With the rise of 5th generation mobile networks [8] and WIFI6 [9], the real-time transmission of data in telemedicine is accelerated, especially in areas with inconvenient transportation. Telemedicine can not only solve the medical inconvenience of people in space, but also shorten the time for people to seek medical treatment.

Telemedicine uses communication technology to lift the traditional medical care fixed area restrictions for patients, thereby improving medical quality and reducing medical costs. Therefore, communication technology is one of the core technologies for the development of traditional medical care into telemedicine. The increase in the penetration rate of wireless communication networks, the improvement of physiological measurement technology, and the rapid development of care medical equipment will drive the rapid growth of the telemedicine industry market.

Health level seven international is an association defined in the telemedicine data exchange format [10]. By formulating a complete electronic health information framework and related standards, the 7 in the name corresponds to the seventh layer of the Open System Interconnection Model. It is expected that this framework, is conducive to the exchange, integration, and sharing of patients’ medical information, and improves the privacy of patients and the quality of medical care [11].

Fast Healthcare Interoperability Resources(FHIR) is an international medical data exchange standard format [12], which is mainly used to describe the data format and data elements of Electronic Health Records, and provide standard system information in the Application Programming Interface [13], and strengthened patient data exchange, covering not only medical institutions, medical records, hospital stay, and discharge and referral records, but also data exchange between insurance institutions and insurance institutions.

FHIR’s biggest aim is to accelerate the effective communication of medical information among medical units and to use medical information widely on computers, tablets, and smartphones so that hospitals and patients can quickly and easily receive medical service information. FHIR is composed of a series of resource implementations. Medical staff use copying and fine-tuning resources to solve medical practice and management problems. The resource is a set of excel worksheets that can be organized and used to record data. At present, in the FHIR R4 version of the standard [14], 145 types of resources are summarized. These resources can be divided into five categories, including foundation, base, clinical, financial, and specialized. The fields and fields contained in the resource are listed in a hierarchical directory. The affiliation, the data description of the field is attached next to the field.

In this way, each hospital can develop a customized FHIR extended data format definition, and publish the customized FHIR extended data format on the official website to provide everyone with a unified format standard reference source. Even after the patient is registered, the patient’s personal information can be included in the Implementation Guide, and the relevant patient code and files can be attached for other hospitals to download and apply.

We will refer to the FHIR standard specification to design the form design system, and then exchange information with other medical units and cross-system interconnection functions. In our system, we will design for three FHIR resource types [15], which include Patient, Encounter, and CarePlan, as shown in Figure 1.

In addition, we use RESTful to obtain or access the JSON or XML format text files of the hospital’s internal medical record database. As shown in Table 1, various RESTful operation types are written in the form of Application Programming Interface, so that users can use them more efficiently.

We use HTML, CSS, and Javascript programming languages to design a web

interface for user login and functional requirements, as shown in Figure 2, and finally, a complete medical interface [16], as shown in Figure 3, so that medical staff can easily view patient’s material.

At present, smartphones have become popular, and many hospitals have introduced

tablets to replace computers for medical care. In response to the above mobile communication devices, we will propose a mobile communication device system environment for telemedicine. Various mobile communication devices have different screen sizes. We use responsive web design technology to solve the problem of cross-platform use. As shown in Figure 4, the system can automatically detect the size of the user’s Internet device and automatically adjust the graphic content of medical web pages for different screens to give users the best browse screen.

In addition, we integrate the Software Development Kit tools with the web system to build a rich application framework on the Android system and the iOS system. The application framework provided by the system can be adjusted according to the situation and can provide exclusive resources for different device settings. In turn, the efficiency of medical data transmission can be improved.

We use Visual Studio as the development tool for the telemedicine system platform, which is mainly compatible with other telemedicine systems and has a complete set of relevant cross-platform device development tools.

The primary task of establishing a telemedicine system platform is to convert paper medical records into electronic storage. We use the medical records of Chiayi Christian Hospital as a reference, as shown in Figure 5, and use the database to design an electronic data table that matches it, as shown in Figure 6. When the patient creates the file for the first time, the corresponding data is stored in the FHIR database at the same time.

The proportion of the aging in the world is gradually increasing, and the proportion

of Chronic condition is also increasing year by year. Usually, the elderly with Chronic condition need to go back to the hospital for treatment, but for the elderly, it is a great physical burden. Therefore, through the telemedicine platform system we have developed, the patient and the medical end conduct medical consultation, as shown in Figure 7, and automatically store the medical data record, and use the collection of medical data as the data analysis data of the telemedicine system.

In this telemedicine system platform, the system will automatically collect various medical data of patients. Through the medical record data collected in the HL7 FHIR format, various patient physiological data, and medical history data are stored. The system can according to different data such as blood pressure, weight, a heartbeat before the physiological data has deteriorated, a reminder is issued in advance to alert patients to precautions and related measures. In addition, doctors use platform analysis to understand the user’s use of the platform and the characteristics of the user population. Provide the improvement direction of this system and understand the user experience.

According to the user’s authority, we are divided into two identities: medical staff and patient. Figure 8 shows that the user chooses the login identity according to his own authority when logging in to the system.

The user can select the medical data of the patient according to the name and time of the visit. It is worth noting that the user is not limited to the medical staff or the patient himself, but in the part of querying the medical data, we select according to the user’s login identity the difference is that if you are medical staff, you can query all patient data, but if you log in as a general user, you can only query your own medical information, as shown in Figure 9.