• 대한한의학회지
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• 제42권3호
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• pp.1-8
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• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3639-3644
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• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• 대한치과의사협회지
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• 제53권10호
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• pp.732-742
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• 2015

The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.

• 한국의료질향상학회지
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• 제19권1호
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• pp.44-52
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• 2013

Objectives: Several studies on hospital malnutrition have reported that malnutrition among patients is highly prevalent and that more than 40% of hospitalized patients have nutritional risk factors. The purpose of this study was to assess the implementation of physicians' prescribed nutrition therapy before and after a protocol on nutrition therapy for malnourished inpatients was instituted. Methods: Data regarding the rates of physician implementation of nutritional therapy and the duration of therapy were collected and analyzed using SPSS version 20. Results: The percentages of physicians who prescribed nutrition therapy before and after the protocol was initiated were 47.5% and 74.6%, respectively, which statistically significant with 95% confidence. The rates of therapy lasting less than 24 hours before and after the protocol was in place were 100% and 86.4%, respectively, which was not statistically significant. This result suggests that the improvement activity was not effective. Conclusion : The percentage of physicians who prescribed nutritional therapy based on improved nutritional program was significantly increased. Nutrition therapy for malnourished inpatients can be advanced through this new model.

• 대한한의정보학회지
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• 제16권1호
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• pp.1-8
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• 2010

Objective: Various controlled vocabulary such as thesaurus and classification make us to reuse and share effectively by defining different concept and linking terms each other. The UMLS(Unified Medical Language System) is one of the most universal medical terminology systems. It is needed various methods to share and reuse information of traditional Korean medicine. We will research on method that adopt SUI of the UMLS(that is de facto standard in medical terminology system) in traditional Korean medical terminology. Method: We described major problems and applying process when we tried to add traditional Korean medicine in the part of meridian into the UMLS metathesaurus. Comparing western medical terms and traditional Korean medical terms for applying UMLS metathesaurus, there is not only many consistency, but also differences. Result: We confirmed what is the differences and consistency between western medical terms and traditional Korean medical terms. And then reviewed methods that apply the CUI, LUI, SUI in traditional Korean medical terms. Traditional Korean medical terms are not discriminated by singular or plural string. In addition, traditional Korean medical terms have vary string by initial law: the law of initial sound of a syllable. Character is described with Korean, traditional Chinese, modern Chinese, etc. According to meaning, language, initial law, SUI has a distinct value respectively. Conclusion: There are many differences to apply the UMLS between western medical terms and traditional Korean medical terms. For the better implementation to traditional Korean medicine into the UMLS, further research is needed in standardization and classification of traditional Korean medical terms, medical information system, etc. We hope this study helps the implementation UMLS, EHR, knowledge based system in Oriental medicine in the future.

• 의학교육논단
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• 제15권1호
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• pp.9-18
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• 2013

An outcome-based curriculum is perceived to be one alternative educational approach in medical education. Nonetheless, it is difficult for curriculum developers to convert from traditional curriculum to an outcome-based curriculum because research documenting its development process is rare. Therefore, this study aims to introduce the development process and method of outcome-based curriculum. For the purpose of this study, we used diverse data analyses, such as an existing literature search, development model analysis, and case analysis. We identified five phases from the analysis. First, the curriculum developers analyze the physician's job or a high performer in a medical situation. Second, curriculum developers extract outcomes and competencies through developing a curriculum, affinity diagraming, and critical incident interviews. Third, curriculum developers determine the proficiency levels of each outcome and competency evaluation methods. Fourth, curriculum developers conduct curriculum mapping with outcomes and competencies. Fifth, curriculum developers develop an educational system. Also, it is important to develop an assessment system for the curriculum implementation in the process of developing the outcome-based curriculum. An outcome-based curriculum influences all the people concerned with education in a medical school including the professors, students, and administrative staff members. Therefore, curriculum developers should consider not only performance assessment tools for the students but also assessment indicators for checking curriculum implementation and managing curriculum quality.

• 대한의사협회지
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• 제61권12호
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• pp.765-775
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• 2018

With growing interest in novel digital healthcare devices, such as artificial intelligence (AI) software for medical diagnosis and prediction, and their potential impacts on healthcare, discussions have taken place regarding the regulatory approval, coverage, and clinical implementation of these devices. Despite their potential, 'digital exceptionalism' (i.e., skipping the rigorous clinical validation of such digital tools) is creating significant concerns for patients and healthcare stakeholders. This white paper presents the positions of the Korean Society of Radiology, a leader in medical imaging and digital medicine, on the clinical validation, regulatory approval, coverage decisions, and clinical implementation of novel digital healthcare devices, especially AI software for medical diagnosis and prediction, and explains the scientific principles underlying those positions. Mere regulatory approval by the Food and Drug Administration of Korea, the United States, or other countries should be distinguished from coverage decisions and widespread clinical implementation, as regulatory approval only indicates that a digital tool is allowed for use in patients, not that the device is beneficial or recommended for patient care. Coverage or widespread clinical adoption of AI software tools should require a thorough clinical validation of safety, high accuracy proven by robust external validation, documented benefits for patient outcomes, and cost-effectiveness. The Korean Society of Radiology puts patients first when considering novel digital healthcare tools, and as an impartial professional organization that follows scientific principles and evidence, strives to provide correct information to the public, make reasonable policy suggestions, and build collaborative partnerships with industry and government for the good of our patients.

• 대한의용생체공학회:의공학회지
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• 제15권2호
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• pp.121-128
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• 1994

In this paper, MIlS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemnted system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression! decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network.

• 한국임상약학회지
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• 제28권1호
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• pp.51-56
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• 2018

Objective: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. Methods: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. Results: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p<0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (${\pm}0.8$). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. Conclusion: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.

• Journal of Chest Surgery
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• 제54권1호
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• pp.17-24
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• 2021

Background: Although extracorporeal membrane oxygenation (ECMO) is generally performed percutaneously, the technology is deployed under sedation and necessitates endotracheal intubation. However, in some patients, the use of venoarterial (VA) ECMO without intubation may be beneficial. Herein, we describe our experiences with VA ECMO performed without prior endotracheal intubation. Methods: A total of 783 patients treated with VA ECMO at a single center between January 2013 and July 2018 were reviewed retrospectively. We included patients who underwent successful VA ECMO implementation without prior endotracheal intubation, and excluded those who were younger than 18 years, had ongoing cardiopulmonary resuscitation status, and had poor quality of the vessels needed for percutaneous cannulation. The primary study outcome was in-hospital survival. Results: In total, 50 patients were included in this study, 94% of whom showed cardiogenic shock. The mean age of the study participants was 56.3±14.5 years. The median VA ECMO support time was 7 days (range, 2-13 days). Twenty-one patients (42%) did not receive ventilator care during the VA ECMO support period, while 29 patients (58%) progressed to intubation after VA ECMO implementation. The rates of survival at discharge and weaning success were 82% (n=41) and 92% (n=46), respectively, and 80% (n=40) of patients presented good Glasgow-Pittsburgh Cerebral Performance Categories scores at discharge. Conclusion: Even in patients with cardiogenic shock, percutaneous VA ECMO can be introduced safely without prior endotracheal intubation by an experienced care team. The application of nonintubated VA ECMO might be a feasible strategy in selected cases.