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Medical Information Dynamic Access System in Smart Mobile Environments (스마트 모바일 환경에서 의료정보 동적접근 시스템)

  • Jeong, Chang Won;Kim, Woo Hong;Yoon, Kwon Ha;Joo, Su Chong
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.47-55
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    • 2015
  • Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.

Research Trend Analysis Using Bibliographic Information and Citations of Cloud Computing Articles: Application of Social Network Analysis (클라우드 컴퓨팅 관련 논문의 서지정보 및 인용정보를 활용한 연구 동향 분석: 사회 네트워크 분석의 활용)

  • Kim, Dongsung;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.20 no.1
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    • pp.195-211
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    • 2014
  • Cloud computing services provide IT resources as services on demand. This is considered a key concept, which will lead a shift from an ownership-based paradigm to a new pay-for-use paradigm, which can reduce the fixed cost for IT resources, and improve flexibility and scalability. As IT services, cloud services have evolved from early similar computing concepts such as network computing, utility computing, server-based computing, and grid computing. So research into cloud computing is highly related to and combined with various relevant computing research areas. To seek promising research issues and topics in cloud computing, it is necessary to understand the research trends in cloud computing more comprehensively. In this study, we collect bibliographic information and citation information for cloud computing related research papers published in major international journals from 1994 to 2012, and analyzes macroscopic trends and network changes to citation relationships among papers and the co-occurrence relationships of key words by utilizing social network analysis measures. Through the analysis, we can identify the relationships and connections among research topics in cloud computing related areas, and highlight new potential research topics. In addition, we visualize dynamic changes of research topics relating to cloud computing using a proposed cloud computing "research trend map." A research trend map visualizes positions of research topics in two-dimensional space. Frequencies of key words (X-axis) and the rates of increase in the degree centrality of key words (Y-axis) are used as the two dimensions of the research trend map. Based on the values of the two dimensions, the two dimensional space of a research map is divided into four areas: maturation, growth, promising, and decline. An area with high keyword frequency, but low rates of increase of degree centrality is defined as a mature technology area; the area where both keyword frequency and the increase rate of degree centrality are high is defined as a growth technology area; the area where the keyword frequency is low, but the rate of increase in the degree centrality is high is defined as a promising technology area; and the area where both keyword frequency and the rate of degree centrality are low is defined as a declining technology area. Based on this method, cloud computing research trend maps make it possible to easily grasp the main research trends in cloud computing, and to explain the evolution of research topics. According to the results of an analysis of citation relationships, research papers on security, distributed processing, and optical networking for cloud computing are on the top based on the page-rank measure. From the analysis of key words in research papers, cloud computing and grid computing showed high centrality in 2009, and key words dealing with main elemental technologies such as data outsourcing, error detection methods, and infrastructure construction showed high centrality in 2010~2011. In 2012, security, virtualization, and resource management showed high centrality. Moreover, it was found that the interest in the technical issues of cloud computing increases gradually. From annual cloud computing research trend maps, it was verified that security is located in the promising area, virtualization has moved from the promising area to the growth area, and grid computing and distributed system has moved to the declining area. The study results indicate that distributed systems and grid computing received a lot of attention as similar computing paradigms in the early stage of cloud computing research. The early stage of cloud computing was a period focused on understanding and investigating cloud computing as an emergent technology, linking to relevant established computing concepts. After the early stage, security and virtualization technologies became main issues in cloud computing, which is reflected in the movement of security and virtualization technologies from the promising area to the growth area in the cloud computing research trend maps. Moreover, this study revealed that current research in cloud computing has rapidly transferred from a focus on technical issues to for a focus on application issues, such as SLAs (Service Level Agreements).

Deep Learning-based Professional Image Interpretation Using Expertise Transplant (전문성 이식을 통한 딥러닝 기반 전문 이미지 해석 방법론)

  • Kim, Taejin;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.26 no.2
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    • pp.79-104
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    • 2020
  • Recently, as deep learning has attracted attention, the use of deep learning is being considered as a method for solving problems in various fields. In particular, deep learning is known to have excellent performance when applied to applying unstructured data such as text, sound and images, and many studies have proven its effectiveness. Owing to the remarkable development of text and image deep learning technology, interests in image captioning technology and its application is rapidly increasing. Image captioning is a technique that automatically generates relevant captions for a given image by handling both image comprehension and text generation simultaneously. In spite of the high entry barrier of image captioning that analysts should be able to process both image and text data, image captioning has established itself as one of the key fields in the A.I. research owing to its various applicability. In addition, many researches have been conducted to improve the performance of image captioning in various aspects. Recent researches attempt to create advanced captions that can not only describe an image accurately, but also convey the information contained in the image more sophisticatedly. Despite many recent efforts to improve the performance of image captioning, it is difficult to find any researches to interpret images from the perspective of domain experts in each field not from the perspective of the general public. Even for the same image, the part of interests may differ according to the professional field of the person who has encountered the image. Moreover, the way of interpreting and expressing the image also differs according to the level of expertise. The public tends to recognize the image from a holistic and general perspective, that is, from the perspective of identifying the image's constituent objects and their relationships. On the contrary, the domain experts tend to recognize the image by focusing on some specific elements necessary to interpret the given image based on their expertise. It implies that meaningful parts of an image are mutually different depending on viewers' perspective even for the same image. So, image captioning needs to implement this phenomenon. Therefore, in this study, we propose a method to generate captions specialized in each domain for the image by utilizing the expertise of experts in the corresponding domain. Specifically, after performing pre-training on a large amount of general data, the expertise in the field is transplanted through transfer-learning with a small amount of expertise data. However, simple adaption of transfer learning using expertise data may invoke another type of problems. Simultaneous learning with captions of various characteristics may invoke so-called 'inter-observation interference' problem, which make it difficult to perform pure learning of each characteristic point of view. For learning with vast amount of data, most of this interference is self-purified and has little impact on learning results. On the contrary, in the case of fine-tuning where learning is performed on a small amount of data, the impact of such interference on learning can be relatively large. To solve this problem, therefore, we propose a novel 'Character-Independent Transfer-learning' that performs transfer learning independently for each character. In order to confirm the feasibility of the proposed methodology, we performed experiments utilizing the results of pre-training on MSCOCO dataset which is comprised of 120,000 images and about 600,000 general captions. Additionally, according to the advice of an art therapist, about 300 pairs of 'image / expertise captions' were created, and the data was used for the experiments of expertise transplantation. As a result of the experiment, it was confirmed that the caption generated according to the proposed methodology generates captions from the perspective of implanted expertise whereas the caption generated through learning on general data contains a number of contents irrelevant to expertise interpretation. In this paper, we propose a novel approach of specialized image interpretation. To achieve this goal, we present a method to use transfer learning and generate captions specialized in the specific domain. In the future, by applying the proposed methodology to expertise transplant in various fields, we expected that many researches will be actively conducted to solve the problem of lack of expertise data and to improve performance of image captioning.

A Review of Personal Radiation Dose per Radiological Technologists Working at General Hospitals (전국 종합병원 방사선사의 개인피폭선량에 대한 고찰)

  • Jung, Hong-Ryang;Lim, Cheong-Hwan;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.137-144
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    • 2005
  • To find the personal radiation dose of radiological technologists, a survey was conducted to 623 radiological technologists who had been working at 44 general hospitals in Korea's 16 cities and provinces from 1998 to 2002. A total of 2,624 cases about personal radiological dose that were collected were analyzed by region, year and hospital, the results of which look as follows : 1. The average radiation dose per capita by region and year for the 5 years was 1.61 mSv. By region, Daegu showed the highest amount 4.74 mSv, followed by Gangwon 4.65 mSv and Gyeonggi 2.15 mSv. The lowest amount was recorded in Chungbuk 0.91 mSv, Jeju 0.94 mSv and Busan 0.97 mSv in order. By year, 2000 appeared to be the year showing the highest amount of radiation dose 1.80 mSv, followed by 2002 1.77 mSv, 1999 1.55 mSv, 2001 1.50 mSv and 1998 1.36 mSv. 2. In 1998, Gangwon featured the highest amount of radiological dose per capita 3.28 mSv, followed by Gwangju 2.51 mSv and Daejeon 2.25 mSv, while Jeju 0.86mSv and Chungbuk 0.85 mSv belonged to the area where the radiation dose remained less than 1.0 mSv In 1999, Gangwon also topped the list with 5.67 mSv, followed by Daegu with 4.35 mSv and Gyeonggi with 2.48 mSv. In the same year, the radiation dose was kept below 1.0 mSv. in Ulsan 0.98 mSv, Gyeongbuk 0.95 mSv and Jeju 0.91 mSv. 3. In 2000, Gangwon was again at the top of the list with 5.73 mSv. Ulsan turned out to have less than 1.0 mSv of radiation dose in the years 1998 and 1999 consecutively, whereas the amount increased relatively high to 5.20 mSv. Chungbuk remained below the level of 1.0 mSv with 0.79 mSv. 4. In 2001, Daegu recorded the highest amount of radiation dose among those ever analyzed for 5 years with 9.05 mSv, followed by Gangwon with 4.01 mSv. The area with less than 1.0 mSv included Gyeongbuk 0.99 mSv and Jeonbuk 0.92 mSv. In 2002, Gangwon also led the list with 4.65 mSv while Incheon 0.88 mSv, Jeonbuk 0.96 mSv and Jeju 0.68 mSv belonged to the regions with less than 1.0 mSv of radiation dose. 5. By hospital, KMH in Daegu showed the record high amount of average radiation dose during the period of 5 years 6.82 mSv, followed by GAH 5.88 mSv in Gangwon and CAH 3.66 mSv in Seoul. YSH in Jeonnam 0.36 mSv comes first in the order of the hospitals with least amount of radiation dose, followed by GNH in Gyeongnam 0.39 mSv and DKH in Chungnam 0.51 mSv. There is a limit to the present study in that a focus is laid on the radiological technologists who are working at the 3rd referral hospitals which are regarded to be stable in terms of working conditions while radiological technologists who are working at small-sized hospitals are excluded from the survey. Besides, there are also cases in which hospitals with less than 5 years since establishment are included in the survey and the radiological technologists who have worked for less than 5 years at a hospital are also put to survey. We can't exclude the possibility, either, of assumption that the difference of personal average radiological dose by region, hospital and year might be ascribed to the different working conditions and facilities by medical institutions. It seems therefore desirable to develop standardized instruments to measure working environment objectively and to invent device to compare and analyze them by region and hospital more accurately in the future.

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A Study on the Use of GIS-based Time Series Spatial Data for Streamflow Depletion Assessment (하천 건천화 평가를 위한 GIS 기반의 시계열 공간자료 활용에 관한 연구)

  • YOO, Jae-Hyun;KIM, Kye-Hyun;PARK, Yong-Gil;LEE, Gi-Hun;KIM, Seong-Joon;JUNG, Chung-Gil
    • Journal of the Korean Association of Geographic Information Studies
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    • v.21 no.4
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    • pp.50-63
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    • 2018
  • The rapid urbanization had led to a distortion of natural hydrological cycle system. The change in hydrological cycle structure is causing streamflow depletion, changing the existing use tendency of water resources. To manage such phenomena, a streamflow depletion impact assessment technology to forecast depletion is required. For performing such technology, it is indispensable to build GIS-based spatial data as fundamental data, but there is a shortage of related research. Therefore, this study was conducted to use the use of GIS-based time series spatial data for streamflow depletion assessment. For this study, GIS data over decades of changes on a national scale were constructed, targeting 6 streamflow depletion impact factors (weather, soil depth, forest density, road network, groundwater usage and landuse) and the data were used as the basic data for the operation of continuous hydrologic model. Focusing on these impact factors, the causes for streamflow depletion were analyzed depending on time series. Then, using distributed continuous hydrologic model based DrySAT, annual runoff of each streamflow depletion impact factor was measured and depletion assessment was conducted. As a result, the default value of annual runoff was measured at 977.9mm under the given weather condition without considering other factors. When considering the decrease in soil depth, the increase in forest density, road development, and groundwater usage, along with the change in land use and development, and annual runoff were measured at 1,003.5mm, 942.1mm, 961.9mm, 915.5mm, and 1003.7mm, respectively. The results showed that the major causes of the streaflow depletion were lowered soil depth to decrease the infiltration volume and surface runoff thereby decreasing streamflow; the increased forest density to decrease surface runoff; the increased road network to decrease the sub-surface flow; the increased groundwater use from undiscriminated development to decrease the baseflow; increased impervious areas to increase surface runoff. Also, each standard watershed depending on the grade of depletion was indicated, based on the definition of streamflow depletion and the range of grade. Considering the weather, the decrease in soil depth, the increase in forest density, road development, and groundwater usage, and the change in land use and development, the grade of depletion were 2.1, 2.2, 2.5, 2.3, 2.8, 2.2, respectively. Among the five streamflow depletion impact factors except rainfall condition, the change in groundwater usage showed the biggest influence on depletion, followed by the change in forest density, road construction, land use, and soil depth. In conclusion, it is anticipated that a national streamflow depletion assessment system to be develop in the future would provide customized depletion management and prevention plans based on the system assessment results regarding future data changes of the six streamflow depletion impact factors and the prospect of depletion progress.

Development of Information Extraction System from Multi Source Unstructured Documents for Knowledge Base Expansion (지식베이스 확장을 위한 멀티소스 비정형 문서에서의 정보 추출 시스템의 개발)

  • Choi, Hyunseung;Kim, Mintae;Kim, Wooju;Shin, Dongwook;Lee, Yong Hun
    • Journal of Intelligence and Information Systems
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    • v.24 no.4
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    • pp.111-136
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    • 2018
  • In this paper, we propose a methodology to extract answer information about queries from various types of unstructured documents collected from multi-sources existing on web in order to expand knowledge base. The proposed methodology is divided into the following steps. 1) Collect relevant documents from Wikipedia, Naver encyclopedia, and Naver news sources for "subject-predicate" separated queries and classify the proper documents. 2) Determine whether the sentence is suitable for extracting information and derive the confidence. 3) Based on the predicate feature, extract the information in the proper sentence and derive the overall confidence of the information extraction result. In order to evaluate the performance of the information extraction system, we selected 400 queries from the artificial intelligence speaker of SK-Telecom. Compared with the baseline model, it is confirmed that it shows higher performance index than the existing model. The contribution of this study is that we develop a sequence tagging model based on bi-directional LSTM-CRF using the predicate feature of the query, with this we developed a robust model that can maintain high recall performance even in various types of unstructured documents collected from multiple sources. The problem of information extraction for knowledge base extension should take into account heterogeneous characteristics of source-specific document types. The proposed methodology proved to extract information effectively from various types of unstructured documents compared to the baseline model. There is a limitation in previous research that the performance is poor when extracting information about the document type that is different from the training data. In addition, this study can prevent unnecessary information extraction attempts from the documents that do not include the answer information through the process for predicting the suitability of information extraction of documents and sentences before the information extraction step. It is meaningful that we provided a method that precision performance can be maintained even in actual web environment. The information extraction problem for the knowledge base expansion has the characteristic that it can not guarantee whether the document includes the correct answer because it is aimed at the unstructured document existing in the real web. When the question answering is performed on a real web, previous machine reading comprehension studies has a limitation that it shows a low level of precision because it frequently attempts to extract an answer even in a document in which there is no correct answer. The policy that predicts the suitability of document and sentence information extraction is meaningful in that it contributes to maintaining the performance of information extraction even in real web environment. The limitations of this study and future research directions are as follows. First, it is a problem related to data preprocessing. In this study, the unit of knowledge extraction is classified through the morphological analysis based on the open source Konlpy python package, and the information extraction result can be improperly performed because morphological analysis is not performed properly. To enhance the performance of information extraction results, it is necessary to develop an advanced morpheme analyzer. Second, it is a problem of entity ambiguity. The information extraction system of this study can not distinguish the same name that has different intention. If several people with the same name appear in the news, the system may not extract information about the intended query. In future research, it is necessary to take measures to identify the person with the same name. Third, it is a problem of evaluation query data. In this study, we selected 400 of user queries collected from SK Telecom 's interactive artificial intelligent speaker to evaluate the performance of the information extraction system. n this study, we developed evaluation data set using 800 documents (400 questions * 7 articles per question (1 Wikipedia, 3 Naver encyclopedia, 3 Naver news) by judging whether a correct answer is included or not. To ensure the external validity of the study, it is desirable to use more queries to determine the performance of the system. This is a costly activity that must be done manually. Future research needs to evaluate the system for more queries. It is also necessary to develop a Korean benchmark data set of information extraction system for queries from multi-source web documents to build an environment that can evaluate the results more objectively.

Analysis of HBeAg and HBV DNA Detection in Hepatitis B Patients Treated with Antiviral Therapy (항 바이러스 치료중인 B형 간염환자에서 HBeAg 및 HBV DNA 검출에 관한 분석)

  • Cheon, Jun Hong;Chae, Hong Ju;Park, Mi Sun;Lim, Soo Yeon;Yoo, Seon Hee;Lee, Sun Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.35-39
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    • 2019
  • Purpose Hepatitis B virus (hepatitis B virus, HBV) infection is a worldwide major public health problem and it is known as a major cause of chronic hepatitis, liver cirrhosis and liver cancer. And serologic tests of hepatitis B virus is essential for diagnosing and treating these diseases. In addition, with the development of molecular diagnostics, the detection of HBV DNA in serum diagnoses HBV infection and is recognized as an important indicator for the antiviral agent treatment response assessment. We performed HBeAg assay using Immunoradiometric assay (IRMA) and Chemiluminescent Microparticle Immunoassay (CMIA) in hepatitis B patients treated with antiviral agents. The detection rate of HBV DNA in serum was measured and compared by RT-PCR (Real Time - Polymerase Chain Reaction) method Materials and Methods HBeAg serum examination and HBV DNA quantification test were conducted on 270 hepatitis B patients undergoing anti-virus treatment after diagnosis of hepatitis B virus infection. Two serologic tests (IRMA, CMIA) with different detection principles were applied for the HBeAg serum test. Serum HBV DNA was quantitatively measured by real-time polymerase chain reaction (RT-PCR) using the Abbott m2000 System. Results The detection rate of HBeAg was 24.1% (65/270) for IRMA and 82.2% (222/270) for CMIA. Detection rate of serum HBV DNA by real-time RT-PCR is 29.3% (79/270). The measured amount of serum HBV DNA concentration is $4.8{\times}10^7{\pm}1.9{\times}10^8IU/mL$($mean{\pm}SD$). The minimum value is 16IU/mL, the maximum value is $1.0{\times}10^9IU/mL$, and the reference value for quantitative detection limit is 15IU/mL. The detection rates and concentrations of HBV DNA by group according to the results of HBeAg serological (IRMA, CMIA)tests were as follows. 1) Group I (IRMA negative, CMIA positive, N = 169), HBV DNA detection rate of 17.7% (30/169), $6.8{\times}10^5{\pm}1.9{\times}10^6IU/mL$ 2) Group II (IRMA positive, CMIA positive, N = 53), HBV DNA detection rate 62.3% (33/53), $1.1{\times}10^8{\pm}2.8{\times}10^8IU/mL$ 3) Group III (IRMA negative, CMIA negative, N = 36), HBV DNA detection rate 36.1% (13/36), $3.0{\times}10^5{\pm}1.1{\times}10^6IU/mL$ 4) Group IV(IRMA positive, CMIA negative, N = 12), HBV DNA detection rate 25% (3/12), $1.3{\times}10^3{\pm}1.1{\times}10^3IU/mL$ Conclusion HBeAg detection rate according to the serological test showed a large difference. This difference is considered for a number of reasons such as characteristics of the Ab used for assay kit and epitope, HBV of genotype. Detection rate and the concentration of the group-specific HBV DNA classified serologic results confirmed the high detection rate and the concentration in Group II (IRMA-positive, CMIA positive, N = 53).

Lodging-Tolerant, High Yield, Mechanized-Harvest Adaptable and Small Seed Soybean Cultivar 'Aram' for Soy-sprout (내도복 다수성 기계수확 적응 소립 나물용 콩 '아람')

  • Kang, Beom Kyu;Kim, Hyun Tae;Ko, Jong Min;Yun, Hong Tai;Lee, Young Hoon;Seo, Jeong Hyun;Jung, Chan Sik;Shin, Sang Ouk;Oh, Eun Yeong;Kim, Hong Sik;Oh, In Seok;Baek, In Youl;Oh, Jae Hyun;Seo, Min Jeong;Yang, Woo Sam;Kim, Dong Kwan;Gwak, Do Yeon
    • Korean Journal of Breeding Science
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    • v.51 no.3
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    • pp.214-221
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    • 2019
  • 'Aram' is a soybean cultivar developed for soy-sprout. It was developed from the crossing of 'Bosug' (Glycine max IT213209) and 'Camp' (G. max IT267356) cultivars in 2007. F1 plants and F2 population were developed in 2009 and 2010. A promising line was selected in the F5 generation in 2011 using the pedigree method and it was evaluated for agronomic traits, yield, and soy-sprouts characteristics in a preliminary yield trial (PYT) in 2012 and an advanced yield trial (AYT) in 2013. Agronomic traits and yield were stable between 2014 and 2016 in the regional yield trial (RYT) in four regions (Suwon, Naju, Dalseong, and Jeju). Morphological characteristics of 'Aram' are as follows: determinate plant type, purple flowers, grey pubescence, yellow pods, and small, yellow, and spherical seeds (9.9 g 100-seeds-1) with a light brown hilum. The flowering date was the 5th of August and the maturity date was the 15th of October. Plant height, first pod height, number of nods, number of branches, and number of pods were 65 cm, 13 cm, 16, 4.5, and 99, respectively. In the sprout test, germination rate and sprout characteristics of 'Aram' were comparable to that of the 'Pungsannamulkong' cultivar. The yield of 'Aram' was 3.59 ton ha-1 and it was 12% higher than that of 'Pungsannamulkong' in southern area of Korea. The yield of 'Aram' in the Jeju region, which is the main region for soybean sprout production, was 20% higher than that of 'Pungsannamulkong'. The height of the first pod and the tolerance to lodging and pod shattering, which are connected to the adaptation to mechanized harvesting, were higher in 'Aram' compared to those in 'Pungsannamulkong'. Therefore, the 'Aram' cultivar is expected to be broadly cultivated because of its higher soybean sprout quality, and seed yield and better adaptation to mechanized harvesting. (Registration number: 7718)

Effect of the Community-Based Chronic Disease Management Service Using Information and Communication Technology (정보통신기술을 이용한 지역사회 기반 만성질환관리 서비스 효과 평가)

  • Eun Jin Park;Yun Su Lee;Tae Yon Kim;Seung Hee Yoo;Hye Ran Jin;Noor Afif Mahmudah;MinSu Ock;Tae-Yoon Hwang;Yeong Mi KIm;Jung Jeung Lee
    • Journal of agricultural medicine and community health
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    • v.49 no.3
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    • pp.257-270
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    • 2024
  • Objective: This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses. Methods: From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness. Results: Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001). Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020). As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017). Conclusion: Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.

Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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