• 제목/요약/키워드: Prescription

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의사 환자 간 원격 의료의 의료법상 적법성에 관하여 - 원격 환자에 대한 처방 중심으로 - (On the Legality of the Telemedicine between the Patient and Doctor Under the Medical Service Act - Focused on the Prescriptions to the Distanced Patients-)

  • 김장한
    • 의료법학
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    • 제22권1호
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    • pp.3-23
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    • 2021
  • 원격의료는 원격지에서 영상, 통화 등 기기를 사용하여 환자를 진단, 치료하는 의료의 한 분야이다. 환자를 대면하여 진단, 치료, 처방하는 전통적인 방식에서 벗어나, 원격에 있는 환자에게 의료를 제공하기 때문에, 의료 소외 지역, 거동이 불편한 환자에 도움이 될 것이고, 의사들은 공간적 제약을 벗어나 환자를 볼 수 있다는 장점이 있다. 하지만 의사가 환자를 대면 진료하는 것에 비하면, 진료의 질이 떨어지는 문제가 나타날 수 있어서, 허용 여부와 한계를 정하는 것도 필요하다. 원격의료 유형 중에서 의사가 환자를 원격에서 진료하고 처방전을 발행하는 것을 원격진료라고 정의할 수 있는데, 현행 의료법상 허용되는지에 대하여 법 해석이 일관되지 못하고 있다. 의료법 처방전 조항은 의사의 '진찰' 또는 '직접 진찰' 규정에 의하여 처방전을 발급한다고 규정하고 있는데, 이것을 대면 진료를 요구하는 규정이라고 해석하는 헌법재판소 결정과 일정한 제한 하에서 전화 처방을 인정할 수 있다는 대법원 판결이 대립하고 있다. 또한 의료법상 원격의료 규정에 의하여 명백하게 법상 허용되는 원격의료자문 외에 의사 환자 간 원격진료는 불법이라는 대법원 판결이 있다. 본 논문에서는 의료법 개정 연혁, 개정 이유 및 관련 의료법 조항과의 관련성을 통하여 원격진료에 대한 대법원 판례를 해석하고자 한다. 결론적으로 의료법상 처방전 규정에 의한, 의사의 직접 진찰 후, 처방전 발급 조항은 환자를 진찰한 의사가 처방전을 발급해야 한다는 처방전 발급 명의에 관한 의무 조항으로 해석하며, 의료법 원격의료 규정에 의하여 의사-환자 간 원격진료는 허용되지 않은 것으로 판단한다.

동의보감(東醫寶鑑) 중 석고(石膏)가 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察) (A Study on Application of Gypsum Main Blended Prescription From Dongeuibogam)

  • 오황;이장천
    • 대한한의학방제학회지
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    • 제15권1호
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    • pp.1-19
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    • 2007
  • This study was investigated to make sure the range of Gypsum treatment, the nature of disease, the pathology and the dosage of it in Dongeuybogam. The following conclusions were reached through investigations on the prescriptions that use Gypsum as a key ingredient. The Gypsum blended prescriptions are utilized in 23 fields of treatment such as cold, head. ect. Prescriptions that use Gypsum as the main ingredient are used commonly in the treatment of cold, head disease, fever, skin disease, diabetes, stroke, ophthalmic disease, jaundice, ENT disease and dental disease. The Gypsum is used for nature of disease which of cold, heat(fever), summer heat, phlegm, malfunction of liver, malfunction of liver and kidney, heat of stomach, malfunction of spleen and fever of stomach. The clinical dosage of Gypsum has ranged at a wide variety of amount from 1.6g to 16g per dose with 4g ${\sim}$ 8g being the typical dose for most treatment. The Gypsum is applied as a fundamental prescription with several herb remedies for the pathology.

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소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석 (The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication)

  • 김동숙;박춘선;장선미
    • 한국임상약학회지
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    • 제18권2호
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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Clinical Analysis of Symptoms and Oriental Medical Prescriptions According to Elapsed Time of Stroke in Oriental Medical Hospital Inpatients

  • Yun, Hen-Ja;Sung, Kang-Keyng
    • 대한한의학방제학회지
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    • 제20권1호
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    • pp.133-147
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    • 2012
  • Objectives : This study was intended to understand characteristics of symptoms, oriental medicine prescription and laboratory test results according to elapsed time of stroke. Methods : Through the medical records of 205 stroke inpatients in the oriental medical hospital in the year 2010, we investigated manifested symptoms, administered oriental medicine prescription and clinical pathological examination results. Collected items were classified to depend on stroke types, cerebral infarction and hemorrhage. We analyzed association between manifested symptoms, the oriental medicine prescription, and laboratory test results of stroke patients and elapsed time. Chi-square tests were performed to determine the significance level of association. Results : All symptoms, prescriptions and laboratory test results in cerebral infarction patients were associated with elapsed time. Especially, symptoms, prescriptions and pathological examination results showed very high statistical significance with elapsed time (a symptom; chi-square(df)=164.3(22), p<0.001, prescription; chi-square(df)=93.5(22), p<0.001, and pathological examination results; chi-square(df)=164.3(22), p<0.0004). But in the case of cerebral hemorrhage, there was not statistical significance. Conclusions : The elapsed time of stroke may be an essential requisite in catching symptoms and prescribing for stroke patients in oriental medical treatment.

암호화 알고리즘을 이용한 안전한 원격 EMR 의료정보 구현 (Implementation of Secur ed Remote EMR Medical Information using Encryption Algorithm)

  • 양재수;이유식;홍유식
    • 한국인터넷방송통신학회논문지
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    • 제14권4호
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    • pp.133-139
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    • 2014
  • 요즈음, 원격 처방전 및 원격 진료가 시범적으로 운영되고 있다. 그러나 대부분의 원격지 병원에서 환자 생체 데이터를 암호화 하지 않고 전송하는 경우, 해커가 환자 처방전 데이터를 해킹해서 처방전 약물을 바꾸면 환자는 심각한 장애를 받을 수 있다. 따라서, 본 논문에서는, 이러한 문제점을 해결하기 위해 원격 처방전과 의료 정보시스템에 환자의 비밀번호, 개인 식별 정보, 바이오 정보 등을 암호화하는 알고리즘과 안전한 보안 구현 방안이 제시되었다.

1차 의료기관의 급성 상기도 감염 질환자 의약품 처방특성 - 가정의학과, 내과, 소아청소년과, 이비인후과, 일반의 중심으로 - (Characteristics of Prescription Drugs for Acute Upper Respiratory Tract Infection in Outpatient Clinics - Centered on Family Medicine, Internal Medicine, Pediatrics, Otorhinolaryngology and General Practitioner Clinics -)

  • 공미진;황병덕
    • 보건의료산업학회지
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    • 제11권3호
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    • pp.37-49
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    • 2017
  • Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

한의사들의 천연물 신약 처방의사에 관한 연구 (A Study on Prescription Intention of Botanical Drug in Korean Medicine Doctors)

  • 권용찬;빈성오;구진숙;서부일
    • 대한본초학회지
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    • 제30권5호
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    • pp.7-13
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    • 2015
  • Objectives : The purpose of this study was to examine the prescription intention of Korean medicine doctors on botanical drug.Methods : The subjects in this study were 340 Korean medicine doctors in Korean medical institutions, on whom a survey was conducted from July 1 to August 31, 2014.Results : The factors that affected the prescription decision making of the Korean medicine doctors were drug superiority, level of Interest, Recognition, marketing of sales associates of pharmaceutical companies and satisfaction with information provided by those companies. When the internal consistency of the variables was measured, that was above 0.8.Conclusions : Accordingly, well-planned education and promotion efforts are required to encourage Korean medicine doctors to put more prescription intention in botanical drug. This study had some limitations : First, the subjects were selected in a manner to allow for the convenience of this researcher, and the findings might not be generalizable. Second, there was a problem with the time for the study in that there were quite fierce disputes on botanical drug at that time. Third, the majority of the subjects run their own hospitals, and the number of them was small. So it's not possible for them to represent every Korean medicine doctor.

평위산증(平胃散證)의 병인논적(病因論的) 분석(分析)을 위한 설문문항(說問問項) 개발(開發) (Developing Questionnaire for Pathogenesis Analysis of Pyungweesan Symptom)

  • 임준성;박영배;이상철;오환섭
    • 대한한의진단학회지
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    • 제11권1호
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    • pp.72-81
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    • 2007
  • Background & Objective: Pathogenesis treats cause of disease. pyungweesan is pathogenesis prescription of indigestion. prescription has been determined subjectively because there is no standardized prescription. so this study developed questionnaire for a objective and standardized prescription. Method: To determine objective pyungweesan prescription, 24 items of questionnaire are researched two times by delphi method. The questionnaire is selected through 5 reference book and opinions of korean medical doctor. Result: By delphi method and average value, 20 items of questionnaire are chosen. Conclusions: This study becomes basic data for a profound research henceforth. The questionnaire will be developed through being verified by korean medical doctor clinically.

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DBS(Deep Brain Stimulation)를 시행한 Essential Tremor 환자의 진전 간정격 치험 1례 (Clinical Observation of Improvement Made by Prescription of Liver Supplementation on a Case of Essential Tremor Patient Who was Operated DBS(Deep Brain Stimulation))

  • 양동호;이경윤;신현승;조송현;임창선;임준혁;윤석훈;이한
    • Journal of Acupuncture Research
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    • 제27권6호
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    • pp.123-131
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    • 2010
  • Objectives : The purpose of these case is to observe the effect of prescription of liver supplementation on essential tremor patient who was operated DBS. Methods : The patient was treated by prescription of liver supplementation. The improvement of patient was judged by tremor scale and VAS(visual analog scale). Results : After treatment patient's tremor scale grade and VAS score were generally decreased. Conclusions : The prescription of liver supplementation might be an effective method to treat the essential tremor patient who was operated DBS.

방약합편(方藥合編) 중(中) 창출(蒼朮)이 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察) (Studies on application of Rhizoma Atractylodis Japonicae blended prescriptions from Bangyahkhappeun)

  • 박종찬;이장천;국윤범;염현식;윤용갑
    • 대한한의학방제학회지
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    • 제11권2호
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    • pp.41-60
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    • 2003
  • This report describes the studies as follows through the research into the data of Rhizoma Atractylodis japonicae blended prescriptions from Bang Yahk Hap Peun. The main pathologies of Atractylodis Japonicae blended prescriptions found chills, bowels, malaria, and they are used 18 disease also. In these prescriptions, the symptoms of chills and bowels are the most frequently used. Atractylodis Japonicae main blended prescriptions use in the symptoms of Sang Han Pyo syndrome, Sang Han Yin syndrome, and they are 25 disease also. Through the research, Atractylodis Japonicae main blended prescriptions are used the pathologes of wet, internal disease, the injury of the cold and wind, stomach and spleen. The actual amount of Atractylodis Japonicae blended has a wide capacity from 6 pun to 6 don, 1-2 don is broadlly used. The structures of Atractylodis Japonicae blended prescriptions are Pyong We San, Yi Myo San, Hyang So San, Warl Gook Hwan, Gook Chul Hwan, such as basic prescriptions are most used.

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