• 제목/요약/키워드: medical act

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OMOP CDM 구축 시 개인의료정보 보호를 위한 HIPAA PHI 적용 방법 연구 (Study on HIPAA PHI application method to protect personal medical information in OMOP CDM construction)

  • 김학기;정은영;박동균
    • 한국차세대컴퓨팅학회논문지
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    • 제13권6호
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    • pp.66-76
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    • 2017
  • 본 연구에서는 OMOP(Observational Medical Outcomes Partnership) CDM(Common Data Model) 구축시 개인의료정보를 보호하는 방법을 연구하였다. 제안된 방법은 HIPAA(The Health Insurance Portability and Accountability Act) PHI(Protected Health Information)에 대응되는 데이터가 CDM으로 추출 되는 것을 제한하거나 식별 불능 화 처리 하는 것이다. 하지만 한국의 개인정보보호법 및 의료법에는 민감 정보의 처리 제한에 관한 내용은 존재하나 그 민감 정보가 무엇인지에 관한 명확한 규정은 없어 개인의료정보 보호를 위한 민감 정보 선정에 어려움이 있다. 본 연구에서는 이러한 문제를 해결하기 위해 HIPAA PHI를 개인정보 보호법 제23조 민감 정보의 처리 제한 기준으로 정하고 CDM데이터와 매핑 하였다. 본 연구를 통해 CDM구축 시 발생되는 개인의료 정보 보호문제에 대한 해결 방법을 제시함으로써 국내 CDM구축 확산에 기여할 것으로 예상된다.

한방 의료행위의 개념과 그 한계 - 법령과 판례를 중심으로 - (The Concept of Practice of Korean Medicine and the Limitations - Focusing on Legislations and Precedents -)

  • 권순조;엄석기
    • 한국의사학회지
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    • 제28권1호
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    • pp.121-133
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    • 2015
  • Objectives : The purpose of this study is to suggest how to interpret the 'practice of Korean Medicine', differentiating it from 'medical practice'. Methods : I analyze the legislations and precedents regarding the practice of Korean Medicine. Results : The Korean Medicine and Pharmaceutics Promotion Act defines 'practice of Korean Medicine' and it clearly differentiates it from the definition of 'medical practice'. However, the scope of this definition is somewhat restricting and it can violate doctors of Korean Medicine's right to equality and their academic freedom. Thus, the application of this definition of the 'practice of Korean Medicine' should be limited to the field of research and development. Meanwhile, criteria of distinguishing 'practice of Korean Medicine' from 'medical practice', which used to make a sharp distinction between Medicine and Korean Medicine by rigorously applying their academic standards, are now focusing more on protecting and improving health of the people. Discussions & Conclusions : I suppose that the distinction between the 'practice of Korean Medicine' and 'medical practice' will be more focused on public health rather than the academic stance of those two medical fields. Meanwhile, in accordance with dualistic medical system, the mutual usage of medical equipment in the area of 'treatment' should be limited while it should be allowed in the area of 'diagnosis' if it satisfies requirements suggested by the Constitutional Court.

참여의 특권 배제에 관한 미국 독점금지법 법리와 그 시사점 (The U. S. Antitrust Law on the Exclusion of Medical Staff Privilege and its Implication)

  • 정재훈
    • 의료법학
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    • 제12권2호
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    • pp.295-316
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    • 2011
  • If the medical staff privileges, which mean the eligibility to practice at open hospitals, are excluded in the United States, antitrust claims based on the violation of the Sherman Act have been raised a lot. The proliferation of these lawsuits in the United States, which are characterized as antitrust lawsuits, can be understandable situation. The reason is because doctors who don't belong to specific hospitals are seriously damaged, if the medical staff privileges are excluded and doctors cannot use facilities of open hospitals. In order to decide to allow the privileges of certain doctors, hospitals have to rely on peer review to maintain high quality of medical services, and it is not easy to find alternative of peer review in the professional areas like healthcare. However, there are possibilities that members of the peer review can abuse power to unfairly exclude privileges of potential competitors. In this sense, it is asserted in the U.S. antitrust lawsuits that the restraint of medical staff privilege can be the illegal restraint of trade in violation of section 1 of Sherman Act and can be monopolization or an attempt to monopoly by hospitals in violation of section 2 of Sherman Act. As Korea adopted open hospital system quite recently, there is still no case related with the exclusion of medical staff privileges. However, medical staff privilege system of Korea is not different from that of the United States in principle. Thus, the U.S. jurisprudence on the exclusion of medical staff privileges can be referred in the interpretation of "practice that interferes with or restricts the activities or contents of the business" based on Article 19.1.9 of Monopoly Regulation and Fair Trade Law of Korea.

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의료법의 개인정보보호에 관한 연구 (A Study on the Protection of Personal Information in the Medical Service Act)

  • 성수연
    • 의료법학
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    • 제21권2호
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    • pp.75-103
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    • 2020
  • 의료기술의 발전과 환자 진료 향상 등을 목적으로 빅데이터나 인공지능에 의료정보를 분석·활용하면 유전적 질병이나 암 등 특이 질병 등에 대비할 수 있어 의료정보가 공유되어야 한다는 목소리가 높아지고 있다. 환자의 개인정보에 관한 활용과 보호는 동전의 양면과 같다. 의료기관 또는 의료인은 일반 정보처리자와 다른 환경적 특수성과 민감도가 높은 개인정보를 처리함에 있어 신중하여야 한다. 대체적으로 환자의 개인정보는 의료인이나 의료기관에서 수집·생성부터 파기까지 개인정보를 처리하고 있으나 의료법의 개인정보에 관한 용어 사용의 혼재되어 있거나 적용 범위가 명확하지 않아 판례의 해석에 의존하고 있다. 의료법 제23조의 전자의무기록에 저장·보관된 개인정보는 고유식별정보만을 의미하는 것이 아니라 진료기록부 등 의무기록의 개인정보와 동일하며, 그 내용은 인적 정보, 고유식별정보, 진료정보, 재산정보 등을 포함한다. 의료인이나 의료기관 개설자는 의료법 제24조의4 진료정보가 침해된 경우 제23조의 개인정보와 동일하게 취급하여야 하는지에 대해 전자의무기록에 환자의 민감정보가 기록·저장·보관되어 있으므로 특별히 개인정보 중 진료정보만을 의미한다고 볼 수 없다. 의료법 제19조의 정보 누설 금지는 업무상 알게 된 '비밀'에서 '정보'로 개정되었으나 명칭만 바뀌었을 뿐 보호법익은 형법상의 비밀과 동일하여 환자의 개인정보자기결정권을 보호하고 있지 못하다. 개인정보보호법과 지역보건법은 '업무상 알게 된 정보'에서의 보호법익을 개인정보자기결정권으로 보아 누출, 위조, 변조, 훼손 등 개인정보 침해 행위에 대하여 동일하게 벌칙을 규정하고 있다. 의료법의 개인정보 보호 규정은 용어의 정의가 불명확하여 정보주체 및 정보처리자, 국민에게 적용 범위 등 혼란을 일으킬 수 있어 용어가 통일적으로 정비되어야 할 필요가 있으며, 개인정보 보호에 관한 특별법인 의료법과 일반법인 개인정보보호법의 규정 내용이나 범위가 일치하지 않아 해석상 혼란이 생길 수 있어 개인정보 보호에 대하여 일정한 한계를 보인다. 환자의 개인정보는 민감정보로서 그 활용과 처리에 있어 안전하게 보호되어야 한다. 개인정보 보호 원칙에 따라 개인정보를 처리하여야 하며, 정보주체인 환자나 보호자의 권리인 사생활의 비밀과 자유, 인격권, 개인정보자기결정권을 보장하여야 할 것이다.

한국·중국·일본의 의료시설 법적기준과 그 변화 과정에 관한 연구 (A Study in the legal standards of healthcare facilities in Korea, China, and Japan)

  • 조준영;뢰청운;양내원
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제26권4호
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    • pp.39-47
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    • 2020
  • Purpose: Korea, China, and Japan can be seen as a geopolitical community that has developed through various relationships in terms of history. However, nowadays, it seems that they are pursuing different societal goals resulting from the difference in political and social systems, demographic structures, and economic situations. The law provides the minimum standards for people's lives in the direction that the society pursues. Therefore, the aim of this study is to examine the architectural differences in medical facilities and their causes comparing the legal standards of medical facilities in Korea, China, and Japan. Methods: The subject of the study is Korea, China, and Japan's legal standards of facilities corresponding to the Korean medical service act; enforcement decree of medical service act; and enforcement rules of medical service act. The scope of the study is as follows: First, the facilities standards and the reason for the revision of the standards after the 1950s when the current system of each country was established are investigated and thus the changing trends of the facilities standards that each country has pursued are analyzed. Second, the range and level presented by the current facilities standards of each country are compared and the differences are analyzed. Finally, cases in which the differences in the legal facilities standards are reflected in the actual design are compared and the effect of the facilities standards of medical facilities on the architectural plan is identified. Results & Implications: Each country differs in the legal standards of facilities because of changes in demographic structure and experience of disease. Moreover, it is identified that differences in social operating systems, especially in the operating methods of medical facilities, affect the range and level enforced by the facility standards. When investigating and researching foreign standards of facilities and cases for foreign medical facilities, it is required that they should be analyzed in consideration of the social and cultural aspects of each country.

생전유언, 의료지시서, 자연사법(natural death act) 입법의 사회적 함의 (Social Implication of Living Wills, Advance Directives and Natural Death Act in Korea)

  • 이인영
    • 의료법학
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    • 제9권1호
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    • pp.413-459
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    • 2008
  • The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

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보건의료정보의 법적 보호와 열람.교부 (A Study on Legal Protection, Inspection and Delivery of the Copies of Health & Medical Data)

  • 정용엽
    • 의료법학
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    • 제13권1호
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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.

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Effectiveness of Acceptance and Commitment Therapy on Life Expectancy of Female Cancer Patients at Tehran's Dehshpour Institute in 2015

  • Ghasemi, Farahnaz;Dehghan, Fateme;Farnia, Vahid;Tatari, Faeze;Alikhani, Mostafa
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.4113-4116
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    • 2016
  • Background: Acceptance and commitment therapy (ACT) increases the psychological flexibility of people afflicted with cancer, and consequently improves their adaptability. The present research was conducted with the aim of determining the effectiveness of ACT for people afflicted with cancer. Materials and Methods: The present research was of semi-pilot type with a pre-test and post-test plan for the proof group. The demographics of the community were composed of all the women with cancer who were under treatment in Tehran's Dehshpour therapeutic center in 2015. The sample was composed of 24 people who were selected as available and chosen randomly in two groups of test and proof. All the participants responded to Snyder questionnaire in two pre-test and post-test stages, and the test group participated in treatment sessions after conducting the pre-test. Results: After collecting the information, data analysis was conducted in two description and inferential levels. The test results of covariance analysis showed that the two groups' hope was meaningfully different. Hope in the test group, compared to the proof group, increased meaningfully. Conclusions: The results show that the ACT is effective in increasing hope of patients with cancer.

해양원격의료 지원제도 개선을 위한 관련 법령정비 방안 (De Lege Frenda for Improvement of Marine Telemedicine Service System)

  • 전영우;홍성화;김재호
    • 수산해양교육연구
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    • 제28권4호
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    • pp.994-1005
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    • 2016
  • Expansion and spreading of marine telemedicine is rather restricted due to the conflict of laws relating to medical service and lack of provisions in the Seafarers' Act, Medical Service Act, etc. Thus, this study is intended to reveal the current status and problems of marine emergency medical advice system for the furtherance of health care of seafarers and emergency medical assistance conditions and deduce relevant proposals for legislative improvements thereof in order to resolve underlying problems and issues. The results of this study can be summated as follows. First, in respect of directions to provide marine emergency service based on marine telemedicine system, emergency radio medical advice system needs to be strengthened to meet domestic and international instrument, marine telemedicine system needs to be provided through integrating u-Health technology and special marine medical center needs to be established. Second, regarding directions to provide health promotion service based on the marine telemedicine system, a new process of health care service for seafarers needs to be devised and provided involving seafarers' life cycle covering from prior to boarding to after leaving a ship. The conclusions of this study can be given as follows. First, the following new provisions need to be introduced in the Seafarers' Act. (1) The Minister of Oceans and Fisheries and a shipowner shall conduct matters pertaining to preventive health promotion and care for seafarers; (2) a provisions regarding establishment of seafarers' health promotion center by the Minister; (3) a special exemption permitting marine telemedicine service and qualification requirements for marine telemedicine assistant; (4) shipowner's obligation of carrying seafarers' health measuring equipment on board. Second, the relevant provisions regarding medical care persons needs to be revised in such a way that master or chief officer shall be appointed to be in charge of medical care on board. Last but not least, it is also essential to amend and update the minimum standards on drug and medicines to be carried on board and medicine chest and equipment on board.

'선한 사마리아인 법'에 따른 민사책임의 감경 - 응금의료에 관한 법률 제5조의2을 중심으로 - (Exemption from Civil Liability in the Good Samaritan Law)

  • 김천수
    • 의료법학
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    • 제15권2호
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    • pp.31-60
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    • 2014
  • In this paper the good Samaritan civil liability is argued. In many cases some damage could be caused by an emergency medical service. In such situations the degree of duty of care taken by the service provider would be alleviated depending upon the degree of emergency. Then the service provided by anyone not carrying any duty to do so could be generally ruled by the 'Korean Civil Act' Article 735. This article is related to the management of affairs in urgency. The application of this article means the mitigation of civil liability of the service provider. If the service provider not carrying any duty to provide it "has managed the affairs" of the service "in order to protect the" victim "against an imminent danger to the latter's life", the provider "shall not be liable for any damages caused thereby, unless he acted intentionally or with gross negligence". Korea has another rule applied in such a situation, that is the Korean 'Emergency Medical Service Act' Article 5-2. This article is established for the exemption from responsibility for well-intentioned emergency medical service. It could be referred to as the Good Samaritan law. It provides: "In cases where no intention or gross negligence is committed on the property damage and death or injury caused by giving any emergency medical service or first-aid treatment falling under any of the following subparagraphs to an emergency patient whose life is in jeopardy, the relevant actor shall not take the civil liability ${\cdots}$" In this paper the two articles is compared in the viewpoints of the requirements for and effects of the application of them respectively. The 'Korean Civil Act' Article 735 is relatively general rule against the the Korean 'Emergency Medical Service Act' Article 5-2 in the same circumstance. Therefore the former could be resorted to only if any situation could not satisfy the requisites for the application of the latter. In this paper it has suggested that the former article be more specific for the accuracy of making decision to apply it; and that the latter be revise in some requirements including the victim, the service provider, and the service.

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