• 제목/요약/키워드: medical record management

검색결과 297건 처리시간 0.159초

농어촌 지역병원 의료이용률 제고방안 (A Methodology for The Improvement of Rural Hospital's Utilization)

  • 안인환;문영전
    • 한국병원경영학회지
    • /
    • 제12권4호
    • /
    • pp.119-142
    • /
    • 2007
  • Although Korea joined OECD in 1996, there has still seen much unbalance in medical care and welfare standard between urban and rural area. The unbalance of medical demand between urban and rural area deepened low utilization of rural hospitals. So it caused many hospital's failure and conversion in rural area. Many rural hospitals are in difficulty managing business because of low medical demand along with the shortage of medical manpower, medical equipment and facilities. The objectives of this study were to reveal the cause of low utilization of hospitals in rural area, and to increase utilization of those hospitals. In this study the improvement methods of rural hospital's utilization were presented by examining were placed in difficult management condition, in respect of hospital's management conditions, manpower input, patient medical treatment record, financial record, and actual output. The causes of rural hospital's low utilization were as follows; 1) changes in number and structure of population 2) rural people's preference for large hospitals and hospitals which located in urban area 3) rural hospitals lacking in hospital management skill. Consequently rural hospital's operation condition got more and more deteriorated. To raise rural hospital's utilization, method for social policy, method for health policy, and intrinsic method of hospitals were presented in turn. For rural residents to utilize medical service conveniently, it is necessary for rural hospitals operated normally. So government must insist that rural hospitals solve the problems which come out from their internal management problems. And also these rural hospitals should be supported and nurtured by the government until their management is operated normally.

  • PDF

EMR 인증제 교육을 위한 보건의료정보관리 실습 프로그램 모델 연구 -환자정보관리 중심- (A Study on the Health Information Management Practice Program Model for EMR Certification System Education -Focus on Patient Information Management-)

  • 최준영
    • 보건의료생명과학 논문지
    • /
    • 제9권1호
    • /
    • pp.1-9
    • /
    • 2021
  • 본 연구에서는 한국보건의료정보원에서 실시하는 EMR 인증기준울 이해할 수 있도록 보건의료정보관리 실습 프로그램에 인증기준을 추가한 모델을 연구하여 제시하였다. 실습 프로그램은 EMR 인증제의 기능성 기준에 해당하는 환자정보관리를 실습하고 이해할 수 있도록 보건의료정보관리 교육시스템에 환자정보관리에 대한 인증기준 기능을 추가하였다. 환자정보관리를 위한 EMR 인증기준 실습프로그램은 다음과 같은 인증기준으로 구성되었다. 등록번호 및 인적사항 관리, 진료예약 일정관리, 인적사항 수정이력관리, 동명이인 구분자 표시, 다중 등록번호 통합관리, 식별정보를 이용한 환자 검색, 진료형태에 따른 환자 검색, 수술시술 동의서 기록·조회, 개인정보활용동의서 기록·조회, 연명의료결정정보 표시, 외부 의료기관문서 등록·조회, 외부 검사결과 등록·조회. 이와 같이 인증기준에 의한 보건의료정보시스템의 기능을 운영하여 실습해봄으로써 인증기준의 기능성 영역에서 환자정보관리의 인증기준과 내역을 이해하고 실습할 수 있다. EMR 인증 기준에 맞춰 환자정보관리 실습을 수행해봄으로써 전자의무기록시스템에서의 표준화된 환자정보관리를 이해할 수 있다. 또한 EMR 인증기준의 기능을 확인할 수 있기 때문에 의료기관에서 보건의료정보관리사의 전자의무기록시스템의 관리 능력을 향상시킬 수 있을 것이다.

3개 대학병원의 주 진단 코딩사례 평가 (Evaluation of Current Coding Practices in 3 University Hospitals)

  • 서순원;김광환;부유경;서진숙;서정돈;;윤석준;이영성;이무식;정희웅
    • 한국의료질향상학회지
    • /
    • 제9권1호
    • /
    • pp.52-64
    • /
    • 2002
  • Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators (MRAs) of 3 university hospitals participated in coding principal Dx. from August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three (A. B, C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses; how they decide and code the principal diagnosis when they see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician's opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of MRAs selected the principal diagnosis recorded by physician, 42.1% of MRAs decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in codings among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

  • PDF

EMR시스템 구축 사례연구: 조선대학교 병원 (The Case Study of EMR System Implementation)

  • 최광석;구철모;이대용
    • 경영정보학연구
    • /
    • 제15권2호
    • /
    • pp.41-58
    • /
    • 2013
  • 최근 국 내외 의료계와 정부는 병원에서 발생하는 진료기록들을 디지털화하여 모든 의료 기관의 전자의료기록을 네트워크로 통합하여 공유하는 첨단 의료정보화에 많은 관심을 가지고 있다. 본 연구는 의료기관의 정보시스템 구축 사례연구로서 조선대학병원의 전자의무기록(EMR: Electronic Medical Record)시스템의 구축 과정을 소개하고 있다. 정보 시스템의 도입에서부터 활용단계까지 Cooper and Zmud(1990)가 제시한 정보시스템 구축 모델을 기반으로 조선대학병원의 EMR 구축 사례를 연구하여 병원정보시스템의 특성과 이슈들을 명확히 하고, 향후 EMR시스템을 도입하고자 하는 의료기관에 유익한 정보를 제공하고자 한다.

  • PDF

균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발 (Development of the Performance Measurement Model of Electronic Medical Record System - Focused on Balanced Score Card -)

  • 이경희;김영훈;부유경
    • 한국병원경영학회지
    • /
    • 제21권4호
    • /
    • pp.1-12
    • /
    • 2016
  • The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

개인키 위탁관리 서버를 이용한 전자의무기록 지문인증 모델 (An Fingerprint Authentication Model of ERM System using Private Key Escrow Management Server)

  • 이용준;전태열
    • 한국산학기술학회논문지
    • /
    • 제20권6호
    • /
    • pp.1-8
    • /
    • 2019
  • 의료정보는 환자에게 중요한 개인정보로써 반드시 보호되어야 하는 중요 정보이다. EMR((Electronic Medical Records) 시스템은 개인정보와 의료정보가 유출될 경우, 환자의 사생활 침해 등 매우 심각한 피해를 초래할 수 있어 EMR 시스템의 의료정보는 사용자 접근에 관한 제어 및 통제 강화 등 높은 보안성이 요구되는 시스템이다. 특히 의료인이 전자의무기록에 접근할 때, 보안이 강화된 신원확인에 대한 인증방식이 반드시 필요하다. 그러나 기존의 공인인증서 기반의 인증모델은 개인키 관리, 권한위임 등의 문제로 인해 전자의무기록의 보안 특성을 반영하지 못하였다. 본 연구에서는 기존의 전자의무기록(EMR) 시스템 접근 시 문제점을 해결할 수 있는 보안이 강화된 지문인식 기반 인증 모델을 제안한다. 제안한 인증 모델은 PEMS(Private-key Escrow Management Server)를 이용한 EMR 지문인증 모델로서, 개인키 위탁 프로토콜과 개인키 인출 프로토콜을 적용하여, 개인키 관리와 권한위임 문제를 해결할 수 있도록 하였다. 제안한 인증 모델은 성능 실험을 통해 기존의 공인인증서 기반 인증에 비해 수행시간 단축된 것을 확인할 수 있었고, 기존 전자서명 비밀번호 방식을 대체 가능하며, 사용자의 편의성이 증가된 장점이 있다.

만성 질병환자를 위한 CDSS를 적용한 PHR 시스템 (CDSS enabled PHR system for chronic disease patients)

  • 마크불 후세인;와자하트 알리 칸;무하마드 아프잘;탁디르 알리;이승룡
    • 한국정보처리학회:학술대회논문집
    • /
    • 한국정보처리학회 2012년도 추계학술발표대회
    • /
    • pp.1321-1322
    • /
    • 2012
  • With the advance of Information Technology (IT) and dynamic requirements, diverse application services have been provided for end users. With huge volume of these services and information, users are required to acquire customized services that provide personalized information and decision at particular extent of time. The case is more appealing in healthcare, where patients wish to have access to their medical record where they have control and provided with recommendation on the medical information. PHR (Personal Health Record) is most prevailing initiative that gives secure access on patient record at anytime and anywhere. PHR should also incorporate decision support to help patients in self-management of their diseases. Available PHR system incorporates basic recommendations based on patient routine data. We have proposed decision support service called "Smart CDSS" that provides recommendations on PHR data for diabetic patients. Smart CDSS follows HL7 vMR (Virtual Medical Record) to help in integration with diverse application including PHR. PHR shares patient data with Smart CDSS through standard interfaces that pass through Adaptability Engine (AE). AE transforms the PHR CCR/CCD (Continuity of Care Record/Document) into standard HL7 vMR format. Smart CDSS produces recommendation on PHR datasets based on diabetic knowledge base represented in shareable HL7 Arden Syntax format. The Smart CDSS service is deployed on public cloud over MS Azure environment and PHR is maintaining on private cloud. The system has been evaluated for recommendation for 100 diabetic patients from Saint's Mary Hospital. The recommendations were compared with physicians' guidelines which complement the self-management of the patient.

보건의료정보관리 전공 학생의 임상실습 수행능력과 실습 만족도 (Clinical Practice Ability and Satisfaction of Clinical Training of Health-Medical Information Management Major Students)

  • 송애랑
    • 보건의료산업학회지
    • /
    • 제12권4호
    • /
    • pp.203-217
    • /
    • 2018
  • Objectives : This study aimed to investigate the clinical practice ability and satisfaction of clinical training of health-medical information management major students. Methods : The data were collected from 68 persons from students finished clinical training at medical record (information) team using self administered questionnaires. The data were analyzed using t-test, ANOVA and correlation with SPSS 22.0 version. Results: Performance of data collection, data management, and data analysis were analyzed in three areas of the job area. In terms of academic characteristics and correlation, they were not related to the level of satisfaction with the practical experience. Conclusions : Research on a virtuous cycle clinical practice program that analyzes the factors by assessing the satisfaction level of clinical practice in each area of health care information management will be conducted continuously.

전자의무기록 기반의 심폐소생술금지 동의서의 전자서식 개발 (Development of an Electronic Document for DNR Informed Consent based on the Electronic Medical Record System)

  • 박지경
    • 보건의료산업학회지
    • /
    • 제10권3호
    • /
    • pp.99-111
    • /
    • 2016
  • Objectives : This study developed an iPad-based animation for an electronic informed consent to directly help patients prepare an informed consent. The goal was to raise patients' understanding about the contents contained in a DNR informed consent in the current medical situation in which DNR informed consents are mostly written by a guardian. Methods : The development of a DNR electronic informed consent was done in 3 stages: analysis, design and development. The analysis stage was done with a survey on the real status of preparing a DNR informed consent in a medical institution. The design stage was done with the contents in the DNR electronic informed consent through a primary and secondary Delphi survey. The development stage created a DNR electronic informed consent and evaluated it through a tertiary Delphi survey. Results : After evaluating the appropriateness of the composition of the contents, the understanding of the contents, the convenience of use, the reflection of an expert opinion, and the suitability of the application, all had scores higher than 4 points. Conclusions : The results of this study show that our proposed DNR electronic informed consent can help patients better understanding the contents of a DNR informed consent.

효율적인 한의 처방조제지원시스템 개발 (Development of Efficient Order Communication and Pharmacy Supporting System for Traditional Korean Medicine)

  • 김철;김상균;장현철;김안나;김익태;송미영
    • 한국한의학연구원논문집
    • /
    • 제16권3호
    • /
    • pp.127-133
    • /
    • 2010
  • The purpose of this study is to develop the order communication system for Traditional Korean Medicine(TKM) which can support prescribing decisions and provide the toxicological information. The relative vulnerability of the infrastructure of TKM has made us start the study. We carried out the benchmarking for TKM charting solution firstly, and then designed the intelligent search and supporting method for prescription decisions. We developed of the medical herbs database and the web-based order communication program which can be used in medical field actually. This system supplies a various functions to oriental medical doctors such as management for prescription history, search for herb's effects, generating prescriptions, inventory management, alerting of toxicity and taboo, guideline for taking medicine, and so on. The design and implementation process has been described in this research. We expect that this system will play an important role in electronic medical record(EMR) or electronic health record(EHR) binding diagnosis and management functions.