• 정보보호학회논문지
• /
• 제20권6호
• /
• pp.251-260
• /
• 2010

의료서비스와 IT 기술간의 융합으로 환자 개인의 건강정보가 전자의무기록(EHR)의 보급과 함께 빠르게 전자화되고 있다. 이와 함께 유헬스사회에 접어들면서 전자화 된 환자의 건강기록들을 진료 이외의 공중보건 및 의학 분야의 연구, 의료서비스 향상을 위해 사용하고자 하는 2차이용의 요구가 증가하고 있다. 개인건강정보의 2차이용으로 의학 분야의 발전의 매우 유익한 일이지만 부주의하게 개인의 건강정보를 이용하는 경우 환자 개인의 프라이버시 손상이 발생, 더불어 2차이용융 통한 연구나 서비스 발전에도 제한이 발생할 수 있다. 하지만 아직 개인건강정보를 이용한 2차적 이용에 대해 체계적인 연구나 논의가 없는 것이 현실이다. 따라서 본 논문에서는 개인건강정보의 2차이용과 관련하여 국내외의 법안들을 살펴보고 이를 비교 분석하여 앞으로 개인의 프라이버시를 존중하고 더불어 의료분야 서비스 있는 방향을 제시하고자 한다.

• 한국병원경영학회지
• /
• 제16권2호
• /
• pp.19-30
• /
• 2011

This study aims to present ways to enhance the stabilization of electronic medical records, ensure the commitment to filling in information of the medical record and improve the overall quality Electronic Medical Record(EMR) information. For that purpose, the present state of the incomplete record rate and the doctor's satisfaction in Electronic Medical Record(EMR) have been surveyed by comparing and analyzing Paper-based Medical Record(PMR) and Electronic Medical Record(EMR). The survey was conducted on 31 doctors in charge of EMR system and each PMR and EMR inpatients were collected for a period of 5 months and analyzed. The results showed that the doctor's satisfaction level was higher for EMR, and the rate of incomplete record appeared to be lower in EMR in departments of both internal and external medicine. In this context, it can be said that the higher efficiency of EMR helped accomplish the increase in commitment to completing medical record information and improve the quality of the data.

• 정보관리학회지
• /
• 제41권1호
• /
• pp.283-311
• /
• 2024

전자의무기록 공유를 추진하기 위해서는 사람들의 인식을 이해할 필요가 있다. 이에 본 연구는 합리적 행동 이론과 프라이버시 계산 모형에 기반하여 전자의무기록 공유에 영향을 미치는 요인을 검증하였다. 또한 직업과 개인 병력 등 인구통계학적 특성에 따라 공유 의도가 달라지는지에 대해서 알아보았다. 145명을 대상으로 온라인 설문조사를 실시한 결과, 이타적 즐거움과 개인정보 보호 인식, 법·제도적 역할 인식 및 건강에 관한 관심 정도가 전자의무기록 공유 의도에 긍정적 영향을 미치고 있었으며 의료기관에 대한 신뢰가 법·제도적 역할 인식과 공유 의도 간의 관계를 긍정적으로 조절하였다. 이에 사람들이 공유 과정에 의료기관뿐만 아니라 정부의 역할도 중요하게 인식하고 있음을 확인할 수 있었다. 전자의무기록 공유에 대한 사람들의 참여와 수용을 촉진하기 위해서는 공유로 인한 공익적 혜택을 강조해야 할 것이며 법적으로 개인정보의 보안과 올바른 활용을 보장하는 가이드라인을 마련하는 것이 필요하다는 점을 제시하였다.

• International Journal of Computer Science & Network Security
• /
• 제21권9호
• /
• pp.19-30
• /
• 2021

Diabetes Mellitus (DM) is one of common chronic diseases leading to severe health complications that may cause death. The disease influences individuals, community, and the government due to the continuous monitoring, lifelong commitment, and the cost of treatment. The World Health Organization (WHO) considers Saudi Arabia as one of the top 10 countries in diabetes prevalence across the world. Since most of the medical services are provided by the government, the cost of the treatment in terms of hospitals and clinical visits and lab tests represents a real burden due to the large scale of the disease. The ability to predict the diabetic status of a patient without the laboratory tests by performing screening based on some personal features can lessen the health and economic burden caused by diabetes alone. The goal of this paper is to investigate the prediction of diabetic and prediabetic patients by considering factors other than the laboratory tests, as required by physicians in general. With the data obtained from local hospitals, medical records were processed to obtain a dataset that classified patients into three classes: diabetic, prediabetic, and non-diabetic. After applying three machine learning algorithms, we established good performance for accuracy, precision, and recall of the models on the dataset. Further analysis was performed on the data to identify important non-laboratory variables related to the patients for diabetes classification. The importance of five variables (gender, physical activity level, hypertension, BMI, and age) from the person's basic health data were investigated to find their contribution to the state of a patient being diabetic, prediabetic or normal. Our analysis presented great agreement with the risk factors of diabetes and prediabetes stated by the American Diabetes Association (ADA) and other health institutions worldwide. We conclude that by performing class-specific analysis of the disease, important factors specific to Saudi population can be identified, whose management can result in controlling the disease. We also provide some recommendations learnt from this research.

• 보건의료생명과학 논문지
• /
• 제11권2호
• /
• pp.173-180
• /
• 2023

본 연구는 2022년 전자의무기록시스템 관리포털에서 인증을 받은 전국의 상급종합병원, 종합병원 의료기관 종사자들을 대상으로 전자의무기록 인증 후 의료기관의 의료정보관리, 정보이용에 대한 업무변화에 관한 인식도와 EMR 시스템 기능성에 대한 인식을 조사하였다. 검증을 통해 향후 인증제 발전 및 전자의무기록 인증제도의 단, 장기적인 발전을 도모하기 위해 수행되었다. 구조화된 설문지를 이용해 총 1,189명의 응답 자료를 최종 분석에 사용하였으며, 특히 EMR 인증 후 인증제도 인식 및 시스템 기능성에 대한 직종별 인식 차이는 평균분석과 ANOVA를 실시해 검증을 적용하였다. 분석결과 전자의무기록 인증제는 의료기관 종사자들에게 긍정적인 업무변화와 인식에 영향을 주는 것을 확인했고, 전자의무기록 시스템 인증 후 다각적인 측면(내부 인식, 시스템 기능성, 상호운용성, 보안성, 추진목적)에서 운영 효과를 보였다. 향후 본 연구결과를 바탕으로 소통적인 후속 연구의 필요를 보인다.

• Journal of Preventive Medicine and Public Health
• /
• 제45권3호
• /
• pp.127-136
• /
• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• 한국전자거래학회지
• /
• 제24권1호
• /
• pp.105-120
• /
• 2019

세계보건기구(WHO)를 비롯해 세계 각국의 정부기관은 항생제 오남용에 따른 항생제 내성균 감염에 대해 심각하게 경고하며 이를 예방하기 위한 관리와 감시를 강화하고 있다. 하지만 감염을 확인하기 위한 감염균 배양에 수일의 시간이 소요되면서 격리와 접촉주의를 통한 감염확산 방지 효과가 떨어져 선제적 조치를 위한 신속하고 정확한 예측 및 추정방법이 요구되고 있다. 본 연구는 Electronic Health Records에 포함된 질병 진단내역과 항생제 처방내역을 neural embedding model과 matrix factorization을 통해 embedding 하였고, 이를 활용한 딥러닝 기반분류 예측 모형을 제안하였다. 항생제 내성균 감염의 주요 원인인 질병과 항생제 정보를 embedding하여 환자의 기본정보와 병원이용 정보에 추가했을 때 딥러닝 예측 모형의 f1-score는 0.525에서 0.617로 상승하였고, 딥러닝 모형은 Super Learner와 같은 기존 기계학습 모형보다 더 나은 성능을 보여주었다. 항생제 내성균 감염환자의 특성을 분석한 결과, 감염환자는 동일한 질병을 진단받은 비감염환자에 비교해 J01 계열 항생제 사용이 많았고 WHO 권고기준(DDD)을 크게 벗어나는 오남용 청구사례가 6.3배 이상 높게 나타났으며 항생제 오남용과 항생제 내성균 감염간의 높은 연관성이 발견되었다.

• 성인간호학회지
• /
• 제26권4호
• /
• pp.413-423
• /
• 2014

Purpose: This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy. Methods: This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics. Results: Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified. Conclusion: The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.

• International journal of advanced smart convergence
• /
• 제10권2호
• /
• pp.21-30
• /
• 2021

With the rapid development of artificial intelligence and big data, a lot of medical data is effectively used, and the diagnosis and analysis of diseases has entered the era of intelligence. With the increasing public health awareness, ordinary citizens have also put forward new demands for panic disorder health services. Specifically, people hope to predict the risk of panic disorder as soon as possible and grasp their own condition without leaving home. Against this backdrop, the smart health industry comes into being. In the Internet age, a lot of panic disorder health data has been accumulated, such as diagnostic records, medical record information and electronic files. At the same time, various health monitoring devices emerge one after another, enabling the collection and storage of personal daily health information at any time. How to use the above data to provide people with convenient panic disorder self-assessment services and reduce the incidence of panic disorder in China has become an urgent problem to be solved. In order to solve this problem, this research applies the context awareness to the automatic diagnosis of human diseases. While helping patients find diseases early and get treatment timely, it can effectively assist doctors in making correct diagnosis of diseases and reduce the probability of misdiagnosis and missed diagnosis.

• 한국병원경영학회지
• /
• 제28권3호
• /
• pp.1-14
• /
• 2023

Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.