• Title/Summary/Keyword: quality of medical record

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A Study on the Evaluation of Electronic Medical Record Systems using the AHP (AHP를 이용한 전자의무기록시스템 선정 평가에 관한 연구)

  • Park, Cheol-Soo;Lee, Jung Seung
    • Journal of Information Technology Applications and Management
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    • v.20 no.4
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    • pp.235-247
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    • 2013
  • The evolution of information technology and proliferation of hospital management and managerial applications of computing has led to change in the characteristics, uses and evaluations of software for the hospital management. With the growing proliferation of microcomputer use and the value-added for management strategies, more and more software has been massively developed, produced and distributed for the hospital industry. The user is faced with an increasingly difficult choice in the evaluation and selection of software. For many reasons, users frequently must rely on expert evaluations of the technical functions and quality of software. The objectives of this study are to provide selection criteria for an Electronic Medical Record (EMR) and to develop an evaluation framework for the Hospital Information Systems. The major findings of our study are as follows (1) the identification of EMR evaluation characteristics (2) the design and development of EMR selection model and (3) the evaluation of the importance for EMR characteristics using Analytic Hierarchy Process (AHP). We identify 6 characteristics and 22 sub-characteristics of the EMR, calculate their weights, and decide the best configuration. Especially, the AHP methodology can be applied to gather knowledge from multiple experts. Because AHP can 1) facilitate the participation of multiple experts 2) increase group productivity and therefore result in both quantitatively and qualitatively superior outcomes than that of a single individual's work 3) provide a mechanism for reconciling conflict from multiple expert 4) validate the acquired knowledge, providing consistency of facts, and 5) enhance the accuracy reliability of the acquired knowledge increase through of the reliability provided by consensus across multiple experts. Although some further research is required, the proposed model can be regarded as a basis for the selection of EMR.

Efficacy of new inspection system of Anticancer Drug Prescription (새로운 항암제 처방 감사 시스템 도입을 통한 의료의 질 향상)

  • Kim, M.S.;Kim, Y.K.;Lee, Y.J.;Choi, Y.J.;Shin, H.Y.;Song, Y.C.
    • Quality Improvement in Health Care
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    • v.14 no.2
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    • pp.125-132
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    • 2008
  • Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

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Sleep Patterns and Factors Related to Sleep Disturbance in Mechanically Ventilated Patients (인공호흡기 적용 환자의 수면양상과 수면장애 요인)

  • Lee, Jeong Mi;Kim, Na Hyun
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.421-432
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    • 2011
  • Purpose: The purpose of this study was to investigate the sleep patterns and the factors related to sleep disturbance in mechanically ventilated patients in intensive care units (ICUs). Sleep patterns in this study included both quality and quantity of sleep. Methods: Forty-four subjects were recruited in ICUs at a tertiary university hospital in D city. Data were collected using questionnaires, observation, and medical record from June, 2008 to May, 2009. Results: The total mean of sleep quality was $1.99{\pm}1.68$. The mean of total sleep time per 24-hour period was $3.75{\pm}1.94$hour (range 1-7.25) in mechanically ventilated ICU patients. The main sleep disturbance factors were listed as frequent nursing activities, attachment of medical appliances, and noise. All these factors were also significantly related to the sleep quality. Conclusion: These results indicated that mechanically ventilated patients were both qualitatively and quantitatively deprived of sleep far more than other ICU patients. In summary, a deeper understanding of sleep characteristics in mechanically ventilated ICU patients could help nurses to improve sleep derangements and patient outcome.

Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement (Westgard Multi-Rules의 효율적 적용과 조치사항의 개선)

  • Jung, Heung Soo;Oh, Youn Jung;Bae, Jin Soo;Baek, Jin Young;Hwang, Bo ra;Shin, Yong Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.60-64
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    • 2017
  • Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

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Barriers on Development of Clinical Practice Guidelines for Cardiopulmonary Resuscitation (임상진료지침 개발과정의 장애요인 - 심폐소생술을 중심으로 -)

  • Park, Seong-Hi
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.46-58
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    • 2000
  • Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

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Clinical Information Protection Behavior in a Medical Institution : Based on Health Psychology Theories (의료기관 종사자의 진료정보 보호행위분석: 건강심리이론관점을 중심으로)

  • Son, Mi-Jung;Yoon, Tai-Young;Lee, Sang-Chul
    • Journal of Korean Society for Quality Management
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    • v.42 no.2
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    • pp.153-163
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    • 2014
  • Purpose: This research aims to find out clinical information protection behavior within a medical institution in mandatory circumstance based on health psychology theories Methods: This research has developed the survey based on the variables from ealth psychology theories; and conducted the survey during the whole month in April 2013. In the end, 256 samples have been used for this research's analysis. Results: First of all, Empirical results has proved that perceived benefits, self-efficacy, and cues to action have an positive influence on clinical information protection behavior. Perceived barriers has an negative influence. Finally, it has proven from the research that perceived severity and perceived susceptibility do not have an impact on clinical inf ormation protection behavior Conclusion: These findings provide an enriched understanding about medical institution workers information protection behavior on patient's clinical information.

Can Health Information Technology Really Improve Patient Safety? (의료정보기술은 환자안전을 향상시키는가?)

  • Lee, JaeHo
    • Quality Improvement in Health Care
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    • v.19 no.1
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    • pp.16-26
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    • 2013
  • Health information technology (HIT) is one of the most familiar tools to healthcare providers. It is used in routine practice to reduce cost, to improve clinical performance, and to improve patient safety. Patient safety is the driving force of recent expansion of HIT industry. But there are many evidences that it can be harmful to patient safety. Role of HIT and HIT-related error became big issues because more and more healthcare providers and healthcare organizations are willing to adopt it. Adoption rate of HIT in Korea is higher than that of United States. But researches of HIT regarding patient safety are rare. In this article, types of HIT, their mechanisms of improving patient safety and HIT-related errors were reviewed. Status of HIT in terms of patient safety in Korea was also reviewed. Knowledge of how HIT can improve patient safety, its' limitation, and how to make it safer is crucial to whom have to use it to improve patient safety. Impact of HIT on patient safety must be evaluated actively in Korea. HIT which was proven to improve patient safety must be widely adopted. Government must prepare a strategic plan to improve HIT quality, support hospitals financially and institutionally to introduce qualified HIT, and develop HIT infrastructures and standard designed for patient safety.

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The effects of Technological and Business Expertise of IT Service Provider on Relationship Quality: The case of EMR system (IT 서비스 제공자의 기술/업무 전문성이 관계품질에 미치는 영향: 전자의무기록 시스템의 사례)

  • Park, Jun-Gi;Lee, Sangwoo;Shin, Hyunkyung;Lee, Jungwoo
    • Korea Journal of Hospital Management
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    • v.20 no.1
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    • pp.39-52
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    • 2015
  • This study provides empirical evidence for the role of IT professional's expertise in hospital IT service encounters. It is posited here that IT professional's technological expertise and business expertise are associated with relationship quality(trust, satisfaction, commitment). Partial least square analyses are conducted, using data collected from 216 hospital workers. The results confirm that technological expertise strongly impacts on commitment and business expertise maintain a strong impact on satisfaction and trust. This study uses a cross-sectional survey as a research method. Longitudinal study seems necessary to further explore how expertise perception is actually formed between IT professionals and users in hospital service environments. The analysis also reveals that it takes time to grow relationship quality. Implications are discussed, and further studies are suggested.

State and subject of health and sports medical devices industry at oversea

  • Seo, Jung-Hwa;Kim, Se-Jin
    • Journal of Sport and Applied Science
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    • v.1 no.1
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    • pp.1-5
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    • 2017
  • Most of people do not remind of 'Who is domestic medical device business?' A lot of people that Johnson and Johnson, GE and Philips and other foreign companies belong to medical device company. In fact, local enterprises small place based on world market. Local medical device industry's production has grown up rapidly last 10 years. Sales increased nearly 3 times from trillion and 500 billion KRW in 2004 to 4 trillion and 600 billion KRW in 2014. The production record constantly increased owing to safety and good quality of domestic medical devices. As many as 59% of medical devices made in Korea is exported to 198 countries in the world. Currently, medical device industry in the world has been given considerable attention. Cognition and awareness are very much low. Medical device industry, high income creating industry, is said to next generation industry to increase scale, and Korea does not follow world flow. The industry is given support from the government that is not enough. Korean enterprises have small scale among a lot of global enterprises. Being interested in development of medical devices, the author selected department of IT at college.

A Adaptive Rendering Image Processing for Based on the Mobile (모바일을 기반으로 하는 적응적인 렌더링 영상 처리)

  • Ju, Heon-Sig;Kim, Ha-Jin
    • The KIPS Transactions:PartA
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    • v.10A no.5
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    • pp.425-432
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    • 2003
  • This paper presents an EMR(Electronic Medical Record) chart for efficient PDA through the quad tree image rendering based on the mobile. Using the intermediate image space algorithm instead of the final one for volume rendering, we have solved the probems of th eholes coming from the point-to-point to mapping. The quad-tree based on the delta-tree efficiently represents volume expressions and results in higher compression effects. With the volume rendering, we can decrease the rendering time and get a higher quality and efficiency for PDA through image based rendering.