• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.64-80
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• 2005

The objectives of this study were to identify factors associated with unexpected revisit to an emergency medical center (EMC) located in Seoul and to examine reasons for revisit. During March, June, September and December, 2002, a total of 168 patients had unexpected revisits to the EMC within 48 hours of a previous discharge. As a 1:1 matched control, we included 136 patients who: discharged from the EMC during the same time period: did not return to the EMC; had the same diagnosis and age(${\pm}5$) with the case. In this study, factors associated with unexpected revisits were defined as characteristics of a previous discharge, which were classified into three: sociodemographic, EMC visit-related, and discharge management factors. Reasons for revisit were categorized into disease, physician, patients, and system-related factors. Data were collected by medical chart review with assistance from clinicians of the EMC. Logistic regression results showed that patients who headed home after discharge without follow-up schedule had a 27.6 times higher risk of revisiting EMC than those who were hospitalized following EMC visit. Patients discharged on his own will had a 5.9 times higher risk of revisiting than those discharged following physician's advice. Patients requiring continual observation at the time of discharge were more likely to revisit by 8.7 times than those discharged with improved condition. About 69.13% of the revisits were due to disease-related factors, followed by 13.90% due to patient-related factors, 8.64% due to system-related factors, and 8.34% due to physician-related factors. It appears that the most significant factors influencing revisits are discharge management factors such as patient's condition at discharge, whether the discharge was accorded with physician's advice, and whether returning home without follow-up schedule. Therefore, appropriate discharge management is necessary to prevent EMC revisit.

• Journal of Internet of Things and Convergence
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• v.10 no.1
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• pp.47-52
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• 2024

The efficiency and quality of healthcare services rely heavily on the secure protection and transparent management of individuals' medical information, which is becoming increasingly important in the digital age. To address this issue, we propose a distributed identity management (DID) and electronic medical record (EMR) integration system based on Hyperledger Indy, which aims to ensure the ownership of medical information to individuals and increase the accessibility and utilization of medical information. The system will allow individuals to manage their own medical information and share it transparently when necessary, which will improve the efficiency of healthcare services. In addition, the system will securely protect and transparently manage medical information, increasing the transparency of medical services and strengthening individuals' control over their medical information. Thus, the system will contribute significantly to improving the quality of medical services, protecting individuals' medical information, and improving the efficiency of medical services.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.6
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• pp.458-465
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• 2016

The information relating to the health of person has been increasing. The information is such as medical information and personal health record and the information collected by utilization and dissemination of mobile devices. Therefore, the interest and demand for systems that can integrate and manage the Personal Health Record(PHR) is increasing. Quantity and quality of information that is collected from the patient can have a major impact on the diagnosis and treatment of Korean Medicine(KM) in clinical practice. Because closely observe the usual clinical symptoms of patients to utilize the treatment. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. Therefore, the personal health care services that can record and manage and own is necessary based on KM. In this paper, we propose Korean Medicine Personal Health Record Platform(KM PHR Platform). We have selected the significant symptoms that mean to the personal records from symptom information required for diagnosis in KM. And classifying and scoring as the symptoms were used as personal health care indicators. And significant symptoms were easily configure a screen that can be recorded. simple operation is recorded as a symptom. It was designed to reflect these functions. So KM PHR Platform helps to Personal health care. Doctor may be able to help in the diagnosis and prognosis observation by reference to shared symptom. We look forward to a variety of health services based on KM using a symptom, a medical record, personal health device information.

• Korean Journal of Adult Nursing
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• v.16 no.4
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• pp.597-607
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• 2004

Purposes: Quality of life is an important health outcome for hemodialysis patients. The purposes of this study were to identify the level of quality of life and to identify the predictors of quality of life among hemodialysis patients. Method: A descriptive correlational study was conducted. Data were collected from 103 hemodialysis patients at the hospitals in a community using structured questionnaire and medical record. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression. Results: Quality of life among hemodialysis patients was relatively lower than that of previous studies. In the final analysis, quality of life was predicted by presence of comorbidity, emotional health, gender, physical health, and knowledge of disease. These variables accounted for 45% of variance of the quality of life. The presence of comorbidity was the most significant predictor of quality of life among hemodialysis patients. Conclusion: Interventions to increase quality of life among hemodialysis patients such as health promotion program and educational program for dietary compliance are needed. These must be developed and applied.

• Journal of the Korea Society of Computer and Information
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• v.20 no.12
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• pp.53-59
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• 2015

In this paper, we developed a Hospital Information System in which the business process is formalized and a wire/wireless integrated solution is used. This system consists of the administration office program, the medical office program, the ward management program and the rounds management program. The administration office program can enroll and accept patients, issue and reissue the RFID card. The medical office program inputs a medical examination and treatment, outputs a diagnosis, requests a hospitalization, retrieves the record of a medical examination and treatment, assigns the corresponding examination room to the accepted patients, and updates the number of an waiting patient and a patient number according to the examination room on real time. The ward management program handles hospitalizations and leaving hospital, a nurse's note, and an isolation ward monitoring. The rounds management program handles a medical examination and treatment, and a leaving hospital using PDA. This developed system can be built at low cost and increase the quality of the medical services highly by making it automated the medical administration automation. Also the small number of the medical staffs can manage the inpatients efficiently by using the monitoring functions.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.52-61
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• 2015

Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.

• Korea Journal of Hospital Management
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• v.19 no.3
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• pp.43-52
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• 2014

We empirically show that the effect of mobile EMR's technological characters on system qualities and user satisfaction. For the study, the relationship among technological characters of mobile, EMR's system quality, EMR's information quality, and user satisfaction were modelled and validated with hypotheses. An empirical test was performed for a path model using structural equation modeling on samples of 148 nurses in hospitals from various size and region. This study find that, for the overall sample, there are positive relationships among the technological characters of mobile, EMR's system quality, EMR's information quality, and user satisfaction. And the results support that mobile is an effective method for EMR. Findings of this study have several theoretical and practical implications as follows : First, this study empirically tested the relationship among technological characters of mobile, EMR's system quality, EMR's information quality. Second, the study shows that the technological characters of mobile should be considered for advance of EMR system's quality in mobile environment. And lastly, this study can practically suggest mobile healthcare information system for process effectiveness.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.57-72
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• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.15-25
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• 2016

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

• Quality Improvement in Health Care
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• v.15 no.1
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• pp.123-133
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• 2009

Background : The principal diagnosis has been used in many different fields such as hospital statistics, medical research, insurance claim, national health statistics and so on. Some principal diagnoses have a relatively low level of reliability in the medium-sized hospitals. The purpose of this study is to identify the reliability level of principal diagnoses and to suggest ways to improve reliability of the principal diagnosis. Method : Data were collected from a medium-sized hospital located in Pusan. The discharge summaries on 323 patients who were discharged in January, 2008 and the outpatient summaries on 251 patients who visited the hospital on March 28, 2008 were collected, and descriptive analysis was performed using SPSS version 12.0K. Result : The findings are the followings: (1) the diagnostic consistency rate between medical records and doctors' was 92.0%; (2) the diagnostic consistency rate between medical records and insurance claims was 86.1%; (3) the diagnostic consistency rate between doctors' diagnoses and insurance claims was 80.2%. The evidence seems to indicate that some principal diagnoses have reliability problems in the medium-sized hospitals. Conclusion : The results of this study suggest the followings: (1) employees should be trained and supervision of hospital activities are needed; (2) network systems should be constructed for each department; (3) professions need to be fostered (4) doctors' awareness of medical records should be changed.