医养随访一体边缘计算架构与医疗物联网融合路径研究

　　健康一体机作为基层医疗卫生服务数字化转型的核心载体，其系统架构设计充分融合了物联网感知、边缘计算与医疗信息学原理，构建起集智能诊断、即时检验、数据管理与远程协作为一体的复合型医疗服务平台。本设备通过模块化硬件集成与分布式系统设计，实现了基础医疗检测能力的全域覆盖与医疗数据流的全周期管控。

　　As the core carrier of the digital transformation of primary medical and health services, the health all-in-one machine fully integrates the Internet of Things perception, edge computing and medical informatics principles in its system architecture design to build a hybrid medical service platform integrating intelligent diagnosis, real-time inspection, data management and remote collaboration. This device achieves full coverage of basic medical detection capabilities and full cycle control of medical data flow through modular hardware integration and distributed system design.

　　数据中枢系统

　　Data center system

　　健康一体机存储单元采用多级缓存架构设计，配置医疗专用固态存储器（容量≥1TB，MTBF≥10万小时），具备三重数据保护机制：

　　The storage unit of the health all-in-one machine adopts a multi-level cache architecture design, equipped with medical dedicated solid-state storage (capacity ≥ 1TB, MTBF ≥ 100000 hours), and has triple data protection mechanism:

　　实时加密存储：对设备参数配置信息采用AES-256加密算法，确保系统设置安全

　　Real time encrypted storage: AES-256 encryption algorithm is used for device parameter configuration information to ensure system security

　　时序数据库管理：以时间戳索引方式存储生理参数时序数据（血压波形、心电信号等）

　　Time series database management: Store physiological parameter time series data (blood pressure waveforms, electrocardiogram signals, etc.) using timestamp indexing

　　智能分级存储：基于LRU算法自动区分热数据（实时监测值）与冷数据（历史档案）

　　Intelligent hierarchical storage: based on LRU algorithm, automatically distinguish between hot data (real-time monitoring values) and cold data (historical archives)

　　配备医疗数据生命周期管理系统，实现数据自动归档（符合HL7 FHIR标准）、定期备份（支持异地容灾）与合规化清除（遵循GDPR医疗数据保留规范）

　　Equipped with a medical data lifecycle management system to achieve automatic data archiving (compliant with HL7 FHIR standard), regular backup (supporting remote disaster recovery), and compliant clearance (following GDPR medical data retention standards)

　　健康一体机血压计、心电仪、体温计和血氧仪通过无线和 / 或有线方式分别与健康一体机物理诊断模块连接，并通过健康一体机物理诊断模块实现常规疾病体格检查 ；健康一体机白细胞计数仪、尿液分析仪、血糖尿酸总胆固醇分析仪通过无线和 / 或有线方式分别与健康一体机快速检验模块连接，并通过健康一体机快速检验模块实现常规化验项目的检验分析。

　　The blood pressure monitor, electrocardiograph, thermometer, and oximeter of the health all-in-one machine are connected to the physical diagnosis module of the health all-in-one machine through wireless and/or wired means, and routine physical examinations for diseases are carried out through the physical diagnosis module of the health all-in-one machine; The white blood cell counter, urine analyzer, and blood glucose, uric acid, and total cholesterol analyzer of the health all-in-one machine are respectively connected to the rapid testing module of the health all-in-one machine through wireless and/or wired means, and the routine laboratory test items are tested and analyzed through the rapid testing module of the health all-in-one machine.

　　智能管理系统

　　Intelligent management system

　　健康管理系统采用微服务架构设计：

　　The health management system adopts a microservice architecture design:

　　核心引擎：医疗知识图谱

　　Core Engine: Medical Knowledge Graph

　　健康筛查：自动生成WHO STEPS式风险评估报告

　　Health screening: Automatically generate WHO STEPS style risk assessment report

　　慢病管理：建立个体化控制目标（如HbA1c靶值动态调整）

　　Chronic disease management: Establish individualized control goals (such as dynamic adjustment of HbA1c target values)

　　转诊协同：智能匹配上级医院专科号源（对接区域分级诊疗平台）

　　Referral Collaboration: Intelligent Matching of Superior Hospital Specialized Number Sources (Connected to Regional Grading Diagnosis and Treatment Platforms)

　　创新应用场景：

　　Innovative application scenarios:

　　家庭医生签约服务移动工作站

　　Mobile Workstation for Family Doctor Contract Service

　　突发公共卫生事件应急筛查终端

　　Emergency screening terminal for sudden public health emergencies

　　医养结合机构健康监护节点

　　Health monitoring nodes in medical and elderly care institutions

　　本健康一体机的技术演进方向聚焦于三个维度：在感知层深化多模态生物信号融合技术，提升亚健康状态早期识别能力；在平台层构建医疗AI联邦学习框架，实现基层诊断模型的持续进化；在应用层拓展5G+AR远程指导场景，突破基层医务人员技能瓶颈。建议建立"设备-人员-制度"三位一体的质控体系：设备端实施每日自检与月度计量校准，人员端开展DTx数字疗法认证培训，制度端完善电子健康档案更新机制。通过打造"检测-诊断-干预-随访"的数字孪生服务体系，最终实现从单点健康检测向全生命周期健康管理的范式转换，为落实国家"十四五"全民健康信息化规划提供可落地的技术支撑。

　　The technological evolution direction of this health all-in-one machine focuses on three dimensions: deepening multimodal biological signal fusion technology in the perception layer to enhance the early recognition ability of sub-health status; Building a medical AI federated learning framework at the platform layer to achieve continuous evolution of grassroots diagnostic models; Expand 5G+AR remote guidance scenarios at the application layer to break through the skill bottleneck of grassroots medical personnel. It is suggested to establish a three in one quality control system of "equipment personnel system": daily self inspection and monthly measurement calibration should be implemented on the equipment side, DTx digital therapy certification training should be carried out on the personnel side, and the electronic health record update mechanism should be improved on the system side. By creating a digital twin service system of "detection diagnosis intervention follow-up", we aim to achieve a paradigm shift from single point health testing to full lifecycle health management, providing practical technical support for the implementation of the national "14th Five Year Plan" for national health informationization.

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