• Proceedings of the Korean Information Science Society Conference
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• 2003.10b
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• pp.763-765
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• 2003

환자 진료 의뢰 과정은1차 진료기관에서 3차 진료기관으로 환자 진료를 의뢰하고 3차 진료기관에서 검사, 처방, 입원 등의 진료행위를 하고 환자가 3차 병원을 나갈 때 퇴원요약정보를 1차 진료기관으로 다시 보내준다. 이러한 퇴원 요약 시스템은 병원간 환자 정보의 공유를 통해서 환자의 회복과 질 높은 의료 서비스를 제공할 수 있게 한다. 방사선과 정보가 다른 퇴원 요약 정보와 함께 제공된다면 지속적이고 일관된 의료 서비스의 제공에 도움이 된다. 또한 방사선과의 경우 3차 진료기관에서 이미지를 획득할 수 없는 경우, 이미지 획득 장비를 갖춘 1차 진료기관으로 진료 의뢰를 해야 하는 특수한 상황도 발생하는데, 이를 역진료의뢰라고 한다. 우리는 이러한 방사선과의 특성을 함께 고려한 방사선과 정보를 지원하는 퇴원정보요약시스템을 제안한다.

• Proceedings of the KAIS Fall Conference
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• 2010.05b
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• pp.1061-1063
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• 2010

본 연구는 2008년 1월 1일부터 12월 31일 까지 1년 동안 대전에 위치한 일개 대학병원 퇴원요약 정보를 활용하여 환자 개인요인 측면과 의료적 측면에서 전원 환자의 특성과 요인을 파악하여 전원환자 관리의 자료로 이용하고자 한다. 연구결과 퇴원환자 30,793명중 타 병원으로 전원 된 990명 전체가 대상이었으며, 성별로 보면 남자가 여자보다 높은 분포를 보였다. CART기법에 의한 의사결정나무는 치료결과, 입원경로 등이 타 의료 기관으로 전원되는 특성을 보여주고 있음을 알 수 있다. 결과적으로 의료적인 측면보다는 개인적인 측면으로 환자들이 전원을 하는 비율이 높았다. 이와 같이 전원환자 특성 및 요인 분석이 병원의 지속적인 환자 관리와 환자와의 신뢰를 형성하고 꾸준한 병원방문을 유도할 수 있을 것으로 생각된다.

• The Journal of Korean Physical Therapy
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• v.10 no.2
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• pp.41-55
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• 1998

An analysis of 87 stroke Patients who were enrolled in 7 hospitals in cities of Pusan, Taegu, Kumi, and Andong from January 1 to May 31, 1998 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals : Initial assessment, one month after initial, at discharge, and ore month after discharge. The mean BI score of patients initial assessment was 26.32. and that of PS was 17.34. There were statistically significant between initial score and one month after initial (16.61 : p<0.001), at discharge(33.51 : p<0,001), one month after discharge(43,56 : p<0.001). PS scores were also improved significantly(-2.1, -3. 94, and -5.52(p<0.001), and BI score between discharge and one month after discharge wag significant improvement(10.06 : p <0.001) and in PS score(-1,57 : p<0.001). Age and BI scone were significantly associated with the improved in BI score between initial and discharge (T3-T1)(p<0.05). Below age forty and the lower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial BI score, BI score at discharge, and religion were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, the high. BI score at discharge, and the religious showed significantly higher improvement(T4-T1)(p<0.05). BI score at discharge and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3)(p<0.05). The lower BI score at discharge, the religious showed significantly higher improvement(T4-T3)(p<0.05) Initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score showed significantly hier improvement(T3-T1)(p<0.05). Initial PS score, Bi score at discharge, and patient's attitude for physical therapy after discharge were significantly associated with the improvement of PS score between initial and one month after discharge(T4- T1)(p <0.05). The higher initial PS scorer the lower PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, Patient's attitude for Physical therapy after discharge were significantly associated with the improvement of PS score between discharge and one month after discharge(T4-T3)(p<0.05). The higher PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T3)(p<0.05). In conclusion, Initial BI score, BI score at discharge, age, and religion were significantly associated with BI score improvement. initial PS score, BI score discharge, and patient's attitude for physical therapy after discharge were significantly associated with PS score improvement in stroke patients.

• Journal of KIISE:Databases
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• v.33 no.2
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• pp.239-249
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• 2006

Interoperability has been deemphasized from the hospital information system in general, because it is operated independently of other hospital information systems. This study proposes a future-oriented hospital information system through the design and actualization of the HL7 clinical document architecture. A clinical document is generated using the hospital information system by analysis and designing the clinical document architecture, after we defined the item regulations and the templates for the release form and radiation interpretation form. The schema is analyzed based on the HL7 reference information model, and HL7 interface engine ver.2.4 was used as the transmission protocol. This study has the following significance. First, an expansion and redefining process conducted, founded on the HL7 clinical document architecture and reference information model, to apply international standards to Korean contexts. Second, we propose a next-generation web based hospital information system that is based on the clinical document architecture. In conclusion, the study of the clinical document architecture will include an electronic health record (EHR) and a clinical data repository (CDR), and also make possible medical information-sharing among various healthcare institutions.

• Journal of Digital Convergence
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• v.11 no.4
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• pp.351-359
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• 2013

This study was conducted to investigate the factors that affect the length of stay in hospital for schizophrenic patients. Of the data from the in-depth injury patient surveillance system, the final subject included 2,239 patients with schizophrenia in their final diagnosis. Using SPSS 18.0, a hierarchical regression analysis was performed by sequentially entering the explanatory variables by setting sociodemographic characteristics, discharge characteristics and hospital characteristics as explanatory variables and the length of stay in hospital as a dependent variable. The findings showed that the sociodemographic characteristics had the highest explanatory power and the explanatory power changed when the explanatory variable of the hospital characteristics was added, as opposed to the discharge characteristics. Male, type-1 medicaid, Chungcheong-do and the number of beds were found to be the factors that mostly affect the length of stay. Since this study used the secondary data, it has a limitation in terms of additional variables that could better explain the length of stay for schizophrenic patients. Nevertheless, it has an implication in that it investigated a large scale of data on a national level. For the effort of reducing the length of stay, it is suggested that an effort should be made at the national level, by focusing more on the hospital characteristics as well as the individual characteristics of patients.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.7-21
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• 1998

An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.5
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• pp.957-964
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• 2017

In this study, It developed a program to carry out the training courses for NCS based medical information management tasks and to can understand the practical working knowledge of learners. This program is an educational program that can generate medical information by analyzing data of medical records after generating and storing data of medical records. Because the contents of the medical records vary and there are quantitative differences in the medical records, the contents of the medical records can be summarized and stored in the discharge analysis program for the standard of educational data. The medical terminology DB, medical terminology related DB, medical care related DB by the NCS ability unit element can be constructed and managed using the program. The following are the contents that can be learned through operation of the program. first, it's can understand Medical information DB management regulations through understanding sturucture of database. Second, it can understand the structure and function of the diagnostic code and medical practice code that are input to the discharge analysis program. The diagnostic codes and medical practice codes entered in the discharge analysis program can be searched and analyzed by each fields. Third, It can be advance medical information management ability by inputting and extracting data and generating medical information. In this study, It developed program that Students can be obtained Knowledge of medical information management and improved management competency by generate and analyze medical record data using discharge analysis program.

• Proceedings of the Korea Society for Industrial Systems Conference
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• 2002.11a
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• pp.304-318
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• 2002

본 연구는 종합병원에서 운영중인 병원정보시스템(Hospital Information System)을 기준으로 업무별 데이터 마트를 구성하여 종합병원 데이터 웨어하우스 시스템을 제안하는 연구이다. 본 연구에서 제안한 병원 데이터웨어하우스 모형은 충남대학교병원 데이터 웨어하우스 시스템 구축 보고서, Inmon의 데이터 웨어하우스 개발방법론에 기초를 두었다. 종합병원의 데이터하우스시스템을 제안하면 다음과 같다. 첫째, 원무 데이터마트, 병원의 원무팀에서 주로 사용하는 것으로써 수입에 관련된 정보, 진료인원에 관한 정보, 심사/청구/삭감에 관한 정보들로 구성되어 있다. 둘째, 약국 데이터마트, 처방전달 데이터 마트와 연결되어 외래/입원의 처방에 관한 정보, 약에 대한 효능과 성분에 대한 정보, 투약과 검사에 대한 정보들로 구성된다. 셋째, 의무기록 데이터마트, 의무기록팀에서 관리하는 퇴원요약 정보, 암환자에 대한 정보, 외래/입원 환자 통계에 대한 정보들로 이루어진다. 넷째, 처방전달 데이터마트, 주로 의사가 환자에게 행한 처치/처방/수술과 진료기록에 대한 정보들을 기준으로 환자진료나 임상연구에 필요한 정보를 제공한다. 다섯째, 병원 행정 데이터마트, 인사정보, 급여정보, 회계정보, 예산정보, 물류정보 등으로 구성되어 병원의 자원활용이나 행정에 대한 전반적인 정보를 제공한다. 여섯째, 경영지원 데이터마트, 병원경영에 필요한 수입정보, 원가분석 정보, 진료인원 정보들을 요약한 형태로 제공한다. 또한 의사결정 형태도 의료진 중심의 병원에서 환자중심의 병원으로 구조를 바꾸었고 투명한 정보공유와 기초 데이터들의 정제는 부가가치가 높은 정보로 가공할 수 있게 되었으며 각 전문 직종간의 단절된 정보 흐름을 유기적으로 교환할 수 있게 되어 지식의 교환을 촉진시켰다 그리고 온라인거래처리시스템(OLTP)의 한계점인 하드웨어적인 문제와 성능 저하에 대한 문제를 해결하였고, OLTP시스템에서 분리되고 이원화된 코드체계와 데이터 형태의 이질화를 통일하는 방법으로 데이터웨어하우스 시스템을 제시하였다. 결국 병원에서 데이터웨어하우스 시스템의 구축은 임상, 연구, 교육의 유기적 순환관계를 정립하여 지식의 순환적 고리인 수집, 공유, 확산, 재창출을 지속적 유지할 수 있는 인프라를 구축해 준다. 반면 상이한 정보들간의 충돌과 이에 따른 해석의 오류로 잘못된 의사결정을 위한 정보를 제공할 수 있고 기초정보의 접근 및 추출의 유용성에 의해서 정보유출에 대한 문제가 한계점으로 나타났다.

• Quality Improvement in Health Care
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• v.14 no.1
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• pp.69-74
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• 2008

문제: 전자의무기록(EMR) 시행 후 의무기록 정리율의 저하와 질적인 측면에서의 충실성과 정확성에 대한 문제점이 제기되었다. 목적: 전자의무기록의 정리율과 충실성 검토를 통하여 문제점을 파악하고 개선점 찾아 의무기록 정리율을 향상시키고 충실성을 높이고자 하였다. 의료기관: 서울시에 소재한 대학병원 의무기록과 질 향상 활동: 전자의무기록의 문제점을 개선하기 위하여 사용자 편의를 위한 EMR 프로그램 수정 및 보완, 진단 수술 관련 작업, 업무개선, 교육, 홍보 등의 활동을 실시하였다. 개선효과: 의무기록 정리율, 전자인증미비, 경과기록 기재일수, 퇴원요약 주진단 적합률, 기록지별 필수항목 기재율, 충실성에서 향상이 이루어졌다.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2000.11a
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• pp.289-299
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• 2000

This study provides an application of datamining approach to CQI(Continuous Quality Improvement) using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data-mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were Identified through the information gain summary. Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the decree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption find postoperative wound infection. This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas fur CQI using other hospital databases.