Purpose: This study aims to determine obstetric and gynecologic (OBGY) nurses' perception and performance propecting patients' privacy, and to contribute to develop educational program and improve the quality of nursing care. Methods: 206 OBGY nurses in 6 hospitals using an electronic medical record or an order communicating system were chosen by convenience sampling and agreed to participate in the study. The questionnaire, explored 4 domains of privacy: direct nursing, linked business, patient information management, communication with relatives. Results: Perception and performance of protecting patient privacy averaged 4.29 (of 5) and 3.55 (of 5), respectively. Most nurses (94.2%) recognized the importance of protecting patient privacy, 80.1% received patient privacy education. There was a distinct difference between the perception and performance of protecting patient privacy of nurses. Performance of protecting patient privacy had a positive correlation with perception. Conclusion: Proper performance of protecting privacy protection requires improving perception of each nurse on the patient privacy, and various efforts should be made to minimize the affect from external factors such as hospital environment. It is needed to educate nurses for patient privacy. It is also needed for medical organizations to improve their policies and facilities to ease the performance for privacy protection.
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.
Electronic Health Record (EHR) systems are widely adopted worldwide in hospitals for generating and exchanging records of patient information. Recent developments are moving towards implementing interoperable EHR systems that enable information to be shared seamlessly across healthcare organizations. In this context, this paper explores the factors that cause medical information privacy concerns, identifies how people react to privacy invasion and what their perceptions are towards the acceptance of the EHR system. Interviews were conducted to draw a grounded theory on medical information privacy concerns in the use of EHRs. Medical information privacy concerns are caused by perceived sensitivity of medical information and the weaknesses in security technologies. Trust in medical professionals, medical institutions and technologies plays an important role in determining people's reaction to privacy invasion and their perceptions on the use of EHRs.
Background: As a descriptive study targeting 2,068 cancer patients as men of national merit in 2013, this study aims to provide the basic data for systematizing the early diagnosis and treatment of cancer by comparatively analyzing the 5-year survival rate. Methods: This study researched the survival of cancer patients through Electronic Medical Record and Patriots-Veterans Qualification Program, targeting 2,068 newly-diagnosed cancer patients verified in five veterans hospitals and consigned management system. This study verified differences between general characteristics of cancer patients as men of national merit and analyzed their survival rate. Results: The cancer patients as men of national merit were super-aged as their average age was 72.5. In the analysis of general characteristics of five major prevalent cancers, there were statistically significant differences according to age, region, cancer diagnostic path, differentiation, diagnostic method, treatment method, SEER stage, and survival period, except for the types of the man of national merit (p<0.001). The whole survival rate of cancer patients as men of national merit was 50%. The 5-year survival rates of predisposing cancers were shown as prostate cancer (79%), colorectal cancer (64%), gastric cancer (57%), liver cancer (32%), and lung cancer (12%). In the cancer diagnostic path, all the predisposing cancers showed the highest survival rate in medical examination. In the treatment method, the surgery showed the highest survival rate. The cancer patients as men of national merit showed a lower survival rate than the general cancer patients of Korea. Conclusion: It would be needed to guarantee the honorable and happy life through health recovery as special treatment of contribution and sacrifice of super-aged men of national merit by increasing the cancer survival rates through regular checkup, early diagnosis, and high-quality treatment system that could have important effects on the survival rate according to the occurrence of cancers.
Objectives: The aim of this study is to develop a methodology for estimating a nationwide statistic for hernia operations with using the claim database of the Korea Health Insurance Cooperation (KHIC). Methods: According to the insurance claim procedures, the claim database was divided into the electronic data interchange database (EDI_DB) and the sheet database (Paper_DB). Although the EDI_DB has operation and management codes showing the facts and kinds of operations, the Paper_DB doesn't. Using the hernia matched management code in the EDI_DB, the cases of hernia surgery were extracted. For drawing the potential cases from the Paper_DB, which doesn't have the code, the predictive model was developed using the data mining technique called SEMMA. The claim sheets of the cases that showed a predictive probability of an operation over the threshold, as was decided by the ROC curve, were identified in order to get the positive predictive value as an index of usefulness for the predictive model. Results: Of the claim databases in 2004, 14,386 cases had hernia related management codes with using the EDI system. For fitting the models with applying the data mining technique, logistic regression was chosen rather than the neural network method or the decision tree method. From the Paper_DB, 1,019 cases were extracted as potential cases. Direct review of the sheets of the extracted cases showed that the positive predictive value was 95.3%. Conclusions: The results suggested that applying the data mining technique to the claim database in the KHIC for estimating the nationwide surgical statistics would be useful from the aspect of execution and cost-effectiveness.
The fusion research subjects of Oriental medicine and Information-Technology are actively advanced. These researches provide Oriental medicine the objectivity and support the infra to all study area of Oriental medicine. This paper considers the inside and outside of the country technical development trend of ontology research by analyzing papers and going through case study. It executed information analysis about changes to number of research papers, present state and star higher officer of research facility from the dissertation which it sees. It is known that our country research result is slight so far in quantity and quality as result of analysis. But hereafter it contains many developmental possibilities. Also it reflects the appearance and a growth of new field like bio-informatics biology. In the area of medicine, ontology used to define the terminology for information documentation and the medical terms linked up by high correlation. Also medical information system developed briskly using ontology technology. The ontology of traditional korean medicine play an important role in base infra of traditional korean medicine EHR(Electronic health record).
Kim, M.S.;Kim, Y.K.;Lee, Y.J.;Choi, Y.J.;Shin, H.Y.;Song, Y.C.
Quality Improvement in Health Care
/
v.14
no.2
/
pp.125-132
/
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.
Recently, demographic studies of veterinary medical database have been conducted to understand patterns of disease occurrence. Understanding incidence of breed-related disease would provide appropriate guidance for future health care strategies and offer useful information for early diagnosis of disease. However, in veterinary medicine, theses research has not yet been investigated in the Republic of Korea. The purpose of this study was to investigate the prevalence of common medical disorders among dog breeds examined at primary-care veterinary clinics in Jeollabuk-Do, Republic of Korea. The data were analyzed based on World Health Organization's International Classification of Disease. A total 13,176 medical records of canine patients were analyzed from six primary veterinary clinics in Jeollabuk-Do from January to December 2016. Results showed that the most common health problems were 'disease of skin' (17.7%); followed by 'diseases of digestive system' (12.26%), 'preventive medicine' (10.08%), and 'diseases of ear and mastoid process' (10.4%). In seven out of ten breeds, the most common medical disorder was skin disease. For poodle such as Pomeranian and Chihuahua, digestive system disease was most prevalent. On the other hand, respiratory system disease was found to be higher in Pomeranian than other breeds; while ear and mastoid process disease was most common for Maltese and Poodle. This study can help owners, breeders, and veterinarians prevent and manage various diseases of popular breeds in Jeollabuk-Do in the future.
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.
Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.
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