• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.318-326
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• 2011

The purpose of this study is to investigate whether standardized patient(SP) can be used as a reliable examiner in Objective Structured Clinical Examination(OSCE). 4 SPs and 4 faculties who have more than 2 years experience of OSCE scoring were selected. For 1 assignment 2 members of faculty and 2 SPs were designated as raters. SPs were educated for assessing 2 technical skills, male Foley catheter insertion and wound dressing, for 8 hours (4 hours / day, each topic). The definition, method, cautions and complications for each of procedural skills were covered in the education. Theoretical lectures, video learning, faculty demonstration and practical training on mannequins were employed. The 8 raters were standardized for an hour with simulated OSCE scoring using previous videos on the day before the OSCE. Each assessment was composed of 14 checklists and 1 global rate. The allotted time for each assignment was 5minutes and for evaluation time 2 minutes per student. The evaluation from the faculty and SPs were compared and analyzed with the GENOVA program. The overall generalizability coefficient (G coefficient) was 0.839 from two cases of OASTS. The reliability of the raters was high, 0.946. The inter-rater agreement between faculty group and SP group was 0.949 for checklist and 0.908 for global rating. Therefore SPs can play a role of raters in OSCE for procedural skills, if they are given the appropriate training.

• Proceedings of the Korea Information Processing Society Conference
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• 2002.11a
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• pp.813-816
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• 2002

컴퓨터 보급의 급속한 발전과 멀티미디어의 등장으로 기존의 텍스트와 이미지, 음성, 오디오, 동영상 등의 정보를 디지털화하고, 컴퓨터를 이용하여 저장, 처리, 전송하게 되면서 의료 분야에서도 상당한 업무의 변화를 요구하게 되었다. 의료 분야에서의 이러한 급격한 개방과 더불어 초고속 정보 통신의 발달은 원격진료라는 또 다른 요구를 대두시키고 있다. 이를 위해서는, 멀티미디어 기술, 대용량의 정보를 저장하는 데이터베이스 기술, 초속의 광 대역 기술 등을 통합하여 종합적인 멀티미디어 의료 정보 시스템을 구축하는 것이 시급하다. 이러한 이유들로 본 논문에서는 병원/의원의 의료진들로 하여금 의료영상이나 자료를 상호 전송하여 환자의 진료 또는 검진결과를 확인하고 전문가의 조언 등을 구하는 원격 진료용 의료영상 시스템의 요구사항을 분석, 설계하고 구현하였다. 본 시스템은 클라이언트/서버 구조로써 영상 획득 및 출력, 의료영상 국제 표준 포맷인 DICOM 포맷으로의 영상 저장, MCA(Multi Channel Analyzer), ROI(Region Of Interest) 등의 영상 분석, 필터링 및 영상 확대/축소/회전 등의 각종 영상 처리의 주요 기능을 갖으며, 사용자가 편리하고 쉽게 사용할 수 있도록 아이콘(icon) 중심의 직관적인 인터페이스를 갖는다.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.133-143
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• 1996

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.19 no.3
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• pp.537-542
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• 2015

SNOMED CT, which is a standard clinical terminology, imposes an ambiguity problem of terminology selections caused by its huge expressive power and structural complexity. It is very difficult to distinguish similar terms and to select an appropriate term among them within short consultation hours. This paper analyzes the ambiguity problem and proposes a novel scheme for comparative search of similar terms. The proposed scheme provides a differential view of similar terms by defining a "is-not-a" relationship based on the hierarchical structure of the concepts. The result of this work improves the utilization of SNOMED CT such that medical officers can efficiently select an appropriate term among similar terms which represents patient's status adequately.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.211-219
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• 2021

This study reports the effectiveness of Korean medicine and Chuna manual therapy on patients with De Quervain's tenosynovitis. Two patients were treated with Chuna manual therapy, electro-acupuncture, moxibustion therapy. We used numeric rating scale (NRS), Finkelstein's test, sonography to measure changes during treatment. After each treatment, NRS, Finkelstein's test, sonography outcome were improved. Korean medicine including Chuna manual therapy can be effectively used to improve De Quervain's tenosynovitis. This study may suggest that korean medicine including Chuna manual therapy can be effective for De Quervain's tenosynovitis.

• The Journal of the Korea Contents Association
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• v.18 no.8
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• pp.345-352
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• 2018

The purpose of this study is to clarify the difference between the scoring results by scorer(doctors and standardization patients) and examination dates. A total of 101 students in the fourth grade of medical school participated in four clinical practice test. Students were randomly assigned to either day-1 or day-2, which was consisted of a standardized patient scoring set or a physician scoring set. Station checklists consisted of history taking, physical examination, patient education, physician-patient relationship and clinical courtesy. The achievement scores of each case and each domain were converted to the standard score, and the differences between groups were compared. Female students' achievement scores were significantly higher than male students' achievement scores in all domains. There was no significant difference between means by the standardized patients' group and doctors group. Day-2 group was significantly higher than day-1 group in both of history taking and physical examination domains. If the principles of checklist are clearly defined, the scorer status (either physician or standardized patients) does not determine the difference of students' practice test scores.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.1-10
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• 2008

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

• The Journal of the Korea Contents Association
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• v.16 no.9
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• pp.649-657
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• 2016

This study is aim to investigate how applying a critical pathway(CP) to stomach cancer patients affects their recovery and treatment. The subjects were 165 patients over the age of 20 who were diagnosed with stomach cancer at the gastrointestinal clinic of C hospital and who underwent laparoscopic subtotal gastrectomy. The case group inclueded 102 patients who underwent laparoscopic subtotal gastrectomy with applying the CP from October 2008 to September 2009. The control group included 63 patients who underwent laparoscopic subtotal gastrectomy without applying the CP from September 2007 to September 2008. Pain at the time of discharge was significantly lower in the CP applicated group than in the non-applicated group (Odds ratio [OR], 0.07; 95% Confidence interval [CI], 0.03-0.21). The CP applied group was significantly lower than non-applied group in total hospitalization days (CP applied group: 8.95[1.33], non-applied group: 10.69[4.04], p<0.001) and in postoperative hospitalization days (CP applied group: 7.16[0.94], non-applied group: 8.79[3.90], p<0.001). In conclusion, application of a critical pathway to laparoscopic subtotal gastrectomy reduced pain at the time of discharge, total hospitalization days and postoperative hospitalization days.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2012.05a
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• pp.799-802
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• 2012

본 논문은 기존의 헬스케어 서비스의 한계를 극복하기 위해 최근 대두되고 있는 스마트 헬스케어 서비스(smart healthcare service)에 관한 연구이다. 스마트 헬스케어는 스마트폰의 기능에 맞추어 기초체력 운동 지수, 섭취 칼로리, 심박 체크 등의 다양한 서비스를 제공할 수 있지만, 최근에는 보건의료서비스에 특화시켜 환자와 의사가 직 간접적으로 진료를 할 수 있게끔 하는 스마트폰 환경에서의 원격진료 서비스가 부각되고 있다. 그러나 헬스케어를 위한 HL7 CDA 표준의 문서 교환방식은 실시간 데이터 획득을 요구하는 원격진료 서비스 환경에 적합하지 못하다. 이에 본 논문에서는 HL7v2.x의 트리거 이벤트를 통한 메시지 전송방식과 HL7 CDA RIM(Reference Information Model)을 응용하는 실시간 HL7 의료정보 전송 방안을 제안한다.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.757-762
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• 2006

Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.