• The Journal of the Korea Contents Association
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• v.20 no.12
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• pp.635-645
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• 2020

An "OpenNote" can be defined as the sharing of medical records between patient and doctors by online, and is a new trial to allow patients to access their medical records any time. To identify the need for the introduction of OpenNotes, which is expanding medical recrods, this study has researched the awareness and attitude towards medical records and OpenNotes among hospital workers in charge of part of medical servises. One of the results in this study is that recognizing his or her own records can impact his or her understanding his or her health status. Also, the subjects who were participated in this study generally agreed with the usefulness of the OpenNote and were willing to participate in the OpenNote. Meanwhile the subjects are admitting counterfeiting the medical records or falsifying them. The conclusion has been shown that patient-doctor sharing of medical records could help patients better understand their health information and encourage their self-care. When patients can access their own medical records easily, Unnecessary misunderstandings and distrust of records between patients and medical staff can be markedly reduced then it can help to build up the trust in a doctor-patient relationship. Considering not only the health utility of OpenNotes but also the impact on the trust of doctors, the pilot project of OpneNotes for experimental verification is proposed.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.359-395
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• 2012

In a broad term, health and medical data means all patient information that has been generated or circulated in government health and medical policies, such as medical research and public health, and all sorts of health and medical fields as well as patients' personal data, referred as medical data (filled out as medical record forms) by medical institutions. The kinds of health and medical data in medical records are prescribed by Articles on required medical data and the terms of recordkeeping in the Enforcement Decree of the Medical Service Act. As EMR, OCS, LIS, telemedicine and u-health emerges, sharing and protecting digital health and medical data is at issue in these days. At medical institutions, health and medical data, such as medical records, is classified as "sensitive information" and thus is protected strictly. However, due to the circulative property of information, health and medical data can be public as well as being private. The legal grounds of health and medical data as such are based on the right to informational self-determination, which is one of the fundamental rights derived from the Constitution. In there, patients' rights to refuse the collection of information, to control recordkeeping (to demand access, correction or deletion) and to control using and sharing of information are rooted. In any processing of health and medical data, such as generating, recording, storing, using or disposing, privacy can be violated in many ways, including the leakage, forgery, falsification or abuse of information. That is why laws, such as the Medical Service Act and the Personal Data Protection Law, and the Guideline for Protection of Personal Data at Medical Institutions (by the Ministry of Health and Welfare) provide for technical, physical, administrative and legal safeguards on those who handle personal data (health and medical information-processing personnel and medical institutions). The Personal Data Protection Law provides for the collection, use and sharing of personal data, and the regulation thereon, the disposal of information, the means of receiving consent, and the regulation of processing of personal data. On the contrary, health and medical data can be inspected or delivered of the copies, based on the principle of restriction on fundamental rights prescribed by the Constitution. For instance, Article 21(Access to Record) of the Medical Service Act, and the Personal Data Protection Law prescribe self-disclosure, the release of information by family members or by laws, the exchange of medical data due to patient transfer, the secondary use of medical data, such as medical research, and the release of information and the release of information required by the Personal Data Protection Law.

• Journal of Korean Library and Information Science Society
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• v.47 no.1
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• pp.149-173
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• 2016

As cloud computing becomes more and more popular and ubiquitous, many organizations are deciding to move their whole information infrastructure to the cloud. The healthcare industry is one of those that is beginning to utilize cloud-based solutions en masse. Cloud based computing and storage offers numerous benefits including scalability, cost efficiency, and accessibility, which in turn have the potential to streamline hospital operations. Despite the potential benefits of acquiring this system, considerations must still be given to the migration of the massive amounts of personal and highly protected data to a cloud-based solution. Health care organizations must consider all matters of security, reliability, and availability, to ensure that patients' data remains compliant to the Health Insurance Portability and Accountability Act (HIPAA) compliant. This paper will examine the benefits and challenges of such operation to determine the best practices for the utilization of Electronic Medical Record (EMR) cloud based networking and storage for small to mid-sized hospitals.

• International Journal of Contents
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• v.13 no.2
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• pp.35-43
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• 2017

This study sought to measure the influence of HIMs' work environment changes on job stress, and to explore measures for improving job satisfaction among them. A total of 275 hospital HIMs' were surveyed using a structured questionnaire. Significant job stress impact variables were sorted out using a simple linear regression analysis. Then, through multiple linear regression analysis, multicollinearity was tested. Significant impact factors were identified from among the control variables, and job stress impact was measured. The survey revealed that in public hospitals where the EMR system has been implemented for a longer period, depression scores in HIMs' were increased. HIMs' job stress level was found to be affected by the following factors: computerization of their working environment, experience of depression, unemployment, and manpower reduction, as well as, their lifestyles, including leisure activities. The results of this study suggest that HIMs' job stress can be reduced through work environment improvement and improvement of their personal lifestyle habits.

• Journal of information and communication convergence engineering
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• v.9 no.5
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• pp.577-582
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• 2011

EMR(Electronic Medical Record) is an emerging technology that is highly-blended between non-IT and IT area. One of methodology to link non-IT and IT area is to construct databases. Nowadays, it supports before and after-treatment for patients and should satisfy all stakeholders such as practitioners, nurses, researchers, administrators and financial department and so on. In accordance with the database maintenance, DAS (Data as Service) model is one solution for outsourcing. However, there are some scalability and strategy issues when we need to plan to use DAS model properly. We constructed three kinds of databases such as plain-text, MS built-in encryption which is in-house model and custom AES (Advanced Encryption Standard) - DAS model scaling from 5K to 2560K records. To perform custom AES-DAS better, we also devised Bucket Index using Bloom Filter. The simulation showed the response times arithmetically increased in the beginning but after a certain threshold, exponentially increased in the end. In conclusion, if the database model is close to in-house model, then vendor technology is a good way to perform and get query response times in a consistent manner. If the model is DAS model, it is easy to outsource the database, however, some technique like Bucket Index enhances its utilization. To get faster query response times, designing database such as consideration of the field type is also important. This study suggests cloud computing would be a next DAS model to satisfy the scalability and the security issues.

• The Journal of Korean Medicine
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• v.36 no.1
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• pp.45-60
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• 2015

Objectives: The purpose of this study was to understand the status of reporting and characteristics of adverse drug reactions (ADRs) induced by herbal drugs and to make a suggestion for the domestic pharmacovigilance system on herbal medicine. Methods: We carried out a hospital-based observational study at Dongguk University Ilsan Oriental Hospital from April 2012 to December 2014. We reviewed all the herbal-drug-associated ADRs reports registered to the spontaneous ADR reporting system in electronic medical records of the hospital in the period. Results: We found out 101 reports including 163 herbal-drug-associated ADRs from 97 patients. Females (69.3%) outnumbered males and the most frequent age group was the 50s (44, 27.0%). No serious adverse event was observed. The most commonly reported ADR was gastro-intestinal system disorders (68, 41.5%) followed by skin-related disorders (42, 25.8%). Diarrhea (29, 17.8%) was the most frequently referred clinical manifestation. Most ADRs were induced by internal medicines (160, 98.2%) including manufactured (36, 22.1%) and self-prepared decoction (160, 76.1%). The pairs of Igi-hwan-diarrhea, gamiboa-tang-vomiting, and Magnoliae Flos-gastro-intestinal-system-related ADRs were observed twice each and the others appeared only once. Conclusions: We propose Korean government to take an initiative in national pharmacovigilance system for herbal medicine. To perform the surveillance on herbal drugs, the Association of Korean Medicine (AKOM) should set up a nationwide network by designating centers connecting the Korean medical hospitals, local Korean medicine clinics, and the public health centers. The government and AKOM should also educate and encourage them to understand the pharmacovigilance system and report the ADRs actively.

• The Korean Journal of Emergency Medical Services
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• v.26 no.2
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• pp.7-18
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• 2022

Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

• Herbal Formula Science
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• v.23 no.1
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• pp.77-89
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• 2015

Objectives : This Study aims to extract the actual prescriptions used frequently in the clinical settings and the frequently used prescription list of textbook on herbal formulae by comparing the prescriptions recorded in the textbook on herbal formulae, and to examine the range of the efficacies of the corresponding prescription on the basis of the records of the Electronic Medical Record (EMR). Methods : By making comparison of the herb weight ratios of the prescriptions recorded in the textbook on herbal formulae with those recorded in EMR, the frequency is measured on the basis of the textbook on herbal formulae prescription and the frequency indication is computed for the clinical prescriptions with lower level of differences. Results & Conclusions : On the basis of the details of the clinical prescriptions used at the P Hospital, Yugmijihwang-tang, Samlyeongbaegchul-san, Jugyeobseoggo-tang, Maegmundong-tang, Olyeong-san and Baegho-tang, among the similar prescriptions for which the title prescriptions of the textbook on herbal formulae and the herbal composition coincide by more than 80%, are not included in the list of prescriptions covered under the national health insurance system even though they are frequently used prescriptions.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.57-72
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• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

• 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.