Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.
Hypertension is one of the major causes of death in the world as it is related with cardiovascular or cerebrovascular disease, so it is needed to provide continuos management for blood pressure. This study selected Health Level 7 Fast Health Interoperability Resources (HL7 FHIR) as a bio-signal data exchange service model that can provide constant blood pressure management in the rapidly growing mobile health care environment. The HL7 FHIR framework developed communicates with the IEEE 11073-10407 Personal Health Device (PHD) protocol through the bluetooth Health Device Profile (HDP) between the manager (smart phone) and the agent (hemomanometer) and acquires information about blood pressure. According to the test results, it performed its tasks successfully including hypertension patients' blood pressure monitoring, management on measured records, generation of document, or transmission of measured information. Because in the actual, clinical environment, it is possible to transmit measured information through the TCP/IP protocol, it will be needed to conduct constant research on it and vitalize it in the field of mobile health care afterwards.
Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.
Objectives: The purpose of this review is to analyze the domestic study trends of clinical use of Digital Infrared Thermal Imaging (DITI) as a diagnosis instrument on obstetrics and gynecological diseases in Korean literature. Methods: We searched for clinical studies using DITI in the journal of Korean obstetrics & gynecology, National Digital Science Library, Research Information Sharing Service, Korean Medical Database up to May 2020. After searching studies, we selected studies and analyzed according to disease. Results: 18 clinical studies were published in two kinds of academic journals. There were 4 studies about dysmenorrhea and menopausal symptoms, 2 studies about postpartum disease and hypercryalgesia, 1 study about amenorrhea, premenstrual syndrome, leukorrhea, infertility, polycystic ovary syndrome and hot flush. Conception vessel was frequently used for DITI measurement, followed by stomach meridian. The temperatures of abdomen (CV4, CV12), face (HN3), upper and lower limb (PC8, LU4, LR3, ST32) were commonly measured. Conclusions: This study shows that DITI could be one of effective diagnosis instrument for obstetrics and gynecological diseases. More well-designed clinical studies using DITI will be needed.
Objective: The aim of this study was to investigate acupuncture therapy for post-stroke cognitive disorder to suggest the methods of a study about acupuncture therapy. Methods: Several academic databases were used in this study, including National Digital Science Library (NDSL), National Assembly Library of Korea, Korean Traditional Knowledge Portal, Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), Korean Medical Database (KMBASE), Korea Med, Oriental Medicine Advanced Searching Integrated System (OASIS), PubMed, MEDLINE with Full Text, and China National Knowledge Infrastructure (CNKI). Keywords used were "중풍", "뇌졸중", "인지장애", "침", "acupuncture", and "cognitive disorder". Results: Ultimately, 28 papers were investigated. that were mainly published in 2012 and 2016. Of these, More than two-thirds received a score of one or less on the Jadad scale. Acupuncture points such as GV20, GV24, PC6, EX-HN1, SP6, and GV26 were most frequently used. The treatment duration was mostly 30 minutes or less, and the treatment cycle was mostly for four weeks. Dilatational wave was generally used in pulse wave form, and amplitude of electricity was increased until patients were able to endure. G6805 was generally used in electric acupuncture apparatus. According to results of acupuncture treatment, assessments such as the MMSE (Mini Mental State Examination) and the Montreal Cognitive Function Assessment Scale (MoCA) showed statistically significant improvements in 28 studies. Conclusions: Future research is needed to standardize the treatment of acupuncture, and more diversified high quality papers should be published to help clarify the therapeutic effects of acupuncture and the mechanisms of cognitive disorder post-stroke.
Background: Various oral health management programs in Korea affect the oral health improvement in the elderly Several studies have been conducted to date; however, those studies have not shown uniform results due to the differences in research methods or designs. Hence, this study aimed to review the overall research trends of the reported oral health care programs for the elderly in Korea, verify their effects, and clarify them based on the systematic literature review. Methods: The literature search selected intervention studies that applied the oral health care program for the elderly in Korea from 2001 to 2020. Following the COre, Standard, and Ideal (COSI) models presented by the US National Library of Medicine, we selected databases including Korean studies Information Service System (KISS), ScienceOn, Research Information Sharing Service (RISS), DBpia, PubMed, and Google Scholar. Of the 1,335 studies searched using keywords, titles, and abstracts, 21 were finally selected based on primary and secondary exclusion criteria. Results: The most frequent intervention period was 4 weeks, and the number of interventions varied between 2 and 90 times. As for the type of intervention, 14 studies that conducted both theory and practice were the most frequent. Significant differences in the clinical indicators, such as calculus, halitosis, salivation rate, swallowing function, and dry mouth, were found in most oral health care programs. Conclusion: Based on the results of this study, the intervention program needs further verification using multiple indicators in future studies. In addition, a study extending the intervention period and the number of samples is considered necessary for verifying continuous effectiveness of the intervention program.
Jun, Ji Hee;Choi, Tae-Young;Lee, Myeong Soo;Song, Eunhye;Ang, Lin;Park, Sunju
Journal of Society of Preventive Korean Medicine
/
v.24
no.1
/
pp.1-14
/
2020
Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I2=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I2=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I2=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.
KIPS Transactions on Software and Data Engineering
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v.4
no.7
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pp.277-282
/
2015
HL7 released V3 CDA(Clinical Document Architecture) and V2.x message standards for medical information exchange. Currently, these standards are successfully adopted by a number of nations across the globe. However, substantial amount of time is required to develop and implement these standards. Moreover, developers need a lot of time to understand these standards. To solve these issues from 2011, the HL7 standard framework started to discuss Fast Healthcare Interoperability Resources(FHIR) as next generation standard of healthcare information exchange. People's interests toward personal health record and smartphone penetration rate are growing and increasing rapidly. Therefore, our research team believes it is necessary to develop a PHR profiling system which could be accessed by using a smartphone and we developed the system. Through a FHIR Profile editor tool developed in Furore, we found that improvements could be made in generating and changing the profile. In order to build the PHR Profiling system, an Open-API on FHIR is used for exchanging information between electronic medical record system and PHR Profiling system. In the PHR Profiling system, the transactions of information between two systems are provided by RESTful service. In this study, we verify the efficiency of development of the PHR Profiling system through FHIR.
Yeongmin Kim;Yunhee Han;Seungkwan Choi;Jungho Jo;Byeonghyeon Jeon;Hyeonjun Woo;Wonbae Ha;Junghan Lee
Journal of Korean Medicine Rehabilitation
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v.33
no.4
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pp.125-144
/
2023
Objectives This study aimed to investigate domestic clinical research trends in Shinbaro pharmacopuncture, identify diseases managed using Shinbaro pharmacopuncture, and suggest the direction for future studies to increase its clinical utilization. Methods This study used five steps proposed by Arksey and O'Malley and the PRISMA-extension for scoping reviews checklist. We examined published literature on Shinbaro pharmacopuncture studies reported until June 5, 2023, in the following eight databases (Research Information Sharing Service, Science ON, Oriental Medicine Advanced Searching Integrated System, KMBASE, The Society of Internal Korean Medicine, PubMed, EMBASE, and the Cochrane Library). The search terms used were 'Shinbaro' or 'Sinbaro'. Results A total of 47 studies were included in our analysis. Of these, 37 (78.7%) were interference time series studies. Shinbaro pharmacopuncture was the most frequently used treatment for lumbosacral disease (n=15). In the facial area, ST4 and ST6 were used in five out of six studies, and in the shoulder area, TE14 and LI15 were used in all studies. Nine of the 15 studies in the lumbosacral area used the EX-B2. The other parts mostly used the pressure points. Compared to other pharmacopuncture methods, the treatment effect was similar to that of bee venom, and faster than that of jungsongouhyul. Conclusions This is the first scoping review of Shinbaro pharmacopuncture therapy in South Korea. Studies with a high level of evidence based on sole treatment, large capacities, and standardization of Shinbaro pharmacopuncture need to be conducted to increase its clinical utilization.
Park, Chai-Soon;Yoo, Yang-Sook;Park, Hyun-Jeong;Choi, Dong-Won;Choe, Sang-Ok;Kim, Seong-Eun;Kim, Hyo-Jung
Asian Oncology Nursing
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v.9
no.1
/
pp.43-51
/
2009
Purpose: The purpose of the study was to develop an educational program reflecting the educational needs of Hospice Smart Patient service providers. Method: The description, goal, curriculum, method, and process evaluation of the educational program were constructed based on Modified Tyler-type Ends-Means Model followed by the analysis of current curriculum and needs of service providers. Results: The curriculum was constructed based on hospice volunteer program currently offered in Korea and the recommendations of hospice service volunteers and experts. A total of 90 hr was required to complete the curriculum that was composed of 'Introduction to cancer', 'Treatment and treatment complications of cancer', 'Post-treatment nutritional care', 'Helpful information', 'Introduction to hospice and palliative care', 'Comprehension of life and death', 'Holistic hospice and palliative care', 'How to communicate as a smart patient', 'Hospice and ethics', 'Pediatric hospice', 'Bereavement management', and 'Clinical practicum'. Conclusion: It is necessary to implement the developed educational program and evaluate its effectiveness, as well as making the service available to a greater number of cancer patients.
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