• Korean Journal of Clinical Pharmacy
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• v.28 no.2
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• Journal of Internet Computing and Services
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• v.22 no.1
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• pp.99-107
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• 2021

With the recent establishment of a ubiquitous-based medical and healthcare environment, the medical information system for obtaining situation information from various sensors is increasing. In the medical information system environment based on context-awareness, the patient situation can be determined as normal or emergency using situational information. In addition, medical staff can easily access patient information after simple user authentication using ID and Password through applications on smart devices. However, these services of authentication and patient information access are staff-oriented systems and do not fully consider the ubiquitous-based healthcare information system environment. In this paper, we present a authentication service model based context-awareness system for providing situational information-driven authentication services to users who access medical information, and implemented proposed system. The authentication service model based context-awareness system is a service that recognizes patient situations through sensors and the authentication and authorization of medical staff proceed differently according to patient situations. It was implemented using wearables, biometric data measurement modules, camera sensors, etc. to configure various situational information measurement environments. If the patient situation was emergency situation, the medical information server sent an emergency message to the smart device of the medical staff, and the medical staff that received the emergency message tried to authenticate using the application of the smart device to access the patient information. Once all authentication was completed, medical staff will be given access to high-level medical information and can even checked patient medical information that could not be seen under normal situation. The authentication service model based context-awareness system not only fully considered the ubiquitous medical information system environment, but also enhanced patient-centered systematic security and access transparency.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.6
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• pp.1256-1264
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• 2009

When unapproved users access to healthcare system and use medical information for other malicious purposes, it could severely threaten important information related to patients' life, because in ubiquitous environment healthcare service makes patient's various examination results, medical records or most information of a patient into data. Therefore, to solve these problems, we design RBAC(Role Based Access Control) for U-healthcare that can access control with location, time and context-awareness information like status information of user and protect patient's privacy. With implementation of the proposed model, we verify effectiveness of the access control model for healthcare in ubiquitous environment.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.1-11
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• 2021

Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion: The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.4
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• pp.171-174
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• 2017

While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

• Women's Health Nursing
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• v.30 no.1
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• pp.26-40
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• 2024

Purpose: This study investigated the scope of patient navigation studies on women's health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs. Methods: A scoping review was conducted following Arksey and O'Malley's framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023. Results: This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women's access to care. Conclusion: Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women's needs could improve the quality of maternity care.

• Journal of Korean Biological Nursing Science
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• v.6 no.1
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• pp.33-42
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• 2004

Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

• Journal of Internet Computing and Services
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• v.18 no.6
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• pp.75-84
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• 2017

As there has been growing interests in PHR-based personalized health management project, various institutions recently explore safe methods of recording personal medical and health information. In particular, innovative medical solution can be realized when medical researchers and medical service institutes can generally get access to patient data. As EMR data is extremely sensitive, there has been no progress in clinical information exchange. Moreover, patients cannot get access to their own health data and exchange it with researchers or service institutions. It can be operated in terms of technology, yet policy environment are affected by state laws as well as Privacy and Security Policy. Blockchain technology-independent, in transaction, and under test-is introduced in the medical industry in order to settle these problems. In other words, medical organizations can grant preliminary approval on patient information exchange by using the safely encrypted and distributed Blockchain ledger and can be managed independently and completely by individuals. More apparently, medical researchers can gain access to information, thereby contributing to the scientific advance in rare diseases or minor groups in the world. In this paper, we focused on how to manage personal medical information and its protective use and proposes medical treatment exchange system for patients based on a permissioned Blockchain network for the safe PHR operation. Trusted Model for Sharing Medical Data (TMSMD), that is proposed model, is based on exchanging information as patients rely on hospitals as well as among hospitals. And introduce medical treatment exchange system for patients based on a permissioned Blockchain network. This system is a model that encrypts and records patients' medical information by using this permissioned Blockchain and further enhances the security due to its restricted counterfeit. This provides service to share medical information uploaded on the permissioned Blockchain to approved users through role-based access control. In addition, this paper presents methods with smart contracts if medical institutions request patient information complying with domestic laws by using the distributed Blockchain ledger and eventually granting preliminary approval for sharing information. This service will provide an independent information transaction and the Blockchain technology under test will be adopted in the medical industry.

• Journal of Digital Convergence
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• v.14 no.7
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• pp.185-191
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• 2016

Recently, various medical services are provided with the advance of IT. However, there is a problem that a third party would exploit medical information when the information is sent and received through wired or wireless connection. In this paper, a patient information management scheme using group index information for the third party not to illegally exploit a patient's medical information without his consent is proposed. This proposed scheme creates index information in each hierarchical level to be used with access information so that not only medical staff can have access to patient's medical information hierarchically but also it can manage access level in groups. The scheme aims to enable the medical staff to minimize the time spent to analyze the type of disease and to prescribe for it so that they can improve patients' satisfaction. Plus, the scheme aims to improve work efficiency by minimizing the medical staff's workload according to the authority to access patients' medical information.

• Journal of Digital Convergence
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• v.12 no.7
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• pp.279-284
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• 2014

Recently, m-health care is be a problem that the patient's information is easily exposed to third parties in case of emergency situation. This paper propose an attribute-based access control protocol to minimize the exposure to patient privacy using patient information in the emergency environment. Proposed protocol, the patient's sensitive information to a third party do not expose sensitive information to the patient's personal health information, including hospital staff and patients on a random number to generate cryptographic keys to sign hash. In addition, patient information from a third party that is in order to prevent the illegal exploitation of the patient and the hospital staff to maintain synchronization between to prevent the leakage of personal health information.