• Title/Summary/Keyword: 전자 의무 기록

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Risk Factors for Development of Acute Renal Failure in Patient undergoing Open Heart Surgery (개심술 환자의 수술 후 급성 신부전 발생 위험요인)

  • Jeon, Hyun Rye;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1728-1736
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    • 2013
  • The purpose of this study is to identify prognostic predictors of postoperative acute renal failure(ARF) for the patient undergoing cardiac surgery. Retrospectively review the electronic hospital database at a A hospital from Jan 2008 to Dec. 2011. 483 patients were included in this study. They were divided into a occurrence of ARF group(n=59) and a non occurrence of ARF group(n=424). ARF occurred in 59 cases (12.2%). Multi-variable logistic regression analysis identified that preoperative risk factors include creatinine(OR 3.92, p=<.001), advanced age(OR 2.142, p=.015), female(OR 2.165, p=.015), hypertension(OR 2.513, p=.005), NYHA(New York Heart Association) class II(OR 3.081, p=.003), and III(OR 6.759, p=.004), and intraoperative risk factor includes blood transfusion(OR 3.753, p=<.001), and postoperative factors include bilirubin(OR 4.541, p=.028), creatine(OR 8.554, p=.003), and cardiac output(OR 0.214, p=.033) as a prognostic predictors. The development of postoperative ARF could be a reason for increase in rate of complication and mortality after cardiac surgery. therefore the prevention of ARF is of paramount importance and treatment strategies are urgently needed.

Clinical and Molecular Characterization of Korean Patients with Glycogen Storage Type 1b (당원병1b형의 임상양상 및 분자유전학적 특징)

  • Cho, Ja Hyang;Kim, Yoo-Mi;Choi, Jin-Ho;Lee, Beom Hee;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.18-24
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    • 2015
  • Glycogen storage disease type Ib (GSD Ib) is one of the rare inherited metabolic disease caused by mutation of SLC37A4 gene. Clinical characteristics include hepatomegaly, hypoglycemia, lactic acidosis, hyperlipidemia and high serum uric acid concentration. The authors analyzed clinical and molecular characteristics of three Korean patients (one male and two females) with GSD Ib by retrospective review of medical records. Two patients were diagnosed in toddler period by hypoglycemia and hepatomegaly. One patient was diagnosed by growth retardation and short stature in puberty. c.412T>C (p.Trp138Arg) (3/6 alleles, 50.0%) was most frequently observed, following by p.Leu348Valfs*53 (1 allele), p.Pro191Leu (1 allele), p.Ala148Val (1 allele) in molecular analysis. Uncooked corn starch and allopurinol was administered. Because all three patients had neutropenia and recurrent infections, G-CSF was administered. Two patients had severe osteoporosis needing calcium supplement. The patient who diagnosed at puberty had relatively poor prognosis demonstrated by having severe infection and complications in liver and kidney.

A Shared Electronic Medical Record for Lung Cancer Clinic (폐암 클리닉을 위한 공유 전자의무기록)

  • Kim, Kyu-Sik;Park, Eun-Sun;Kim, Seung-Seok;Kim, Hyung-Woo;Kim, Young-Chul;Bom, Hee-Seung;Ahn, Sung-Ja;Na, Kook-Joo;Kim, Yun-Hyeon;Kim, Yu-Il;Lim, Sung-Chul;Moon, Jai-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.480-486
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    • 2005
  • Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.

Comparison of Vessel Disease and Gensini Score according to Ankle-Brachial Index in Patients with Cardiovascular Disease (심혈관 질환자의 발목-상완 지수에 따른 Vessel disease 및 Gensini score 비교 융복합 연구)

  • Choi, Suk-Kyeong;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.15 no.1
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    • pp.267-275
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    • 2017
  • The purpose of this study was to evaluate the clinical availability of ankle-brachial index(ABI) according to severity of cardiovascular disease. The subjects of this study were the patients who had ABI in a general hospital. In this study, total 441 patients were enrolled for analysis. Electric medical records were reviewed to investigate the result of ABI and severity of cardiovascular disease measured vessel disease and Gensini score. Collected data were analyzed using SPSS 21.0 program. Subjects with $ABI{\leq}0.90$ and > 0.90 were classified as having abnormal and normal ABI. There were significant differences in vessel disease categorization($x^2=4.731$, p=.030) and Gensini score(t=2.351, p=.019) between two groups. Therefore, ABI is an effective and non-invasive tool for the diagnosis of cardiovascular disease with high severity. ABI is a valuable predictive index of ischemic heart disease.

Development of the Performance Measurement Model of Electronic Medical Record System - Focused on Balanced Score Card - (균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발)

  • Lee, Kyung Hee;Kim, Young Hoon;Boo, Yoo Kyung
    • Korea Journal of Hospital Management
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    • v.21 no.4
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    • pp.1-12
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    • 2016
  • The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

Application of Text-Classification Based Machine Learning in Predicting Psychiatric Diagnosis (텍스트 분류 기반 기계학습의 정신과 진단 예측 적용)

  • Pak, Doohyun;Hwang, Mingyu;Lee, Minji;Woo, Sung-Il;Hahn, Sang-Woo;Lee, Yeon Jung;Hwang, Jaeuk
    • Korean Journal of Biological Psychiatry
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    • v.27 no.1
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    • pp.18-26
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    • 2020
  • Objectives The aim was to find effective vectorization and classification models to predict a psychiatric diagnosis from text-based medical records. Methods Electronic medical records (n = 494) of present illness were collected retrospectively in inpatient admission notes with three diagnoses of major depressive disorder, type 1 bipolar disorder, and schizophrenia. Data were split into 400 training data and 94 independent validation data. Data were vectorized by two different models such as term frequency-inverse document frequency (TF-IDF) and Doc2vec. Machine learning models for classification including stochastic gradient descent, logistic regression, support vector classification, and deep learning (DL) were applied to predict three psychiatric diagnoses. Five-fold cross-validation was used to find an effective model. Metrics such as accuracy, precision, recall, and F1-score were measured for comparison between the models. Results Five-fold cross-validation in training data showed DL model with Doc2vec was the most effective model to predict the diagnosis (accuracy = 0.87, F1-score = 0.87). However, these metrics have been reduced in independent test data set with final working DL models (accuracy = 0.79, F1-score = 0.79), while the model of logistic regression and support vector machine with Doc2vec showed slightly better performance (accuracy = 0.80, F1-score = 0.80) than the DL models with Doc2vec and others with TF-IDF. Conclusions The current results suggest that the vectorization may have more impact on the performance of classification than the machine learning model. However, data set had a number of limitations including small sample size, imbalance among the category, and its generalizability. With this regard, the need for research with multi-sites and large samples is suggested to improve the machine learning models.

Referral Trends of Children in Jeonbuk National University Dental Hospital for Last 3 years (최근 3년간 전북대학교 치과병원의 소아청소년환자 의뢰경향)

  • Bae, Cheolhyeon;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.362-368
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    • 2019
  • The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018. Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2nd referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2nd referral was relatively delayed with increased ratio of 'during treatment'. These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.

Design and Implementation of Picture Archiving and Communication System Component using the RFID for Mobile Web Environments (모바일 웹 환경을 위한 의료영상저장전송시스템 컴포넌트의 설계 및 구현)

  • Kim Chang-Soo;Yim Jae-Hong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.10 no.6
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    • pp.1124-1131
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    • 2006
  • The recent medical treatment guidelines and the development of information technology make hospitals reduce the expense in surrounding environment and it requires improving the quality of medical treatment of the hospital. Moreover, MIS, PACS(Picture Archiving and Communication System), OCS, EMR are also developing. Medical Information System is evolved toward integration of medical IT and situation is changing with increasing high speed in the ICT convergence. Mobile component refers to construct wireless system of hospital which has constructed in existing environment. Through RFID development in existing system, anyone can log on easily to internet whenever and wherever. It is the core technology to implement automatic medical processing system. This paper provides a basic review of RFID model, PACS application component services. In addition, designed and implemented database server's component program and client program of mobile application that recognized RFID tag and patient data in the ubiquitous environments. This system implemented mobile PACS that performed patient data based db environments, and so reduced delay time of requisition, medical treatment, lab.

Current status of allergic rhinitis patients in Korean Medicine hospitals - Exploratory study based on electronic medical records of 3 hospitals (국내 한방병원의 알레르기 비염 환자 현황에 대한 탐색적 연구 - 3개 대학한방병원의 전자의무기록 자료를 중심으로)

  • Jang, Bo-Hyoung;Choi, In-Hwa;Kim, Kyu-Seok;Kim, Hee-Taek;Kim, Kyung-Jun;Kim, Min-Hee;Park, Jeong-Su;Ko, Seoung-Gyu
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.1
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    • pp.117-129
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    • 2014
  • Objective : To study current status on characteristics of allergic rhinitis patients by using the electronic medical record (EMR) data and to explore the feasibility of clinical studies using the EMR data in three different Korean medical hospitals. Methods : We studied allergic rhinitis patients who visited the department of ophthalmology, otolaryngology and dermatology in the three different Korean hospitals from January 1, 2012 to December 31, 2012. We retrospectively collected medical history and characteristics of study subjects using data of EMR. Results : In hospital A, we were able to collect data of 18 years of age or older. In hospital C, we could only collect data after July 1, 2012. Therefore, each hospital's data had different settings in measuring them. Men and women were accounted for similar percentage, and teens were the highest in the age group. J30.4, unspecified allergic rhinitis, was the highest in diagnosis of the allergic rhinitis. Most of the patients have received acupuncture treatments. Moreover, 74.6 percent of the total patients were prescribed with Chinese medicine. Conclusions : Based on this exploratory study, further studies were needed on clinical studies using data of systematic EMR.

Pop-up Chart for Managing CRRT Improves the Quality of CRRT Care (전자의무기록 팝업차트를 활용한 CRRT 관리의 질향상 활동)

  • Go, Su-Ryeong;Lee, An-Na;Kim, Ki-Pyo;Chin, Ho-Jun;Na, Ki-Young;Chae, Dong-Wan;Kim, Se-Joong
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.43-51
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    • 2019
  • Purpose: The time lag between the decision to initiate continuous renal replacement therapy (CRRT) and its actual initiation remains a major barrier in our intensive care units. We developed a CRRT pop-up chart on EMR for managing CRRT machines. Methods: This study measured time interval between the decision to prepare the CRRT machine and the actual use of the machine before and after using a CRRT pop-up chart. This study conducted a questionnaire of the medical staff to assess the changes in the quality of CRRT preparation. Results: A total of 95 patients on CRRT is analyzed. The time to find an available CRRT machine is decreased by 24.6%. The time to move a CRRT machine to the patient's bedside is decreased by 55.8%. Medical surveys of 44 nurses gave the following results. 1) The time to apprehend machines for 1 to 3 minutes is improved from 29.5% to 81.8%, and the time to apprehend machines over 3 minutes is decreased from 70.5% to 18.2%. 2) The number (6-all) of known machine locations is improved from 22.7% to 63.4%. 3) Interruption of a nurse's work due to telephone calls asking for the possession of movable CRRT equipment also is improved. Scores of 1-4 are improved from 15.9% to 41%. Scores of 5-7 are reduced from 52% to 15.9%. Conclusions: CRRT pop-up chart is shortened the time lag of CRRT machine preparation, reduced the nurse's phone workload and helped to improve the quality of CRRT care.