• Title/Summary/Keyword: Patient Care Management

Search Result 1,342, Processing Time 0.033 seconds

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions (의료정보 표준에 관한 연구 : 표준화 분석 및 전망)

  • Kim, Chang-Soo
    • Journal of radiological science and technology
    • /
    • v.31 no.1
    • /
    • pp.1-10
    • /
    • 2008
  • Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

  • PDF

Clinical Patterns of Penetrating Torso Injury at Emergency Department (응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰)

  • Yun, Soon Young;Cheon, Young Jin;Won, Tae Hee
    • Journal of Trauma and Injury
    • /
    • v.18 no.1
    • /
    • pp.47-52
    • /
    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

Advances in Radiation Oncology in New Millennium in Korea (21세기 방사선종양학의 전망:최근의 진보와 한국에서의 발전)

  • Huh, Seung-Jae;Park, Chan-Il
    • Radiation Oncology Journal
    • /
    • v.18 no.3
    • /
    • pp.167-176
    • /
    • 2000
  • The objective of recent radiation therapy is to improve the quality of treatment and the after treatment quality of life. In Korea, sharing the same objective, significant advancement was made due to the gradual increase of patient number and rapid increase of treatment facilities. The advancement includes generalization of three-dimensional conformal radiotherapy (3D-CRT), application of linac-based stereotactic radiosurgery (SRS), and furthermore, the introduction of intensity modulated radiation therapy (IMRT). Authors in this paper prospectively review the followings: the advancement of radiation oncology in Korea, the recent status of four-dimensional radiation therapy, IMRT, the concept of the treatment with biological conformity, the trend of combined chemoradiotherapy, the importance of internet and radiation oncology information management system as influenced by the revolution of information technology, and finally the global trend of telemedicine in radiation oncology. Additionally, we suggest the methods to improve radiotherapy treatment, which include improvement of quality assurance (QA) measures by developing Koreanized QA protocol and system, regional study about clinical protocol development for phase three clinical trial, suggestion of unified treatment protocol and guideline by academic or research societies, domestic generation of treatment equipment's or system, establishment of nationwide data base of radiation-oncology-related information, and finally patterns-of-care study about major cancers.

  • PDF

Smart-Telemedicine System Design and Business Model Analysis for Longitudinal Healthcare (예방의학을 위한 Smart-Telemedicine 시스템과 비즈니스 모델의 설계와 분석)

  • Kim, Chanyoung;Kwon, Dosoon;Lee, Jaebeom;Kim, Jinhwa
    • Information Systems Review
    • /
    • v.14 no.2
    • /
    • pp.1-19
    • /
    • 2012
  • Recently due to the enhancement of education and lifestyle, the trend of healthcare services are changed to a more active and differentiated service in which a continuous self health care is possible. The Smart-Telemedicine system offers medical services by merging Blue-tooth and telecommunication modules to former blood pressure, blood sugar, heartbeat and temperature measuring devices. Moreover, it could analyze one's health pattern which would be helpful for the patient to prevent potential future illness. In addition, the easier accesses to various remote controllable medical check-up programs are offered to public as a number of available smart phone are rapidly escalating. The Smart-Telemedicine system provides the most ideal interactive medical service via accessible smart phones and mobile medical check-up devices at anywhere and anytime. It is very beneficial since it can save patients' time and money because people can reach to the service right at their home and be allowed to take charge of their health care process via longitudinal health data. Therefore, not only social costs that occur in elderly community would be saved, but also business in various forms of medical service field transactions could be possible. This paper will suggest the Smart-Telemedicine System for preventive medicine, its design and analysis of business models and the evaluation of those model.

  • PDF

Dental students' clinical confidence in denture treatment after clinical experiences (의치진료 경험 후 치과대학 학생들의 임상진료능력에 대한 자기인식도)

  • Lee, Bora;Shim, June-Sung;Lee, Jae Hoon;Kim, Jong-Eun;Park, Ji-Man;Kim, Jee-Hwan
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.58 no.3
    • /
    • pp.185-192
    • /
    • 2020
  • Purpose: The purpose of this study is to investigate dental students' self-perception of clinical care ability after a denture treatment experience. Materials and methods: Of the 58 fourth-year students at the dental school in 2019, 50 students completed the questionnaire concerning their denture treatment session, including treatment planning and pre-prosthetic treatment (4 questions), clinical and laboratory procedures (20 questions), and students' opinions on clinical denture education (4 questions). Each question was answered on a five-point scale, of which points four and five, "agree" and "strongly agree" respectively, were classified as positive responses while points one and two, "disagree" and "strongly disagree" respectively, were classified as negative. Results: All the items on clinical and laboratory procedures received a positive response rate of over 60%, and the overall self-perception of the students appeared to be positive. However, the questions on the ability to perform denture treatment independently after graduation received only 48% of positive answer. Those on patient management, explanations of denture precautions, customized tray production, boxing, and work model production were answered with the highest positive response rate whereas those on treatment planning, final impression acquisition, and surveying, were the lowest in each session. Conclusion: The dental students with experience in denture treatment generally have a positive opinion of their clinical care ability, but further education may be necessary to improve their ability to treat their patients independently.

Symptomatic Pneumothorax in the Full-term Neonate (만삭 신생아의 기흉)

  • Choi, Woo-Kyoung;Hong, Chan-Eui;Lee, Dong-Jin;Hur, Nam-Jin;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
    • /
    • v.22 no.2
    • /
    • pp.183-190
    • /
    • 2005
  • Background: This study was performed to evaluate the incidence and clinical characteristics of symptomatic pneumothorax in the full-term neonate. Materials and Methods: We retrospectively reviewed the medical records of 32 symptomatic pneumothorax patients in the full term neonates who admitted to the neonatal intensive care unit in Ulsan Dong Kang General Hospital from January, 2000 to December, 2004. The subjects were divided into two groups according to underlying causes; spontaneous pneumothorax group and secondary pneumothorax group, then each clinical characteristics were assessed. Results: Spontaneous pneumothorax patients were 10(31%) and secondary pneumothorax patients were 22(69%). Overall incidence of spontaneous pneumothorax was 0.4%. Most common cause of secondary pneumothorax was pneumonia. Twelve cases(54.5%) among secondary pneumothorax patients were associated with mechanical ventilator care. Clinical characteristics, courses and managements were similar between two groups, but more shorter duration of admission and chest-tube insertion in spontaneous pneumothorax group Conclusion: The patient with symptomatic pneumothorax needs careful observation and proper management with or without underlying respiratory diseases.

  • PDF

A Study on the Motivation to Write Signing Advance Medical Directives (사전연명의료의향서 작성 동기에 관한 연구)

  • Chang, Kyung-Hee;Kang, Kyung-hee;Kim, Doo Ree;Lim, HyoNam;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.10
    • /
    • pp.243-249
    • /
    • 2019
  • This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.

Comparison of the nutritional indicators of critically Ill patients on extracorporeal membrane oxygen (ECMO) (체외막산소화장치 (ECMO) 적용 중환자의 영양지표 비교)

  • Shin, Nah-Mee;Ha, Suk Yeon;Cho, Yoon Soo
    • Journal of Nutrition and Health
    • /
    • v.54 no.5
    • /
    • pp.489-500
    • /
    • 2021
  • Purpose: This study aimed at investigating the nutritional status, nutritional support, and nutritional indicators of critically ill patients on extracorporeal membrane oxygen (ECMO) in intensive care units (ICU). Methods: This descriptive study obtained data from the medical records of 37 patients who were treated using ECMO at a university hospital in Korea. The patients were admitted to the Korea University Anam Hospital ICU with acute or serious damage to vital organs from January 1, 2014 to June 30, 2016. Results: Although 32 patients (86.5%) were at a high risk of malnutrition, 26 patients (70.3%) were considered normal in terms of nutritional status by the nutritionist at the beginning of their ICU stay. However, after two weeks, nine patients had passed away and only one patient maintained normal status. Parenteral nutrition was started first but took 4.25 ± 6.95 days till initiation. Only eight patients (21.6%) were able to meet their requirement for both calories and protein. The group provided with adequate calorie and protein showed significantly longer use of the ECMO and respirator and longer ICU and total hospital stay than their counterparts. Normal levels of serum albumin and protein of the group at low-risk for malnutrition on the day of initiation of ECMO, which were significantly higher than the high-risk group, declined by the last day of ECMO leading to a lack of significant differences between the two groups. Conclusion: Considering that the nutritional indicators of patients deteriorated as the days on ECMO increased, more aggressive nutritional management to ensure adequate nutritional support should be emphasized from the beginning and throughout the ICU stay.

A Study on the Image of a Nurse in Korean Modern Novels (한국 현대소설에 나타난 간호사 이미지 연구)

  • Hwang, Hyo Sook
    • Journal of Digital Convergence
    • /
    • v.20 no.4
    • /
    • pp.725-735
    • /
    • 2022
  • This study analyzed how the literary works embodying nurses accommodate various discourses about nurses and reproduce them in literature. The subject of analysis is a Korean modern novel featuring a nurse, and 29 works were selected from 1927 to 2016. The analysis method is the content analysis of the novel among the qualitative research methods. The unit of analysis adopts a narrative or dialogue that deals with the image of a nurse in a novel as a unit of analysis, The image determining factors of previous studies were integrated and categorized into 4 types and considered. As a result of analyzing the image of a nurse in the novel, First, traditional image types include Lee Kwang-soo 『Love』, Kim Eui-jung 『Doctor Han』, Jo Jung-rae 『Han River』, Gong Ji-young's 「Field of Stars」, Baek Min-seok 「Poor Little Hans」 Second, social image types include Kang Kyung-ae 「Dark」, Kim Kyung-wook 「Heaven's Gate」, Choi Jeong-hee 「Cheonmaek」 Third, professional image types include Lee Cheong-jun 「Mr. Jo Man-deuk」, 「Discharge」, Choi In-hoon 『The Square』, Kim Yeon-soo 「The Night in the Tunnel Where I Listened to Jusaeng Tudipini」, Jeong Se-lang 『Public health teacher Ahn Eun-young』and Fourth, personal image types include Choi In-ho 「Apprentice Patient」, Kim Jeong-han 「The Third Ward」, Eun Hee-kyung 『Minor League』, Hoon Kim 「Hwajang」, Ha Seong-ran 「The Joy of Eating」, Kim Ji-yeon 「Hippocrates Love Song」, Park Kyung-ri 「Era of Distrust」, Jeong Mi-kyung 「The Lady of Arsenal」 typed as. Through the image of the nurse in the novel, the implications of the novel for human care were discussed.

Programmed Follow-up and Quality Control of Treatment Techniques Enhance Chronic Thromboembolic Pulmonary Hypertension Management: Lessons From a Multidisciplinary Team

  • Taek Kyu Park;Sung-A Chang;Jeong Hoon Yang;Woochan Kwon;Min Yeong Kim;Young Seok Cho;Hye Yun Park;Dong Seop Jeong;Hojoong Kim;Duk kyung Kim
    • Korean Circulation Journal
    • /
    • v.54 no.7
    • /
    • pp.409-421
    • /
    • 2024
  • Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.