• Title/Summary/Keyword: 표준진료

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Design and Implementation of medical information model based on the xml (XML 기반에서의 진료정보표현 모델 설계 및 구현)

  • 박애숙;강성수;김완규;김홍준
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2002.11a
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    • pp.115-119
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    • 2002
  • In the recent you, as the development of computer network and web, the amount of electric document exchange is dramatically increased through B2B, B2C, electric bid and et cetera. The medical world also needs to share and exchange good information for medical treatment like H2C(hospital to hospital), H2C(hospital to company). In this paper, we design medical information model using DTD and inplement medical information support system based on xml and xslt.

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Institutional Approach to Healthcare Information Exchange: Focused on Medical Law (의료법상 진료정보교류를 위한 법제도적 고찰)

  • Kim, Soomin;Park, Jong Son
    • The Journal of the Korea Contents Association
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    • v.17 no.10
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    • pp.483-491
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    • 2017
  • Compared to penetration of Electronic Medical Record(EMR) system, Healthcare Information Exchange(HIE) has been less active in South Korea. The aim of this study is to explore medical law newly legislated to introduce HIE through the nation. The important insights are that the medical institutions exchange the patient's healthcare information based on the consent of the patient, and it is expected to be set up and managed the medical record exchange support system by the government and a consignment organization. In addition, the certification program for standardization and interoperability on the EMR system would be conducted. Nevertheless, continued policy developments and researches for the promotion of HIE will be urgently needed such as the education for the vendors and developers, developments of the certification programs and the incentive payment programs and the public relations.

Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

The Reduction ways of Medicine Material Costs of Nuclear Medicine In Vitro (핵의학 체외검사의 진료재료비용 절감 방안)

  • Song, Hun-Kang;Seo, Jung-Mi;Yang, Joon-Ho;Kim, Eun-Jung;Kim, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.111-115
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    • 2011
  • Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.

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Implementation of Mobile Medicine Image Viewer System Based on Embedded (임베디드 기반의 모바일 의료영상 검색시스템 구현)

  • Kim Hyeong-Gyun;Kim Yong-Ho;Lee Sang-Beom;Bae Yong-Guen
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.913-916
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    • 2006
  • 의료시스템은 모든 것이 병원 네트워크를 중심으로 의료 서비스가 제공되어 진다. 하지만 자연재해, 천재지변과 같은 갑작스런 환자 발생으로 인한 응급 이동 사항, 혹은 진료자의 외진 및 환자 방문시에는 일반 데스크탑 PC에서 이루어지는 상태의 의료 서비스가 아닌 휴대하기 간편하고 언제 어디서나 의료서비스를 받을 수 있는 Personal Digital Assistant (PDA)와 같은 휴대용 기기에서의 의료시스템이 필요하다. PDA는 휴대가 용이하며 유선 네트워크 시스템에 구애받지 않는 무선 모바일 장비로서 무선 통신이 가능한 곳이라면 언제 어디서라도 환자에 대한 의료 정보를 조회할 수 있다. 또한 PDA의 통신 기술로서 병원과의 실시간 통신이 가능하여 응급 환자에 대해 빠른 진료를 제공 할 수 있다. 이와 더불어 임베디드기기 프로세서의 발달로 인하여 연산처리 기술도 많은 향상을 가져왔고 이로 인하여 기존의 PDA에서의 문제였던 DICOM영상의 조회 및 처리속도에도 많은 향상을 가져왔다. 이에 본 연구에서는 의료영상 표준인 DICOM표준을 따르며 이동성이라는 장점을 통하여 언제 어디서나 손쉽게 진료자가 환자의 의료정보 및 의료 영상을 조회할 수 있도록 하는 PDA용 모바일 의료영상 조회 시스템을 PXA255 기반의 Embedded Linux 상에서 QT/C++을 사용하여 구현하였다.

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Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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충북지역 보건진료원이 업무 분석적 연구

  • Kim, Hui-Ja
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.174-175
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    • 1989
  • 본 연구는 보건진료원의 업무를 분석하기 위하여 충북에서 활동하고 있는 보건진료원 136 명을 대상으로, 설문지를 흥해 자료수집을 하였으며 백분률, 평균값, 표준편차로 자료처리를 하였다. 조사기간은 1968 년 8월 1일부터 11월 20일까지 했으며 그 결과를 요약하면 다음과 같다. 1. 보건진료원의 일반적 특성과 업무에 관련 된 배경을 살펴보면 다음과 같다. 보건진료원의 일반적 특성으로 연령 분포는 30 - 34세가 30.1 %로 가장 많았고 결혼 상태는 기혼자가 61.8 % 였다. 종교는 기독교가 42.6% 로 많았고 학력은 3 년제 간호전문대학 과정졸업 자가 78.9 %로 많았다. 현 가족과 동거상태에서 배우자와 자녀가 함께 사는 경우가 76.5% 였고, 보건진료원의 경력은 1 년 마만이 41.2 %로 가장 많았다. 보건진료원의 업무에 관련된 배경을 살펴보면, 근무지역조건은 갑지가 65.3 % 였고, 현 거주지는 보건진료소내 숙소가 대다수 였다. 보건진료소는 신축된 건물이 대다수였고, 보건진료소 시설은 '그저 그렇다'고 대답한 수가 가장 많았다. 보건진료소 운영협의회 수당은 월 $5\sim7$만원인 경우가 85.6 % 였다. 2. 보건진료원의 보건의료제공 실태는 다음과 같다. 보건진료원이 현재 담당하는 주민수는 $501\sim1,000$ 명이 35.3 % 이고, 1,500 명 이상의 주민을 담당하는 경우도 32% 였다. 보건진료소를 이용한 주만은 연평균 1,956 명이고, 보건진료소 평균 이용건수는 1,812건이다. 보건진료원의 직업만족도는 만족한다가 40.6%로 대체로 긍정적으로 나타났다. 3. 보건진료원과 보건의료 관련기관과의 관계는 다음과 같다. 지역주민의 보건의료자원 이용 정도는 보건소 진료소가 1 위로 가장 많았고, 약국, 약방, 의원, 보건지소의 순위로 나타났다. 보건의료 관련기관과의 협조가 잘 되고 있지 않다고 응답한 경우도 있는데, 보건소(19.7 %), 보건지소( 20.2%) 민간보건 의료기관(22.4 %)이며, 그 이유를 알아서 협조가 잘 이루어지도록 노력해야겠다. 원하는 감독체계는 보건소장(47.3 %), 보건간호 전문가(37.2 %)로 나타났으나 이는 현재있는 감독체제내에서 생각한 것이며 간호전문가에 의한 새로운 감독체제를 원하고 있었다. 많이 이용하는 의뢰 기관은 병원(52 %), 의원(24.4 %), 보건소(10.2 %) 순이었다. 4. 보건진료원의 업무 영역별 수행정도를 살펴보면 다음과 같다. 보건진료원의 업무 영역을 7개 영역으로 구분하여 수행평균 평점을 보면통상질환 관리가 3.70점, 사업운영 관리 및 지도가 3.44 점, 사업계획 수립이 3.19 점, 지역사회 조직 및 개발이 3.17 점, 모자보건 및 가족계획이 3.14 점, 지역사회 보건관리가 3.09 점, 보건 정보체계 개발이 3.02 점으로 나타났다. 위의 결과에서 지역사회 보건관리가 3.09점으로 통상질환 관리 3.70 점 보다 낮게 나타났는데 이는 일차보건의료 사업 정착의 과도기적인 현상으로 생각하며, 이 부분을 더 많이 수행해야 할 것으로 사려된다. 5. 보건진료원의 업무 영역별 수행 소요시간의 평균은 다음과 같다. 지역사회 조직 및 개발 3.48 시간, 사업계획 수립 3.55 시간, 지역사회보건 관리 6.74 시간, 모자보건 및 가족계획 5.55 시간, 통상잘환 관리 15.94시간, 사업운영 관리 및 지도 4.39시간, 보건정보체계 3.62 시간으로 나타났다. 보건진료원이 통상질환 관리와 더불어 예방활동을 효율적으로 할 수 있도록 적절한 행정적, 교육적 지원이 있어야 한다고 생각한다.

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Effective Searching of Clinical Terms from Standard Clinical Terminology (표준 의학용어 체계에서의 효과적인 용어 검색 방안)

  • Ryu, Wooseok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2014.05a
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    • pp.323-325
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    • 2014
  • SNOMED CT is a standard clinical terminology which is to efficiently record, manage and utilize clinical records during clinical processes. However, huge expressive power of SNOMED CT makes it difficult to select appropriate terms during short consultation hours. In addition, true meaning of a written record using the terminology may be misunderstood or even distorted since one clinical meaning could be expressed in a variety of ways. This paper analyzes such known problems in a database point of view, and presents effective selection methods of similar terminologies to mitigate the problem.

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