• 한국의료질향상학회지
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• 제14권2호
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• 대한약침학회지
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• 제22권4호
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• pp.260-268
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• 2019

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.

• Journal of Information Processing Systems
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• 제16권3호
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• pp.648-662
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• 2020

Bluetooth low energy (BLE) beacon is an actively push-to-broadcast electronic signal and can be used for object identification. This paper uses such beacon-based identification and Internet of Things (IoT) technologies for the elder health management service system to simplify the user interfaces and steps for preventive elder care. In the proposed system, an elder's family member, caregiver, or medical worker can conveniently and quickly record daily health management information. Besides, through the statistics and analysis of the data on the back end of the system, it is helpful for the elderly to refer to the data of daily care management and future management trends. Similarly, it is also an essential reference data for system maintenance and the new preventive health care services development.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.90-97
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• 2015

Background: Contrast-induced nephropathy (CIN) can cause serious adverse effects. To reduce the occurrence of CIN related computed tomography (CT) in emergency patients, we assessed the respective roles of serum creatinine (SCr) alone and estimated glomerular filtration rate (eGFR) as an early predictor for CIN related CT. Methods: For patients with SCr <1.5 mg/dL who underwent CT in emergency department (ED) between September 2012 and October 2013, we assessed the prevalence of CIN and its adverse effects. The Modification of Diet in Renal Disease Study (MDRD) and Cockcroft-Gault (CG) formula was used for the calculation of eGFR. Practical calculation was performed by electronic medical record (EMR) system for MDRD and internet calculating service for CG. And we investigated the prevalence of CIN in eGFR $<60mL/min/1.73m^2$ before CT. Results: A total of 1,555 patients were enrolled. The prevalence of CIN after CT was 4.6% and it showed correlation with renal deterioration, increased in-hospital mortality, and prolonged hospitalization. Despite baseline SCr <1.5 mg/dL, among enrolled patients, 11.3% as MDRD equation and 29.5% as CG formula were $<60mL/min/1.73m^2$ and in this condition, the prevalence of CIN was significantly high (odds ratio was 2.87 [1.64-5.02] as MDRD equation and 2.03 [1.26-3.29] as CG formula). Conclusion: Just SCr <1.5mg/dL was not appropriate to recognize preexisting renal insufficiency, but eGFR using MDRD equation was useful in predicting the risk of CIN related CT in ED. Using EMR, calculation of eGFR can be easier and more convenient.

• Journal of information and communication convergence engineering
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• 제17권2호
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• pp.91-96
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• 2019

In this study, a system to increase the expressiveness of existing standard terminology using three-dimensional (3D) data is designed. We analyze the existing medical terminology system by searching the reference literature and perform an expert group focus survey. A human body image is generated using a 3D modeling tool. Then, the anatomical position of the human body is mapped to the 3D coordinates' identification (ID) and metadata. We define the term to represent the 3D human body position in a total of 12 categories, including semantic terminology entity and semantic disorder. The Blender and 3ds Max programs are used to create the 3D model from medical imaging data. The generated 3D human body model is expressed by the ID of the coordinate type (x, y, and z axes) based on the anatomical position and mapped to the semantic entity including the meaning. We propose a system of standard terminology enabling integration and utilization of the 3D human body model, coordinates (ID), and metadata. In the future, through cooperation with the Electronic Health Record system, we will contribute to clinical research to generate higher-quality big data.

• 공학논문집
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• 제8권1호
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• pp.79-85
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• 2006

일반적으로 Electronic Medical Record(EMR) 과 OCS를 통해 환자의 계속적인 치료와 결과, 향후 치료방향 등을 결정한다. EMR 내용은 각개 병원소유 양식으로, 소유권을 인정 함과 동시에 장려 정책을 통해 확산 발전시켜야 할 필요가 있다. 여기에서 유의 해야 할 점은, EMR이 작성되고, 전자서명이 끝난 Data는 그 내용이 임의로 변경 또는 훼손 되어서는 안된다. 현재는 각 병원에서만 환자정보를 제어, 관리하고 있으므로, 의료 분쟁 또는 Data의 손실로 인한 몇 가지 문제가 발생할 소지가 있다. 본 논문에서는, 각 병원에서 사용하고 있는 EMR의 내용을 전자서명을 통해 객관적인 인증과 동시에 환자 개인의 정보보호에도 문제가 없는 system 구축에 대하여 논하고, 실제로 검증해 본다.

• 임상간호연구
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• 제19권3호
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• pp.357-368
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• 2013

Purpose: The purpose of this study was to investigate risk factors related to delirium and to develop screening model on delirium occurrence in MICU (Medical Intensive Care Unit) patients. Methods: For developing a preliminary tool for delirium, the data of 166 patients were collected and analyzed. In order to estimate the accuracy and discriminating power for the developed screening model, 98 patients were enrolled. The data used in this study were collected by EMR (Electronic Medical Record) review from January to September in 2012. The collected data were analyzed using SPSS/PC Win 18.0 program. Results: Screening model on delirium in MICU patients was developed using the results of logistic regression. The total score of screening model was 24 point and measuring point was 10 point. When the measuring point is over 10 point, it means that the risk of delirium occurrence is high. The discriminating power and the validity of screening model showed AUC .908 (p <.001) and .935 (p <.001) respectively. This result showed that the screening model on delirium which developed in this study was an appropriate model for screening the delirium risk group in MICU. The sensitivity of the screening model was 83%, specificity 89% and accuracy 84%. Conclusion: The developed screening model on delirium occurrence in MICU should be combined with EMR for screening and preventing delirium in a high risk group.

• 한국멀티미디어학회논문지
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• 제22권4호
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• pp.480-490
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• 2019

Nowadays, Electronic Medical Record (EMR) has just implemented at few hospitals for Outpatient Department (OPD). OPD is the diversified data, it includes demographic and diseases of patient, so it need to be clustered in order to explore the hidden rules and the relationship of data types of patient's information. In this paper, we propose a novel approach for unsupervised clustering of patient's demographic and diseases in OPD. Firstly, we collect data from a hospital at OPD. Then, we preprocess and transform data by using powerful techniques such as standardization, label encoder, and categorical encoder. After obtaining transformed data, we use some strong experiments, techniques, and evaluation to select the best number of clusters and best clustering algorithm. In addition, we use some tests and measurements to analyze and evaluate cluster tendency, models, and algorithms. Finally, we obtain the results to analyze and discover new knowledge, meanings, and rules. Clusters that are found out in this research provide knowledge to medical managers and doctors. From these information, they can improve the patient management methods, patient arrangement methods, and doctor's ability. In addition, it is a reference for medical data scientist to mine OPD dataset.

• 한국통신학회논문지
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• 제39C권6호
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• pp.497-502
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• 2014

일반적으로 모든 전문분야 의사들은 어느 정도 표준화된 진단, 치료 방식을 취하고 있다. 그러나 세부적인 처방 및 검사, 입원일수 등은 병원 규모 및 시스템, 의료 장비 구축정도에 따라 차이가 발생할 수 있다. 이러한 차이를 줄이기 위해 최근 진료지침의 표준화에 대한 관심이 높아지면서 다양한 연구가 진행되고 있다. 표준화된 진료지침은 의료의 질을 보장하고 의사의 자율성을 보장하기 위해 병원규모 및 구축된 시스템 등에 상관없이 똑같은 진료지침을 제공하는 것이 아니라 각 병원의 상황과 환경에 맞도록 임상데이터를 기반으로 진단 및 처치, 검사 등을 제공할 수 있어야 한다. 따라서 본 논문에서는 병원 내 같은 과의 두 전문의의 임상데이터를 분석하고 이를 기반으로 해당 질병 및 병원에 맞춘 표준 진료지침을 자동으로 생성할 수 있는 시스템을 연구 및 구현하여 적용 가능한 표준 진료지침을 제시하고자 한다.

• 보건의료산업학회지
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• 제12권1호
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• pp.81-93
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• 2018

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.