基于国密算法和手机认证的医疗文书无纸化系统的设计与实现  

Design and Implementation of Paperless Medical Document System Based on State Secret Algorithm and Mobile Phone Authentication

作　　者：苏玉成 张亚娜 高荷 陈帆 任斌 赵福占 蒋昆 SU Yucheng;ZHANG Yana;GAO He;CHEN Fan;REN Bin;ZHAO Fuzhan;JIANG Kun(Department of Information,The First Affiliated Hospital of Air Force Medical University,Xi’an Shaanxi 710032,China;Department of Outpatient,The First Affiliated Hospital of Air Force Medical University,Xi’an Shaanxi 710032,China)

机构地区：[1]空军军医大学第一附属医院信息科,陕西西安710032 [2]空军军医大学第一附属医院门诊部,陕西西安710032

出　　处：《中国医疗设备》2023年第8期99-104,共6页China Medical Devices

基　　金：陕西省重点研发计划高校联合项目一般项目(2020GXLH-Y-023)。

摘　　要：目的 对原有数字签名系统进行升级,满足未来5年医院无纸化业务发展需要。方法 运用国密算法、云签系统、电子签名技术和互联网技术,搭建一套横跨内网、安全区和外网的双机热备证书授权(Certificate Authority,CA)认证云服务体系,并将云签业务系统和实际医疗业务系统进行融合。结果 建立了一套符合医院业务需要的CA认证签章业务体系,实现我院所有CA业务系统国密算法升级,升级USB_KEY超330个,搭建手机登录及签章服务平台,失败成功比约为5.8×10-5。用户进入系统操作时间显著低于系统应用前,有效登录率显著高于系统应用前,差异均有统计学意义(P<0.05)。结论 通过项目升级,满足了医院5年内业务增长和系统稳定运行需求,改变了原有实体USB_KEY登录带来的不便,使医务人员通过手机1 s扫码便捷登录系统,帮助医院推进医疗文书无纸化业务发展,为下一步全院CA业务手机升级奠定基础,为我院医疗数据共享提供建设基础。Objective To upgrade the existing digital signature system to meet the needs of paperless business development in hospitals in the next five years.Methods Using state secret algorithm,cloud signature system,electronic signature technology and internet technology,a dual machine hot standby certificate authority(CA)identification cloud service system that spans the internal network,security zone,and external network was established,and the cloud signature business system was integrated with the actual medical business system.Results A set of CA identification and signature business system meeting the needs of hospital business was established,the state secret algorithm of all CA business systems in our hospital was upgraded,over 330 USB_KEY were upgraded,and a mobile phone login and signature service platform was built.The failure to success ratio was about 5.8×10-5.The operation time of users entering the system was significantly lower than that before system application,and the effective login rate was significantly higher than that before system application,the difference was statistically significant(P<0.05).Conclusion Through the upgrade of this project,it meets the needs of the hospital’s business growth and stable system operation within five years.And it changes the inconvenience caused by the original entity USB_KEY login,allows medical personnel to easily log in to the system through 1 second code scanning on their mobile phones,helps the hospital promote the development of paperless medical documents business,prepares for the next step of the hospital’s CA business mobile phone upgrade,and provides a construction foundation for medical data sharing in our hospital.

关 键 词：国密算法 数字签名 证书授权 医疗文书 无纸化 

分 类 号：R197.324[医药卫生—卫生事业管理] TP319[医药卫生—公共卫生与预防医学]