• Title/Summary/Keyword: clinical information resources

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An Analysis of Physicians' Online Information Search Process at the Point of Care (의사의 임상질문 해결을 위한 온라인 정보검색과정 연구)

  • Kim, Soon;Chung, EunKyung
    • Journal of the Korean Society for information Management
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    • v.33 no.3
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    • pp.177-193
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    • 2016
  • This study aims to analyze physicians' online information search process to solve the clinical questions at the point of care. To achieve this purpose, ten university hospital-based physicians participated in-depth interviews and observation studies. Based on Wilson's problem solving process, this study analyzed the characteristics of each information search stage and efficiency of online searching. The results showed that participants tend to relatively immediately formulate their clinical questions. However, basic searching strategies were only used and a few preferred information sources were chosen. However, average satisfaction degree of online searching appeared high with 5.7 (7 Likert-scale) and problem-solving index increased after searching. As physicians are likely to use well organized and evidenced-based credible information easily, it implies the needs for an integrated search system within the electronic medical record (EMR). In addition, as other online resources' awareness is lower comparing Google and PubMed, active promotions and training of other resources are needed.

A Qualitative Study of Physicians' Use of Clinical Information Resources and Barriers (임상의사의 진료목적 정보원 이용과 장애요인에 관한 질적 연구)

  • Kim, Soon;Chung, EunKyung
    • Journal of the Korean Society for Library and Information Science
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    • v.50 no.4
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    • pp.55-75
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    • 2016
  • We analyzed the characteristics of the physicians preferred information sources and barriers through in-depth interviews. Information searches for patient treatment were subdivided into deciding patient treatment methods, understanding the latest treatment trends, and preparing presentation materials for conferences. The variables that affected the search behaviors were identified as being background knowledge on the topic, clinical experience, job title, search skills, user training, and familiarity with the library homepage. PubMed was the most preferred choice because of users' familiarity, reliability, and the vastness of information; Google was also used frequently for easy access and fast search result. The accuracy and the recentness of information were the most significant criteria. Easy interface and convenient access were also considered important due to physicians' time constraints. Searching obstacles were divided into difficulty of searching system, unfamiliar term, too vast resources, difficulty to get fulltext articles and complex advanced search features. The results of this study can be utilized as a basis for improving information service of library and curriculum development for physicians.

Nurses' Access & Use of Information Resources and Barriers & Competency of Evidence Based Practice (간호사의 정보자원 접근 및 활용정도와 근거중심실무 장애요인 및 역량)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.23 no.3
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    • pp.255-266
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    • 2011
  • Purpose: The purpose of this study was to explore nurses' access and use of information resources and to identify the barriers and competency to evidence based practice (EBP). This study used descriptive method to identify baseline data for the purpose of developing strategies for establishing EBP in clinical nursing practice. Methods: Participants in this study were 278 nurses from five hospitals in Daegu and Kyungsangbukdo. The data were collected by self administered questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, t-test, Pearson's correlation coefficients, and ANOVA. Results: Nurses reported $^*most$ frequently using paper and human resources. The mean score of barriers was $3.02{\pm}0.41$, and competency was $2.70{\pm}0.50$. The reported competency was correlated with nurse factors (r=-.31, p<.001) organization factors (r=-.20, p<.001) and research factors (r=-.12, p<.040) as the barriers to evidence based practice. Conclusion: To promote competency in EBP and to decrease the barriers, it would be necessary to develop the organizational culture that encourages nurses to be involved in research activities. In addition, the development of systemic methods to introduce and establish an education program for facilitating EBP in the clinical settings is needed.

Evaluation of Pharmacy Students' Perception on Clinical Pharmacy Practice Experience in the Tertiary and Secondary Hospital settings (상급종합병원과 종합병원 필수실무실습에 관한 학생들의 인식 평가)

  • Chun, Pusoon;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.30-39
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    • 2018
  • Background: Clinical Pharmacy Practice Experience (CPPE) is an important curriculum that offers students patient-centered disease prevention and treatment with evidence-based optimal pharmacotherapy for better clinical outcomes. However, few studies have evaluated the perception of pharmacy students regarding CPPE in tertiary and secondary hospitals. This study aimed to evaluate the perception of pharmacy students regarding the learning program of CPPE. Methods: The survey questionnaire consisted of 15 self-administered questions regarding pharmacy practices, barriers, and improvement of practical training. Fourteen institutional pharmacies located in seven regions responded to a survey questionnaire from March 1 to June 30, 2017. The participants were pharmacy students doing clerkship in a hospital setting. Results: The response rate was 73.6%. Thirty-five participants (22.4%) had used a hospital library, but 121 (77.6%) had never used the library for drug information resources. Eighty-one (50.0%) responded that clinical knowledge and drug information was the most beneficial practice. Thirty-seven (31.1%) respondents in the tertiary hospitals and 19 (46.3%) in the secondary hospitals answered that they were filling prescriptions during the daily break. On the other hand, 72 respondents (60.5%) in the tertiary hospitals and 17 (41.5%) in the secondary hospitals did literature research to prepare for presentation. Conclusion: More students in secondary hospitals continue to fill prescriptions during the daily break, as compared to those in tertiary hospitals. Therefore, the authors suggest self-directed learning to improve clinical performance and each institution considers offering onsite or online library service to improve evidence-based CPPE for pharmacy school students.

Salmonellosis in swine: Clinical perspectives

  • Shim, Minkyung;Hong, Sanghyun;Seok, Min-Jae;Kim, Hyeun Bum
    • Korean Journal of Agricultural Science
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    • v.43 no.3
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    • pp.320-329
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    • 2016
  • Salmonella is one of the most important food-borne zoonotic pathogens, causing acute or chronic digestive diseases such as enteritis. The acute form of enteritis is common in young pigs of 2 - 4 months of age. The main symptoms include high fever ($41-42^{\circ}C$), loss of appetite, and increased mortality within 2 - 4 days of onset of the disease. It is often the cause of increasing mortality, decreasing growth rate and reducing feed efficiency of piglets. In the case of chronic enteritis in pigs, the main symptom is weight loss due to the continuing severe diarrhea. Salmonella enterica serovar Typhimurium and Salmonella enterica serovar Choleraesuis are typical pig adapted serotypes, which cause one of four major syndromes: enteric fever, enterocolitis/diarrhea, bacteremia and chronic asymptomatic carriage. These syndromes cause a huge economic burden to swine industry by reducing production. Therefore, it is necessary that swine industries should strive to decrease Salmonellosis in pigs in order to reduce economic losses. There are several measures, such as vaccination to prevent salmonellosis, that are implemented differently from country to country. For the treatment of Salmonella, ongoing antibiotic treatment is needed. However constant doses of antibiotics can be a problem because of antibiotic resistance. Therefore, the focus should be made more on prevention than treatment. In this review, we addressed the basic information about Salmonella, route of infection, clinical symptoms, and prevention of Salmonellosis.

The medical 3-dimensional image exchange via health level 7 fast healthcare interoperability resource (HL7 FHIR) (Health level 7 fast healthcare interoperability resource (HL7 FHIR)를 통한 3차원 의료 영상의 교환)

  • Lee, Jung Hwan;Choi, Byung Kwan;Han, In Ho
    • Journal of Digital Convergence
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    • v.18 no.6
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    • pp.373-378
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    • 2020
  • For improving interoperability of medical information, health level 7 has initiated the development of a next-generation framework for the exchange of medical information called the Fast health interoperability resources (FHIR). However, there was no attempt to exchange the medical three-dimensional (3D) image with clinical data via FHIR. Thus, we designed a new method. The 3D image to be made from computed tomography was converted to the javascript object notation (JSON) file format, and clinical data was added. We made a test FHIR server, and the client used the postman. The JSON file was attached to the body, and was then transmitted. The transmitted 3D image could be seen through a web browser, and attached clinical data was identified in the source code. This is the first attempt to exchange the medical 3D image. Additional researches will be needed to develop applications or FHIR resources that apply this method.

Role of Online Knowledge Resources in Clinical Decision Making (임상 의사 결정에서 온라인 지식 자원의 역할)

  • Afzal, Muhammad;Hussain, Maqbool;Khan, Wajahat Ali;Ali, Taqdir;Lee, Sungyoung
    • Proceedings of the Korea Information Processing Society Conference
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    • 2012.11a
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    • pp.450-451
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    • 2012
  • The need of Clinical Decision Support System (CDSS) in healthcare setup is increasing day by day. EHR Meaningful Use advocates CDSS as an important component of EHR/EMR systems. CDSS can be ranged from a simple to a very sophisticated system. The more complex CDSS systems need more attention to develop because of many reasons including its Knowledge Base (KB) structure/maintenance/evolution, inference capabilities and usability. Above all the KB maintenance and evolution is very crucial and important from the perspective of useful decision capabilities. Also the richness of the KB is important to cover the decision gaps handling a particular situation in the course of patient care. It cannot be expected from the clinicians to remember everything in regard to patient diagnosis and treatment. Similarly, it is also crucial for clinicians to keep themselves updated with the new research in the area. That is the reason they frequently require accessing to the online knowledge resources. Literature proved that online knowledge resources are capable providing answers to questions that might not be answered rely only on clinician wisdom and experience. This paper provides the theme of meaningful utilization of online knowledge resources in the context of diagnosis and treatment process for cancer patients more specifically Head and Neck cancer.

Reliability and Validity of Korean Version of Nursing Students' Anxiety and Self-Confidence with Clinical Decision Making Scale (한국어판 간호대학생 임상의사결정능력 자신감과 불안 측정도구의 타당도와 신뢰도)

  • Yu, Mi;Eun, Young;White, KA;Kang, KyungJa
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.411-422
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    • 2019
  • Purpose: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale ($NASC-CDM^{(c)}$) for Korean nursing students. Methods: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the $NASC-CDM^{(c)}$ were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. Results: The Korean version of the $NASC-CDM^{(c)}$ (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's ${\alpha}$ was .93 for self-confidence and .95 for anxiety. Conclusion: The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original $NASC-CDM^{(c)}$ version.

PHR Profiling System Based on FHIR (FHIR 기반 개인건강기록 프로파일링 시스템 개발방법)

  • Kim, Young Sik;Kim, Il Kon
    • KIPS Transactions on Software and Data Engineering
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    • v.4 no.7
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    • pp.277-282
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    • 2015
  • HL7 released V3 CDA(Clinical Document Architecture) and V2.x message standards for medical information exchange. Currently, these standards are successfully adopted by a number of nations across the globe. However, substantial amount of time is required to develop and implement these standards. Moreover, developers need a lot of time to understand these standards. To solve these issues from 2011, the HL7 standard framework started to discuss Fast Healthcare Interoperability Resources(FHIR) as next generation standard of healthcare information exchange. People's interests toward personal health record and smartphone penetration rate are growing and increasing rapidly. Therefore, our research team believes it is necessary to develop a PHR profiling system which could be accessed by using a smartphone and we developed the system. Through a FHIR Profile editor tool developed in Furore, we found that improvements could be made in generating and changing the profile. In order to build the PHR Profiling system, an Open-API on FHIR is used for exchanging information between electronic medical record system and PHR Profiling system. In the PHR Profiling system, the transactions of information between two systems are provided by RESTful service. In this study, we verify the efficiency of development of the PHR Profiling system through FHIR.

Epilepsy syndromes during the first year of life and the usefulness of an epilepsy gene panel

  • Lee, Eun Hye
    • Clinical and Experimental Pediatrics
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    • v.61 no.4
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    • pp.101-107
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    • 2018
  • Recent advances in genetics have determined that a number of epilepsy syndromes that occur in the first year of life are associated with genetic etiologies. These syndromes range from benign familial epilepsy syndromes to early-onset epileptic encephalopathies that lead to poor prognoses and severe psychomotor retardation. An early genetic diagnosis can save time and overall cost by reducing the amount of time and resources expended to reach a diagnosis. Furthermore, a genetic diagnosis can provide accurate prognostic information and, in certain cases, enable targeted therapy. Here, several early infantile epilepsy syndromes with strong genetic associations are briefly reviewed, and their genotype-phenotype correlations are summarized. Because the clinical presentations of these disorders frequently overlap and have heterogeneous genetic causes, next-generation sequencing (NGS)-based gene panel testing represents a more powerful diagnostic tool than single gene testing. As genetic information accumulates, genetic testing will likely play an increasingly important role in diagnosing pediatric epilepsy. However, the efforts of clinicians to classify phenotypes in nondiagnosed patients and improve their ability to interpret genetic variants remain important in the NGS era.