cancer. The comparisons include three‐field vs four‐field (box) techniques and the treatment planning with full bladder vs post voiding bladder. Method and Materials: The different planning techniques for the same patient were compared via score function of TCP (TumorControl Probability) and NTCP (Normal Tissue Complication Probability). The organs contoured include femoral head, intestine, and urinary bladder walls with full bladder and with post voiding bladder for the same PTV. All patients were treated with preoperative irradiation at VGH‐Taipei. These patients include 6 male and 3 female with a mean age of 51.67 (28–76). The clinical stages for all patients are stage II and III rectal cancer (AJCC T2–4 N0–2 M0). The total dose was 4500 cGy with a fraction size of 225 cGy. ANOVA (F‐test) was performed for the results analysis Results: The results from score function show the treatment with 3‐field is better than that with 4‐field. It also shows the treatment with full bladder is better than that with post voiding bladder. Conclusion: In the F test, the P value of field factor (3‐field vs 4‐field) is 0.00024. It means the field factor is a significant factor. The P value of the bladder‐status factor (full or empty bladder) is 0.59 (<0.95). It means the bladder‐status factor isn&apos;t significant. Therefore, we conclude the treatment field is a treatment planning factor, but not bladder‐status. However, we need more patients to make a much solid conclusion for the bladder‐status factor.
    No preview · Article · Jun 2007 · Medical Physics
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    ABSTRACT: The integration of medical informatics and e-learning systems could provide many advanced applications including training, knowledge management, telemedicine, etc. Currently, both the domains of e-learning and medical image have sophisticated specifications and standards. It is a great challenge to bring about integration. In this paper, we describe the development of a Web interface for searching and viewing medical images that are stored in standard medical image servers. With the creation of a Web solution, we have reduced the overheads of integration. We have packaged Digital Imaging and Communications in Medicine (DICOM) network services as a component that can be used via a Web server. The Web server constitutes a content repository for searching, editing, and storing Web-based medical image content. This is a simple method by which the use of Picture Archiving and Communication System (PACS) can be extended. We show that the content repository can easily interact and integrate with a learning system. With the integration, the user can easily generate and assign medical image content for e-learning. A Web solution might be the simplest way for system integration. The demonstration in this paper should be useful as a method of expanding the usage of medical information. The construction of a Web-based repository and integrated with a learning system may be also applicable to other domains.
    Full-text · Article · Oct 2006 · Journal of Digital Imaging
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    ABSTRACT: This article demonstrates a gateway system for converting image fusion results to digital imaging and communication in medicine (DICOM) objects. For the purpose of standardization and integration, we have followed the guidelines of the Integrated Healthcare Enterprise technical framework and developed a DICOM gateway. The gateway system combines data from hospital information system, image fusion results, and the information generated itself to constitute new DICOM objects. All the mandatory tags defined in standard DICOM object were generated in the gateway system. The gateway system will generate two series of SOP instances of each PET-MR fusion result; SOP (Service Object Pair) one for the reconstructed magnetic resonance (MR) images and the other for position emission tomography (PET) images. The size, resolution, spatial coordinates, and number of frames are the same in both series of SOP instances. Every new generated MR image exactly fits with one of the reconstructed PET images. Those DICOM images are stored to the picture archiving and communication system (PACS) server by means of standard DICOM protocols. When those images are retrieved and viewed by standard DICOM viewing systems, both images can be viewed at the same anatomy location. This system is useful for precise diagnosis and therapy.
    Full-text · Article · Apr 2005 · Journal of Digital Imaging
  • T. Kao · Len-Jon Hwang · Yui-Han Lin · Tzong-Huei Lin · Chia-Hung Hsiao
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    ABSTRACT: The volume of electrocardiograms (ECG's) recorded in hospital is increasing. Although modern electrocardiographs have digital output, most of ECG's are still recorded on plain papers. Recently, exchanging patients' clinical information between healthcare facilities has become very important. It will be very helpful, if plane paper type of ECG could be converted to digital form. In general, the background of ECG paper charts can be divided into three types: uniform background, background with colored grid and background with black grid. In this study, we developed a morphological method to retrieve ECG data on paper charts using optical scanner and computer. The results show that our method can erase the background noise and acquire the digital ECG signal from ECG paper charts correctly. Conversion of ECG by optical scanner is of practical use when attempting ECG data exchange between healthcare providers.
    No preview · Conference Paper · Feb 2001
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    ABSTRACT: In the developed country, it is necessary that the enterprise should arrange the occupational physical exami-nation yearly, there are millions cases, results in heavy loading to the hospital. Because of the limited scale, the hospital usually needs outsourcing physical examination institutes. But the introduction of the outsourcing institute results in prob-lems of examination information sharing. Although the information systems for hospital have been developed for decades, and now there are various successful systems. But the information system for outsourcing institute integration is not yet developed. This study is to develop the information architecture for outsourcing institute integration, which is basing on the relational medical information standards, includes DICOM, HL7 CDA, and IHE XDS. The proposed architecture would provide the information sharing in heterogeneous systems for different hospitals.
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Publication Stats

72 Citations
16.08 Total Impact Points


  • 2008-2013
    • Tzu Chi University
      Hua-lien, Taiwan, Taiwan
  • 2007
    • Taipei Veterans General Hospital
      T’ai-pei, Taipei, Taiwan
  • 2001-2006
    • National Yang Ming University
      • Department of Biomedical Engineering
      Taipei, Taipei, Taiwan