• Proceedings of the Korean Society of Computer Information Conference
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• 2014.07a
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• pp.143-144
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• 2014

2014년 2월 정보통신 진흥 및 융합 활성화 등에 관한 특별법(ICT 특별법)이 시행되었고, 2014년 6월 의료법개정에 따른 원격의료서비스 시범사업이 가능해졌다. 본 연구에서는 기존의 병원을 방문하여 진료 후에 약 처방을 받던 일반적인 내시경 의료서비스와 병원 방문 없이 전화를 이용한 진료 및 처방과 함께 약을 배송해 주는 원격의료서비스를 의료서비스 제공자들을 대상으로 FGI(Focus Group Interview)를 통하여 비교하였다. 본 연구는 향후 보다 나은 내시경환자를 위한 원격의료서비스 설계를 위한 기초자료로 활용될 것으로 기대한다.

• Proceedings of the Korean Society of Computer Information Conference
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• 2012.07a
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• pp.399-400
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• 2012

본 논문은 보건의료서비스 공급을 민간이 주도하고 있는 현실에서 인구가 밀집한 도시 지역 병 의원의 집중과 과잉으로 농촌지역의 효율적인 의료서비스 공급이 절대적으로 부족한 현실을 고려하여 의료서비스의 질적 수준을 높일 수 있는 On-line 의료서비스 공급기반 확충과 저비용-고효율의 의료전달체계를 확립하기 위한 U-healthcare service 모델 연구와 발굴을 제안하고 IT기술을 기반으로 한 의료취약계층에 대한 건강관리 및 치료나 수술 후 질병의 예후관리에 대한 보다 효율적이고 기술 집약적인 의료서비스 제공을 통한 농촌지역 의료서비스 활성화를 제안한다.

• Information and Communications Magazine
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• v.31 no.12
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• pp.44-50
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• 2014

지난 수십년간 의료기기는 비약적인 발전을 거듭하며 의료서비스에 이바지하여 왔다. 최근의 기술동향으로는ICT(Information and Communication Technology) 기술의 발전이 전통적인 진단과 치료 방법에서 새로운 의료서비스의 형태로 진화를 유도하고 있다. ICT 기술과 의료기기의 융합을 통하여 진단, 치료, 의료정보화 및 개인건강관리 분야에 이르기 까지 신속하고 정확하고 효율적인 의료서비스 개선을 추구하고 있다. 인구의 고령화, 만성질환자 증가, 의료비상승, 의료진의 부족이 예상되는 미래환경에서 ICT 기술의 기여도는 점점 더 커질 것이다. 전세계적인 정보통신망 인프라의 활성화와 개인용 스마트 디바이스의 보급으로 정보와 기기에 대한 접근성이 훨씬 용이해지고 웰빙에 대한 관심이 높아지면서 개인 건강관리에 대한 서비스 요구가 높아지고 있다. ICT 종주국으로서 의료기기 산업에서도 국내기업의 활약을 기대하며 ICT 융합 의료기기의 현황을 소개하고자 한다.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.139-161
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• 2017

In this paper, The Supreme Court of Korea 2016. 1. 28. 2015Da9769 was reviewed. In the previous case, Korean Supreme Court 2009Da17417 for the element to requirement for permission of the withdrawal of life-sustaining treatments, the patient's consent for withdrawal of life-sustaining treatments was assumed a declaration of intention to terminate the contract. But the consent for withdrawal of life-sustaining treatments corresponds not to those. The consent for medical treatments is not the juristic acts but the real acts. If the presumptive intention about these withdrawal regards as the termination of medical contract, the contract must be up to the starting the civil proceedings. According to this case, although the partial cancellation of medical contract is admitted, on the other hand medical expenses obligation ist exempted only after the final decision. At the withdrawal of life-sustaining treatments the medical obligation ist exempted because of the inability to providing the medical payment, which confirmed by the final decision about the withdrawal of life-sustaining treatments. Therefore the judgement of this case ist appropriate in that sense, the medical obligation ist waived only after the final decision. However that legal basis lies not at the partial cancel but at the partial inability.

• Fire Science and Engineering
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• v.20 no.3 s.63
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• pp.42-47
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• 2006

Direct medical control by medical doctors is an essential part of emergency medical services system (EMSS). However, the indications are not specifically defined, even in 119 system with their own medical control team. The Seoul Metropolitan Fire and Disaster Management Department has operated internal medical consultation services on its own since January 2004. Based on the experiences from these services, we reviewed the cases of the direct medical consultation and establish the indications for direct medical control. And we presumed the demand of direct medical control with the established indications. The crews of 119 in Seoul made 793 calls to Medical Control Team during November 2004. We reviewed all of the calls according to the level of consciousness (AVPU), the kinds of emergency care done by crews during transport (10 categories), and the mechanisms of injuries (9 categories). The need for direct medical control was judged by authors with reviewing the records reported by the crews and control teams. Among 23 items, 14 items assigned as the indications, which were abnormal level of consciousness (VPU), 6 kinds of emergency care, and 5 mechanisms of injures. The sum of the three of them, 7,782 cases (45.9%), was in need of direct medical control. In conclusion, about half of the patients transported by 119 crews in Seoul require direct medical control. The need for the direct medical control in Seoul was estimated as many as 260 calls per day. To fulfill the need for direct medical control and to provide a effective medical control, the direct medical control should be accomplished through the communications between the crews and the medical staffs in the local hospitals.

• The Korean Society of Law and Medicine
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• v.22 no.1
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• pp.3-23
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• 2021

Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.81-109
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• 2021

This paper review about the relationship between the prohibition against medical refusal and the principle of private autonomy in medical contracts. The obligation to this Prohibition in Medical Law does not restrict the liberty of contracting a medical contract. On the other hand, the prohibition limits the freedom to terminate medical contracts. Medical contracts can be terminated if the trust between doctors and patients is vanished. However certain restrictions should be placed on termination of the medical contract, because termination of the contract should not be detrimental to patients' health. According to the current medical law the medical contract is to be enforced in principle and can be revoked only with justifiable reason. At the Civil Code on Medical Contracts the freedom to terminate the medical contract is permitted, but this paper suggests the restrictions of the revocation under certain conditions. The Criminal Punishment Regulations against medical refusal should be removed. Refusal the provide medical service should be regulated by administrative sanctions under the National Health Insurance Act's obligation.

• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.3-33
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• 2022

In relation to telemedicine in Korea's medical law, there are Articles 17, 17-2, and 34 of the Medical Act. Since 'direct examination' in Articles 17 and 17-2 of the Medical Act can be interpreted as 'self-examination' rather than 'face-to-face examination', it is difficult to see the above regulation as a regulation prohibiting telemedicine. Prohibiting telemedicine only with the concept of medical examination or the 'principle of face-to-face treatment' is against the principle of "nulla poena sine lege"(the principle of legality). However, in order to qualify as 'examination', it must be faithful enough to replace face-to-face examination, so issuing a medical certificate or prescription after a poor examination over the phone is considered a violation of the Medical Act. In that respect, the above regulation can be said to be a regulation that indirectly limits telemedicine. On the other hand, most lawyers interpret that telemedicine between medical personnel and patients is completely prohibited based on Article 34, and the Supreme Court recently ruled that such telemedicine is not permitted even if there is a patient's request. However, this interpretation is not only far from the legislative intention at the time when telemedicine regulations were introduced into the Medical Act of 2002, but also does not match the needs of reality or the legislative trend of foreign countries. The reason is that telemedicine regulations are erroneously legislated. The premise of the legislation is wrong, and there are considerable problems in the form and content of the legislation. As a result, contrary to the original legislative intent, telemedicine was completely banned. In foreign countries, it is difficult to find cases where telemedicine is completely banned and criminal punishment is imposed for it. In order to fundamentally solve the problem of telemedicine, Article 34 of the Medical Act needs to be deleted.

• Proceedings of the Korean Society of Health Policy and Administration Conference
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• 2011.05a
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• pp.7-18
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• 2011

질병관리와 의료서비스에 있어서의 공공부문의 역할은 오래된 화두이다. 이번 학회에서도 중요한 주제로 자리매김을 하고 있는 데는 몇 가지 이유가 있을 것으로 사료된다. 첫째, 질병관리와 건강이 갖는 주제 자체의 중요성이다. 건강은 국민의 기본 권리이다. 국민의 기본 건강권을 유지, 향상시키는 데 있어서 질병관리와 의료서비스의 방향 모색은 시대와 장소를 불문하고 우선적으로 다루어져야 하는 주제임이 분명하다. 둘째, 공공보건의료를 전체 인구집단의 건강향상을 위한 총체적 활동으로 볼 때 건강위험요인의 변화와 질병패턴의 변화에 따라 인구집단이 필요로 하는 서비스의 내용이 변화되어야 한다. 그러므로 논의 당시의 시점에서 요구되는 공공보건의료 서비스의 내용을 검토하고 전략을 수립하는 노력은 주기적이고 연속적으로 이루어질 필요가 있다. 셋째, 최근 공공보건의료에 대한 사회적 합의가 변화하는 가운데 공공부문의 역할에 대한 논의가 제기되고 있다. 과거 "공공보건의료에 관한 법률"에서는 공공보건의료 기관만을 공공보건의료 수행자로 정하고 있었으나 최근 수행자의 범위를 민간의료기관까지 확대시키는 개정작업이 진행 중이다. 이에따라 공공부문의 역할과 활동의 범위를 검토하는 기회가 필요하겠다. 본 원고에서는 발표자가 국립대학병원의 공공보건의료 활동과 지역사회 단위의 보건사업 활동에 참여하면서 직 간접적으로 경험한 내용을 중심으로 질병관리와 보건의료서비스 제공에 있어서의 개선점을 제안하고자 하였다.

• Proceedings of the Korean Society of Computer Information Conference
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• 2012.01a
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• pp.257-260
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• 2012

본 연구의 목적은 결혼이주여성의 건강문제와 이들의 의료기관 이용 실태를 연구하여 의료경영정보시스템을 구축하기 위한 선수 연구에 그 목적이 있다. 연구에 이용된 자료는 2010년 1월 1일부터 12월 31일까지 원주의료원에서 진료한 289명의 원주지역 결혼이주여성의 진료기록을 통하여 조사된 것이며, 결혼이주여성의 일반적인 현황과 미충족 의료 수준을 파악하기 위해 통계청 통계포털자료와 2010년 원주시 통계연보를 활용하였다. 결혼이주여성의 의료서비스 이용은 소득수준과 밀접한 관련이 있으며 의료기관 이용 시 언어적 불편, 재정적 어려움, 가족의 지원 부족이 가장 많이 발생했다. 결혼이주여성의 진료지원 비율은 산부인과 진료비율이 가장 높은 24.3%, 내과 23.2%, 치과 7.9%로 나타났으며 결혼이주여성 자녀들의 소아청소년과 진료비율도 18.6%로 높은 진료비율을 나타났다. 본 연구는 결혼이주여성의 의료서비스 향상과 의료경영정보 시스템의 구축에 도움을 줄 것이다. 또한 이주여성의 건강권 보호를 위한 국가적, 지역적 차원의 노력에 도움이 될 것으로 사료된다.