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

• Korean Journal of Clinical Pharmacy
• /
• v.22 no.4
• /
• pp.304-315
• /
• 2012

Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

• Journal of the Korean Institute of Intelligent Systems
• /
• v.21 no.4
• /
• pp.456-462
• /
• 2011

As the ARRA enacted recently in the United States, the interest in EHR systems have been increased in the field of medical industry. The passage of the ARRA presents a program that provides incentives to office-based physicians and hospitals adapting the EHR systems to guarantee interoperability with various medical standards. Thanks to the incentive program, a great number of EHR systems have been developed and lots of office-based physicians and hospitals have adapted the EHR systems certified by CCHIT. Keeping pace with the rapid changes in the market of healthcare, some enterprises try to push in to the United States healthcare market based on the experience acquired by developing EHR systems for hospitals in Korea. However, the developed system must be customized because of the different medical environment between Korea and the United States. In this paper, therefore, we design and develop an integrated EHR platform to guarantee the interoperability between different medical information systems based on medical standard technologies. In the developed platform, an integrated system has been composed by integrating various basic techniques such as data transmission standards and its methods, medical standard terminologies and its usage, and knowledge management for medical decision-making support. Moreover, medical data can be processed electronically by adapting an HL7 interface engine and the terminologies for exchanging medical information and the standardization of medical information. We develop SeniCare, an EHR system for supporting ambulatory care of the office-based physicians, based on the platform, and we verify the usability of the platform by confirming whether SeniCare satisfies the criteria of "meaningful use" issued by CMS or not.

• Journal of the Korean Society of Radiology
• /
• v.10 no.3
• /
• pp.161-169
• /
• 2016

In this study, the proposal to seek ways to reduce the amount of radiation is drawn by comparing and analyzing CT Dose Index(CTDI) on the pediatric head CT which was performed at the busan regional hospitals, to the national diagnostic reference levels. As a result, it was appeared to exceed the amount of the dose recommendation in order of hospital, general hospital and senior general hospital in the hospital-specific classification and from 2 to 5 year, from 1 month to 1 year and from 6 to 10 year in the age-specific classification. In addition, the amount of the dose recommendation was exceed in order of helical, axial and volume in the scan-specific classification. As the results of the scan range reset to match the diagnostic reference level, the dose reduction showed 11.68%, 15.79% and 20.66% in senior general hospital, general hospital and hospital respectively. In the results of analysing patient average scan ranges which does not deviate from the guideline of patient dose recommendation, there was age of 1 month to 1 year, 2 to 5 year and 6 to 10 year of $03.2{\pm}11.8mm$, $110.5{\pm}14.5mm$, and $117.8{\pm}17.2mm$ respectively.

• Journal of the Korean Society of Radiology
• /
• v.6 no.2
• /
• pp.143-149
• /
• 2012

Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

• Korean Journal of Psychosomatic Medicine
• /
• v.27 no.2
• /
• pp.101-110
• /
• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.