• Title/Summary/Keyword: Electronic Medical Records

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A Development Study of Common Clinical Document Forms for Traditional Korean Medicine Information Standardization (한의 정보 표준화를 위한 공통 임상 기록 서식 개발 연구)

  • Moon, Jin-Seok;Kim, Jeong-Cheol;Park, Sae-Wook;Ko, Ho-Yeon;Kim, Bo-Young;Kang, Byoung-Gap;Kang, Kyung-Won;Choi, Sun-Mi
    • The Journal of Korean Medicine
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    • v.30 no.1
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    • pp.40-50
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    • 2009
  • Objectives: The clinical document forms, a format for collecting clinical data, is the most fundamental object of standardization. Doctors must have a mutual understanding of the clinical chart. Methods: Clinical document forms were developed by investigating existing conditions in hospitals and conducting demand surveys, doing literature research, and seeking expert advice for the improvement of version 1.0. In addition, an organization of a network of 19 Oriental medical doctors and nurses, 190 patients, and users of collected and assessed data was formed to come up with version 2.0. Results: The overall format was divided into different portions that the patient, nurse, and doctor must fill out, respectively. The patient's section consists of demographic data, lifestyle details, history, and symptoms. The data to be supplied by the nurse include the patient's vital signs and anthropometric parameters. As for the doctors, they are to supply data regarding the patient's palpitation, the detailed symptoms of the patient's head, ophthalmological and otorhinolaryngological symptoms (mouth), respiration, circulatory organ and chest conditions, digestive-organ conditions (thirst), neuropsychiatric conditions, reproductive system, musculoskeletal system, skin (depilation), etc. Conclusions: Common clinical chart development is the prior question to Traditional Korean Medicine standardization. A web-based clinical document format should be developed to support diagnosis and treatment, and furthermore EMR (electronic medical record system) and EHR (electronic health record) developed. Clinical information could be shared through a network of medical institutions and be useful Traditional Korean Medicine for evidence-based medicine.

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The Effect of the Immediate Postoperative Nutritional Status in Liver Transplant Recipients in SICU on Clinical Outcome (간이식 환자의 수술 후 영양상태가 건강상태에 미치는 영향)

  • Ha, Ji Su;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.15 no.4
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    • pp.193-201
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    • 2013
  • Purpose: The purpose of the study was to evaluate the effect of the immediate postoperative nutritional status and calorie adequacy on clinical outcomes in liver transplant recipients. Methods: A total number of 99 patients who received liver transplants were recruited from a tertiary university hospital. Demography, subjective global assessment, clinical outcomes and calorie adequacy were evaluated through personal interviews, electronic medical records and dietary records. Anthropometric measures, body mass index and percent of ideal body weight were also obtained. Results: At admission to the Surgical Intensive Care Unit (SICU), the triceps skinfold thickness and mid-arm muscle circumference were significantly lower in the malnourished group than in the well-nourished group (p<.05, respectively). In the clinical outcomes, transfusion of red blood cells, mechanically ventilated hours, length of stay in the Intensive Care Unit (ICU), length of stay in the hospital, and prothrombin time were significantly higher in the malnourished group than in the well-nourished group (p<.05, respectively). The mechanically ventilated hour was significantly higher in the group with less than 50% of their required energy intake (p<.05). Conclusion: Therefore, it is important to assess the nutritional status of immediate postoperative patients. Furthermore, studies on nutritional interventions are urgently needed to provide adequate nutritional care for patients in ICUs.

Implementation of Subsequence Mapping Method for Sequential Pattern Mining

  • Trang Nguyen Thu;Lee Bum-Ju;Lee Heon-Gyu;Park Jeong-Seok;Ryu Keun-Ho
    • Korean Journal of Remote Sensing
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    • v.22 no.5
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    • pp.457-462
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    • 2006
  • Sequential Pattern Mining is the mining approach which addresses the problem of discovering the existent maximal frequent sequences in a given databases. In the daily and scientific life, sequential data are available and used everywhere based on their representative forms as text, weather data, satellite data streams, business transactions, telecommunications records, experimental runs, DNA sequences, histories of medical records, etc. Discovering sequential patterns can assist user or scientist on predicting coming activities, interpreting recurring phenomena or extracting similarities. For the sake of that purpose, the core of sequential pattern mining is finding the frequent sequence which is contained frequently in all data sequences. Beside the discovery of frequent itemsets, sequential pattern mining requires the arrangement of those itemsets in sequences and the discovery of which of those are frequent. So before mining sequences, the main task is checking if one sequence is a subsequence of another sequence in the database. In this paper, we implement the subsequence matching method as the preprocessing step for sequential pattern mining. Matched sequences in our implementation are the normalized sequences as the form of number chain. The result which is given by this method is the review of matching information between input mapped sequences.

Sharing and Privacy in PHRs: Efficient Policy Hiding and Update Attribute-based Encryption

  • Liu, Zhenhua;Ji, Jiaqi;Yin, Fangfang;Wang, Baocang
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.15 no.1
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    • pp.323-342
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    • 2021
  • Personal health records (PHRs) is an electronic medical system that enables patients to acquire, manage and share their health data. Nevertheless, data confidentiality and user privacy in PHRs have not been handled completely. As a fine-grained access control over health data, ciphertext-policy attribute-based encryption (CP-ABE) has an ability to guarantee data confidentiality. However, existing CP-ABE solutions for PHRs are facing some new challenges in access control, such as policy privacy disclosure and dynamic policy update. In terms of addressing these problems, we propose a privacy protection and dynamic share system (PPADS) based on CP-ABE for PHRs, which supports full policy hiding and flexible access control. In the system, attribute information of access policy is fully hidden by attribute bloom filter. Moreover, data user produces a transforming key for the PHRs Cloud to change access policy dynamically. Furthermore, relied on security analysis, PPADS is selectively secure under standard model. Finally, the performance comparisons and simulation results demonstrate that PPADS is suitable for PHRs.

A Study on the Significance of Acupuncture and Pharmacopuncture Therapy for Cold Accumulation Through a Literature Review on the Historical Development Process in Cold Accumulation Treatment

  • Jin-Ho, Jeong;Jaseung, Ku;Ji Hye, Hwang
    • Journal of Acupuncture Research
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    • v.39 no.4
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    • pp.267-274
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    • 2022
  • In order to secure clinical evidence for the treatment of cold accumulation (CA), this study reviewed and analyzed 91 records of literature and related records. To perform a classical literature search, the Oriental Medicine Classic databases and the Uibujeonrok electronic data were searched. Books on Immunopharmacopuncture (IP) were also reviewed. A common etiology for CA was attributed to the abdomen, while the detailed sites of the abdomen differed. In IP, CA had a more comprehensive list of symptoms of physiological and pathological significance. As for the treatment of CA, typically, herbal medicine was used until the end of the Korean Empire period, and moxibustion treatment on CV4, CV6, CV-12, ST36, EX-B4, and conduction exercise therapy were also reported. Since 1965, acupuncture needle-based invasive treatment such as acupuncture for CA, and IP have been described in IP theory. Consequently, the treatment of CA (as described in the IP theory), was considered to be a more advanced method of treatment compared with the existing classical treatment methods.

Efficacy of new inspection system of Anticancer Drug Prescription (새로운 항암제 처방 감사 시스템 도입을 통한 의료의 질 향상)

  • Kim, M.S.;Kim, Y.K.;Lee, Y.J.;Choi, Y.J.;Shin, H.Y.;Song, Y.C.
    • Quality Improvement in Health Care
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    • v.14 no.2
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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.

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A Clinical Data Repository as an Autonomous Agent (자동 에이전트 기법을 활용한 임상문서저장시스템)

  • Kim, Hwa-Sun;Houshiaryan, Kambiz;Cho, Hune
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.54 no.12
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    • pp.732-736
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    • 2005
  • ln general, hospital information system should provide interoperability hat usually and operate independence of other HIS. This study proposes a new HIS paradigm that can be implemented within standard HL7 Interface engine and clinical data repository (CDR). We have developed an alternative architecture relying on agent solutions with distributed queries to heterogeneous databases. This architecture creates a very fine and flexible repository that can handle queries with the bases of standard HL7 messaging structure. Deploying Agent solutions to manipulate autonomy of storage management and sociality for communication with open world is another issue that keeps this system from reinventing existing wheels in medical informatics. This study the first attempt to construct CDR based private clinic. We used the information stored in the clinical patient record system of the internal medicine private hospital which is used rational database. We were searched increasing the 1,000 data entry from 1,000 to 10,000. By the result, experimental CDR showed highly efficient performance more than 6,000. In the future, the CDR can be further extended for clinical information among private hospitals estranged from EHR (Electronic Health Records).

Evaluation of Postoperative Nutrition Support after an Ivor-Lewis Esophagectomy in Patients with Esophageal Cancer (식도암 환자에서 아이보-루이스 식도절제술 시행 후 영양지원 평가)

  • Park, Su Jin;Lee, Young Mi;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.240-247
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    • 2014
  • Objective: Undernutrition is common amongst esophageal cancer patients and therefore appropriate nutrition support is critical. Nevertheless, the effectiveness of enteral nutrition (EN) versus parenteral nutrition (PN) is still controversial. The aim of this study was to investigate the effect of EN and PN on the nutritional state and the length of hospital stay for patients who underwent an Ivor-Lewis (IL) esophagectomy. Method: A retrospective clinical analysis was performed that utilized the electronic medical records of patients who underwent IL esophagectomy during a 3-year period between January 2010 and December 2012 at a tertiary teaching hospital located in Seoul, Korea. The EN group and PN group were analyzed by comparing the nutrition supply, postoperative complications, length of hospital stay, and weight variation. Results: After an IL esophagectomy, the complication rate between the EN group and PN group was insignificant and the length of hospital stay was significantly shorter for the PN group compared to the EN group (14 vs. 16 days, respectively; p<0.001). At the time of discharge, those in the PN group lost less weight postoperatively (p=0.003). Conclusion: PN may be considered as safe nutrition support for esophageal cancer patients who underwent an esophagectomy.

Characteristic Changes in First-Visit Patients with Peripheral Facial Palsy before and during COVID-19 Pandemic: Focused on a Korean Medicine Hospital

  • Yoonji Lee;Suji Lee;Yong-Suk Kim
    • Journal of Acupuncture Research
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    • v.41 no.1
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    • pp.17-28
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    • 2024
  • This study aimed to analyze whether the coronavirus disease 2019 (COVID-19) pandemic affected the characteristics of first-visit patients with peripheral facial palsy (PFP) and observe changes in their characteristics. This study analyzed the electronic medical records of 2,310 first-visit patients with PFP who visited the Facial Palsy Center, Kyung Hee University Korean Medicine Hospital from January 1, 2019, to December 31, 2021, in terms of demographic characteristics, disease phase, residence locations, hospital visit route, and patient care. During COVID-19, the proportion of acute patients increased by 5.3%, the proportion of visits by residents in Seoul increased by 3.8%, and the proportion of patients receiving only outpatient treatments increased by 12.8%. Significant relationships were present between the presence of the COVID-19 pandemic and the number of patients by disease phase (p = 0.043), residence locations (p = 0.003), and patient care (p = 0.003). Thus, several differences in the characteristics of first-visit patients with PFP visiting a Korean medicine hospital during the COVID-19 pandemic in terms of demographic characteristics, disease phase, residence locations, and patient care.

The Effect of Aprepitant Regimen on the Prevention of High-Dose Cisplatin-Induced Nausea and Vomiting (Aprepitant Regimen의 고용량 Cisplatin 유발 오심 및 구토 예방 효과)

  • Park, Su-Jin;Choi, Ji-Seon;Ahn, Jin-Seok;Shin, Ka-Young;Min, Kyoung-A;Chung, Seon-Young;In, Yong-Won;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.17-23
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    • 2010
  • Aprepitant is a substance P/neurokinin-1 (NK1)-receptor antagonist that was approved in 2003 for prevention of CINV. In addition, updated anti-emetic guidelines that include the aprepitant regimen have been published by NCCN and ASCO. However there is scarce clinical data in Korea. The prospective study was performed to evaluate the prevention of high dose cisplatin induced nausea and vomiting in all patients who started high-dose cisplatin-based chemotherapy at our hospital. We checked the nausea severity and vomiting episodes by calling patients within 4 to 5 days after chemotherapy. The retrospective study was performed to compare the prevention of CINV in solid tumor patients who switched their anti-emesis regimen from the standard regimen to the aprepitant regimen. In aprepitant regimen, aprepitant was added to the same anti-emetic regimen used during previous cycles. We checked the nausea, vomiting grades and adverse events in electronic medical records (EMR). In prospective study, 195 patients were included in the analysis. 88.2% of patients achieved a complete response (no emesis and no rescue therapy). In retrospective study, 54 patients were reviewed. With aprepitant regimen, nausea and vomiting grades were improved in 22 patients (40.7%) and in 9 patients (16.7%), respectively. Compared with standard regimen, addition of aprepitant provided superior prevention against CINV in Korean patients receiving highly emetogenic cisplatin-based chemotherapy. Moreover, aprepitant significantly prevented CINV in patients who received the standard regimen to prevent CINV in previous chemotherapy cycles.