• 한국임상약학회지
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• 제28권2호
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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.

• 인터넷정보학회논문지
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• 제22권1호
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• pp.99-107
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• 2021

최근 유비쿼터스 기반의 의료 및 헬스케어 환경이 구축됨에 따라 다양한 센서들로부터 상황정보를 얻을 수 있는 의료정보시스템이 증가되고 있다. 이러한 상황인식 기반의 의료정보시스템 환경에서는 상황정보를 이용하여 환자상황을 정상 또는 응급으로 판별이 가능하며, 또한 의료진은 스마트기기의 애플리케이션을 통해 ID와 Password를 이용한 간단한 사용자인증이후 환자정보에 쉽게 접근이 가능하다. 그러나 이러한 인증서비스 및 환자정보접근서비스는 의료진 중심의 시스템이며, 유비쿼터스 기반의 의료정보시스템 환경을 충분히 고려하지 못한다. 이에 본 논문에서는 의료정보에 접근하는 사용자에 대해 기존 의료진 중심의 인증과는 달리 상황정보 중심의 인증서비스를 제공하기 위한 상황인식 기반의 인증서비스 모델을 제시하고 구현하였다. 본 논문에서 제안한 상황인식 기반의 인증서비스 모델은 센서들을 통해 환자상황을 인식하여 환자상황에 의하여 의료진의 인증방식 및 권한부여를 다르게 진행하는 서비스이다. 다양한 상황정보 측정환경을 구성하기 위해 웨어러블 및 생체데이터측정모듈, 카메라센서 등을 이용하여 구현하였다. 환자상황이 응급상황일 경우, 의료정보서버는 담당의료진의 스마트기기에 응급메시지를 전송하고, 응급메시지를 받은 담당의료진은 환자정보에 접근하기 위해 스마트기기의 애플리케이션을 이용하여 인증을 시도한다. 모든 인증이 완료되면 의료진은 상위등급 의료정보 접근권한을 부여받아 정상상황에서 볼 수 없었던 환자 의료정보까지 확인이 가능하도록 하였다. 제안한 상황인식 기반의 인증서비스 모델을 통하여 유비쿼터스 의료정보시스템 환경을 충분히 고려할 뿐만 아니라, 환자중심의 시스템적인 보안 및 접근투명성을 강화하였다.

• 한국산학기술학회논문지
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• 제10권6호
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• pp.1256-1264
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• 2009

유비쿼터스 환경에서의 헬스케어 서비스는 환자의 의무기록 뿐 아니라 각종 검사 자료 등 환자에 대한 대부분의 정보를 데이터화 하게 되므로 인가되지 않은 시용자가 의료 시스템에 접근하여 의료 데이터를 원래의 목적과 다른 목적으로 사용하게 된다면 환자의 생명과 관련된 중요한 정보에 큰 위협을 가져올 수 있다. 따라서 이러한 문제를 해결하기 위해서 사용자의 위치나 시간과 같은 상황정보에 따른 접근제어가 가능하고 사용자의 프라이버시 보호를 가능하게 하는 RBAC for U-healthcare 모델을 설계하고 이를 구현함으로써 유비쿼터스 환경에서의 헬스케어를 위한 접근제어 모델의 유효성을 검증한다.

• 한국임상약학회지
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• 제31권1호
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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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• 제44권4호
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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.

• 여성건강간호학회지
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• 제30권1호
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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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• 제6권1호
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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.

• 인터넷정보학회논문지
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• 제18권6호
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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.

• 디지털융복합연구
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• 제14권7호
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• pp.185-191
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• 2016

최근 의료 서비스는 IT 기술의 발달과 함께 다양한 서비스를 제공하고 있다. 그러나, 의료 정보가 유 무선을 통해 송 수신될 때 제3자가 악용할 수 있는 문제점이 존재한다. 본 논문에서는 환자의 동의없이 제3자가 환자의 의료정보를 불법적으로 이용할 수 없도록 그룹 인덱스 정보를 이용한 환자 의료 정보 관리 기법을 제안한다. 제안 기법은 의료진이 계층적으로 환자의료 정보에 접근할 수 있도록 접근 레벨을 그룹으로 관리할 수 있도록 각 계층에 인덱스 정보를 생성하여 접근 정보와 함께 사용한다. 제안 기법은 의료진이 환자 질병 분석 및 처방에 소요되는 시간을 최소화하여 환자의 의료 만족도를 높이는데 목적이 있다. 또한, 제안 기법은 환자의료정보의 접근 권한에 따른 의료진의 업무부담을 최소화하여 업무 효율성을 향상시키는데 또 다른 목적이 있다.

• 디지털융복합연구
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• 제12권7호
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• pp.279-284
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• 2014

최근 m-헬스케어는 응급상황이 발생할 경우, 환자의 정보가 제 3자에게 쉽게 노출되어 악용될 수 있는 문제가 있다. 본 논문에서는 m-헬스케어의 응급상황 환경에서 환자의 정보를 이용하여 환자의 프라이버시 노출을 최소화하기 위한 속성 기반의 환자 접근 제어 프로토콜을 제안한다. 제안 프로토콜은 환자의 민감한 정보를 제 3자에게 노출시키지 않도록 환자의 민감한 정보를 개인 건강 정보에 포함하여 병원관계자와 환자가 생성한 랜덤수로 해쉬한 서명키로 암호화한다. 또한 제 3자로부터 환자 정보가 불법적으로 악용되는 것을 예방하기 위해서 환자와 병원관계자 사이의 동기화를 유지함으로써 개인 건강 정보의 유출을 예방한다.