• Journal of Korean Clinical Nursing Research
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• v.17 no.1
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• pp.101-112
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• 2011

Purpose: The purpose of this study is to develop a detailed clinical model for recording initial nursing assessment items, and to test the applicability of the model to facilitate semantic interoperability for sharing and exchanging nursing information. Methods: First, the researchers extracted items by analyzing initial nursing assessment records. Second, defining characteristics were identified by analyzing nursing records and reviewing the literature. Third, value sets for defining characteristics were identified and types and cardinalities of defining characteristics were defined based on the value sets. Finally, the detailed clinical model was tested through evaluation by experts and comparison with the initial nursing assessment in a clinical setting. Results: Sixty-one detailed clinical models were developed with 178 defining characteristics and value sets. The experts evaluation and comparison with the initial nursing assessment in a clinical setting showed that the detailed clinical model developed in this study was valid. Conclusion: Use of this detailed clinical model can ensure that the Electronic Health Record contains meaningful and valid information and supports semantic interoperability of nursing information. This use will promote quality in the nursing records and eventually quality of nursing care.

• Genomics & Informatics
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• v.16 no.4
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• pp.31.1-31.7
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• 2018

The prevalence of metabolic syndrome (MS) in the nonobese population is not low. However, the identification and risk mitigation of MS are not easy in this population. We aimed to develop an MS prediction model using genetic and clinical factors of nonobese Koreans through machine learning methods. A prediction model for MS was designed for a nonobese population using clinical and genetic polymorphism information with five machine learning algorithms, including naïve Bayes classification (NB). The analysis was performed in two stages (training and test sets). Model A was designed with only clinical information (age, sex, body mass index, smoking status, alcohol consumption status, and exercise status), and for model B, genetic information (for 10 polymorphisms) was added to model A. Of the 7,502 nonobese participants, 647 (8.6%) had MS. In the test set analysis, for the maximum sensitivity criterion, NB showed the highest sensitivity: 0.38 for model A and 0.42 for model B. The specificity of NB was 0.79 for model A and 0.80 for model B. In a comparison of the performances of models A and B by NB, model B (area under the receiver operating characteristic curve [AUC] = 0.69, clinical and genetic information input) showed better performance than model A (AUC = 0.65, clinical information only input). We designed a prediction model for MS in a nonobese population using clinical and genetic information. With this model, we might convince nonobese MS individuals to undergo health checks and adopt behaviors associated with a preventive lifestyle.

• Journal of the Korea Society of Computer and Information
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• v.17 no.9
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• pp.157-164
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• 2012

Recently medical service environment, the clinical information exchange which contribute to medical safety, promotion of service quality and patient's convenience, efficiency of medical procedures and medical management is essential medical service model. But, practical exchange of clinical information which variation of information level, absence of standardization system, build of heterogeneous information systems is difficult in each medical institute. In this paper, We analyzed the related technical standardizations and the models of clinical information exchange. So, we designed the clinical information exchange system based on the ideal lazy response model which is aimed at vitalizations the exchange of clinical information under domestic law environment. In case of exchange the clinical information, we separate CDA document flow from metadata flow. As a experimental result we acquired 24% improved performance compared with existed system based on the lazy response model.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.8
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• pp.2899-2905
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• 2010

To be applicable under electronic health record system in order to ensure semantic interoperability of clinical information, the development principle for clinical information model to reflect objective and function is required. The aim of this study is to develop the development principles for clinical information model and evaluate the Clinical Contents Model. In order to develop the principle, from November 2008 to March 2009, the surveys about 1) definition, 2) function and 3) quality criteria were done, and 4) the components of advanced model were analyzed. The study was processed in 3 levels. Firstly in the development level, key words and key words-paragraph were driven from the references, and the principles were drawn based on the clinical or functional importance and frequency. In the application level, the 3 experts of clinical information model assessed 30 Clinical Contents Models by applying it. In the feedback level, the Clinical Contents Model in which errors were found was modified. As the results, 18 development principles were derived with 3 categories which were structure, process and contents. The Clinical Contents Models were assessed with the principles, and the 17 models were found that they did not follow it. During the feedback process, the necessity of the advanced education of the principle and the establishment of the regular quality improvement strategy to use it is raised. The proposed development principle supports the consistent model-development between clinical information model developers, and could be used as evaluation criteria.

• Journal of KIISE:Software and Applications
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• v.37 no.12
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• pp.871-881
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• 2010

Objective: A clinical contents model is an essential data model to exchange clinical data, among existing computer systems and enhance consistency of necessary data, in terms of its meaning and reusability. However, there has not been a domestic case where such clinical model is developed till present. Methods and Results: This research is based on determining principles of developing clinical information model which is a specified model of Health level 7 Reference Information Model and attempts to identify clinical contents with types of ENTITY-ATTRIBUTE-VALUE, based on terminology standard by clinicians and domain modelers. Conclusion: This model is projected to be utilized in the next generation of EMR as core contents.

• Proceedings of the Korean Society for Bioinformatics Conference
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• 2006.02a
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• pp.30-36
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• 2006

Tissue microarray (TMA) is an array-based technology allowing the examination of hundreds of tissue samples on a single slide. To handle, exchange, and disseminate TMA data, we need standard representations of the methods used, of the data generated, and of the clinical and histopathological information related to TMA data analysis. This study aims to create a comprehensive data model with flexibility that supports diverse experimental designs and with expressivity and extensibility that enables an adequate and comprehensive description of new clinical and histopathological data elements. We designed a Tissue Microarray Object Model (TMA-OM). Both the Array Information and the Experimental Procedure models are created by referring to Microarray Gene Expression Object Model, Minimum Information Specification For In Situ Hybridization and Immunohistochemistry Experiments (MISFISHIE), and the TMA Data Exchange Specifications (TMA DES). The Clinical and Histopathological Information model is created by using CAP Cancer Protocols and National Cancer Institute Common Data Elements (NCI CDEs). MGED Ontology, UMLS and the terms extracted from CAP Cancer Protocols and NCI CDEs are used to create a controlled vocabulary for unambiguous annotation. We implemented a web-based application for TMA-OM, supporting data export in XML format conforming to the TMA DES or the DTD derived from TMA-OM. TMA-OM provides a comprehensive data model for storage, analysis and exchange of TMA data and facilitates model-level integration of other biological models.

• Journal of Korea Multimedia Society
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• v.11 no.3
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• pp.386-397
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• 2008

This study proposes the actualization of a standard data model for activities through the development of clinical document architecture for medication administration using the health level 7 development frameworks(HDF) process based on object oriented analysis and development method of health level 7 V 3. Medication administration is the most common activity performed by clinical professionals at healthcare settings. A standardized information model and structured hospital information system are necessary to achieve evidence-based clinical activities. We had used HDF and various tools(Rose tree, RMIM designer, V3 generator) to create the clinical document architecture(CDA). This allowed us to illustrate each step of the HDF in the administration of medication. This study generated a information model of the medication administration process, which is one clinical activity. It should become a fundamental conceptual model for understanding international standard methodology by information technology(IT) developers with the objective of modeling healthcare information systems.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.301-314
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• 2001

The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.

• 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.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.2
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• pp.212-222
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• 2014

Purpose: The purpose of this study was to evaluate the nursing students' clinical judgment skills in simulation using Tanner's Clinical Judgment Model. Method: Forty-five teams of a total 93 nursing students participated in a post-operative patient care scenario using human patient simulator. Data were collected from students' responses in scenario and guided reflective journaling according to the framework of Tanner's model which comprised noticing, interpreting, responding, and reflecting on response. Data were analyzed using descriptive statistics. Results: The students' responses of the situation were in accordance with the goals of scenario, i.e. relieving patient' pain and preventing pulmonary complications. However, most of students needed clinical cues and focused on a given clue to solve the issues. They were lack of ability to collect additional information as well as connect the relevant clues in simulated clinical situation. Conclusion: The nursing students have difficulty in what they notice, how they interpret finding, and respond appropriately to the situation. The simulation training using Tanner's model could provide faculty and nursing students with an effective teaching and learning strategy to develop the clinical judgment skills.