• Title/Summary/Keyword: 진료 기록

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A Survey on Malpractice Accidents and Disputes Concerned with Dental Hygienists in the Seoul and Gyeonggi Province (서울·경기 지역 치과위생사의 의료사고 및 분쟁에 대한 태도 조사)

  • Kim, Bit-Na
    • Journal of dental hygiene science
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    • v.8 no.1
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    • pp.13-20
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    • 2008
  • The purpose of this study was to find out experiences of dental hygienists working on dental care sites, to prevent potential malpractice accidents and disputes, and to examine why it is necessary to provide corresponding education or training courses. As a result, this study came to the following conclusions: 1. It was found that 32.5% had ever experienced in malpractice suits or disputes, and 55.0% of such experienced group had ever experienced in malpractice suits or disputes concerned with dental hygienists. 2. According to inquiry on whether dental hygienists have certain liability for malpractice disputes, it was found that 66.3% respondents ascribed the medical liability to dental hygienists. And according to inquiry for those respondents on liability ratio, it was found that 57.1% of them thought 11%~30% as appropriate liability ratio. 3. According to survey on extent of doubts about potential malpractice accidents and disputes in future, it was found that 72.4% respondents sometimes had doubts about them. 4. It was found that 64.2% respondents thought it necessary and urgent to provide education related to prevention and countermeasures for malpractice disputes.

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A method for improving security and data accessibility in EMR systems based on GRID technologies (EMR 시스템을 위한 그리드 기술 기반의 보안성 및 데이터 접근성 향상 기법)

  • Shin, Dong-Min;Shin, Dong-Kyoo;Shin, Dong-Il
    • Proceedings of the Korean Information Science Society Conference
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    • 2010.06c
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    • pp.211-215
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    • 2010
  • 지금까지 병원에서 사용하던 일반 종이차트를 벗어나 전자적으로 환자의 데이터를 기록하고 유전자 데이터를 이용하여 환자의 유사 질병까지 찾아 낼 수 있는 EMR(Electronic Medical Record 전자 의무 기록)이 개발되면서 의료계는 환자에게 더욱 신속하고 정확한 진료를 할 수 있게 되었다. 본 논문은 이에 그리드 환경을 접목하여 더 빠른 데이터 처리와 신뢰성 과 접근성을 높일 수 있는 방법을 제시한다. 첫째, 현재 기 개발된 EMR 시스템의 환경에서 인증된 사용자만이 스토리지에 접근 할 수 있도록 GSI Service를 이용하여 단일 인증 방식으로 보안성을 높이며 동시에 단 한번의 인증절차로 모든 자원을 활용 할 수 있다. 둘째, Replica Service를 이용하여 기존의 스토리지를 복제 하여 중요한 데이터 들을 보호하며 다수의 접근이 발생할 경우 처리를 분산 시킬 수 있는 방법을 제시한다. 그리드 미들웨어인 글로 버스가 스토리지와 서버 상에서 CA인증을 담당하며 파일 전송을 담당하는 RFT는 스토리지의 Replica를 관리하는 RLS서버의 정보를 사용 하여 멀리 떨어져 있는 복제된 데이터와의 관계를 기억하고 접근시 가장 가용성이 뛰어난 머신에서 데이터를 불러온다. 이런 글로버스의 서비스 들은 중요하며 고용량이 데이터를 분산 시킴으로써 데이터의 지역성을 높여 재사용 혹은 동시 접근시 처리 시간을 단축 시킬 수 있다. 본 논문은 그리드 환경을 접목하여 이러한 서비스를 구현할 경우 높은 신뢰성과 접근의 신속성을 보장할 수 있다고 제시한다.

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Retrospective Analysis of Chief Complaints and Causes of Dogs and Cats during Emergency Visits: 3,180 Cases (응급실에 내원하는 개와 고양이의 주증과 원인에 대한 후향분석: 3,180례)

  • Lee, Hyekyung;Son, Won-Gyun;Seo, Jimin;Kim, Hyunwook;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.90-94
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    • 2014
  • This study was performed to investigate on the frequent chief complaints and the causes of dogs and cats visiting to an emergency department, and to suggest the minimum requirements for veterinary emergency clinics in South Korea. The medical records were reviewed for 2,368 dogs and 347 cats visiting the emergency department of Haemaru Referral Animal Hospital from March 2012 to August 2013. Among them, 255 dogs and 35 cats visited more than one time and each visit was considered as an individual case. Therefore, 2,784 cases of dogs and 396 cases of cats were reviewed. The medical records were analyzed according to the criteria such as signalment, chief complaints, diagnoses, hospital admission, and outcome. In dogs, vomiting, diarrhea, or both were the most common chief complaints, followed by dyspnea, trauma, seizure, and lethargy. The most common causes of emergency visits were gastrointestinal disorders, followed by neurologic, cardiovascular, respiratory, urologic, and hematologic disorders. In cats, dyspnea was the most common chief complaint, followed by vomiting, diarrhea, or both, trauma, dysuria, and lethargy. The most common causes of emergency visits were urologic disorders followed by gastrointestinal, respiratory, infectious, and cardiovascular disorders. According to the results, vomiting, diarrhea, dyspnea, and trauma were the most frequently encountered chief complaints, which accounted for approximately 48.6% of all cases in both dogs and cats. However common causes were differed between the dogs and the cats. In order to provide proper emergency service, it is required to prepare the clinicians and facilities to diagnose and stabilize these emergency patients.

Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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Geographical Characteristics and Patients' Determinants of Online Referrals : A Case Study of Choongbook, Korea (온라인 협진에 대한 지리적 특성과 환자의 결정에 관한 연구 : 충청북도 사례를 중심으로)

  • Park, Soo-Kyung
    • Journal of the Korean association of regional geographers
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    • v.17 no.5
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    • pp.617-637
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    • 2011
  • This study employs qualitative approaches to examining geographical characteristics and patients' determinants of online referrals in terms of regionalization. In this light, I conducted interviews with 20 patients receiving online referrals in Choongbook, Korea, and investigated their behaviors regarding these referrals between July and August 2009. I found that many patients who suffered from various levels of illness preferred tertiary care centers outside of Choongbook and did not enjoy their experience with the local medical institutions as the online referral service sites. This result might be because patients choose online referrals for psychological considerations such as quality and level of health care services, personal stakes in online referral service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. Meanwhile, immediate benefits with regard to the technological value of online referrals, such as convenience, utility, and original purpose associated with regionalization, did not influence patients' decision-making. Therefore, the social and public networks affiliated with online referrals plus the effect of Korean medical laws play hostage to private decisions made by citizens, who prefer high-level medical institutions. Accordingly, the technological contribution of online referrals does not halt the outflow of patients from local, tertiary care centers. Especially, the existing health care system and patients' behaviors are deeply related to referrals in the online system. To protect regionalization, the improvement of health care services from the present state of affairs is required.

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Design and Implementation of Picture Archiving and Communication System Component using the RFID for Mobile Web Environments (모바일 웹 환경을 위한 의료영상저장전송시스템 컴포넌트의 설계 및 구현)

  • Kim Chang-Soo;Yim Jae-Hong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.10 no.6
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    • pp.1124-1131
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    • 2006
  • The recent medical treatment guidelines and the development of information technology make hospitals reduce the expense in surrounding environment and it requires improving the quality of medical treatment of the hospital. Moreover, MIS, PACS(Picture Archiving and Communication System), OCS, EMR are also developing. Medical Information System is evolved toward integration of medical IT and situation is changing with increasing high speed in the ICT convergence. Mobile component refers to construct wireless system of hospital which has constructed in existing environment. Through RFID development in existing system, anyone can log on easily to internet whenever and wherever. It is the core technology to implement automatic medical processing system. This paper provides a basic review of RFID model, PACS application component services. In addition, designed and implemented database server's component program and client program of mobile application that recognized RFID tag and patient data in the ubiquitous environments. This system implemented mobile PACS that performed patient data based db environments, and so reduced delay time of requisition, medical treatment, lab.

Design and Implementation of Mobile Medical Information System Based Radio Frequency IDentification (RFID 기반의 모바일 의료정보시스템의 설계 및 구현)

  • Kim, Chang-Soo;Kim, Hwa-Gon
    • Journal of radiological science and technology
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    • v.28 no.4
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    • pp.317-325
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    • 2005
  • The recent medical treatment guidelines and the development of information technology make hospitals reduce the expense in surrounding environment and it requires improving the quality of medical treatment of the hospital. That is, with the new guidelines and technology, hospital business escapes simple fee calculation and insurance claim center. Moreover, MIS(Medical Information System), PACS(Picture Archiving and Communications System), OCS(Order Communicating System), EMR(Electronic Medical Record), DSS(Decision Support System) are also developing. Medical Information System is evolved toward integration of medical IT and situation si changing with increasing high speed in the ICT convergence. These changes and development of ubiquitous environment require fundamental change of medical information system. Mobile medical information system refers to construct wireless system of hospital which has constructed in existing environment. Through RFID development in existing system, anyone can log on easily to Internet whenever and wherever. RFID is one of the technologies for Automatic Identification and Data Capture(AIDC). It is the core technology to implement Automatic processing system. This paper provides a comprehensive basic review of RFID model in Korea and suggests the evolution direction for further advanced RFID application services. In addition, designed and implemented DB server's agent program and Client program of Mobile application that recognized RFID tag and patient data in the ubiquitous environments. This system implemented medical information system that performed patient data based EMR, HIS, PACS DB environments, and so reduced delay time of requisition, medical treatment, lab.

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A Study of Sound Analysis of Temporomandibular Joint (악관절 잡음에 관한 연구)

  • Soo-Yong Kim;Sung-Chang Chung;Hyung-Suk Kim
    • Journal of Oral Medicine and Pain
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    • v.17 no.2
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    • pp.51-61
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    • 1992
  • 저자는 서울대학병원 치과진료부 구강진단과를내원한 두 개하악장애 환자 중, 악관절음이 있음을 호소하는 환자 106명을 대상으로 SonoPAK을 이용하여 악관절음을 분석하고 Transcranial TMJ Series와 파노라마상 판독결과를 종합하여 다음과 같은 결론을 얻었다. 1. SonoPAK에 기록된 210회의 발생 악관절음 중 왕복성 관절음은 44건, 88회 발생하였고, 개구시 관절음은 74회, 그리고 폐구시 관절음은 48회 발생하였으며, 개구시에 관절음이 더 빈번히 나타났다. 2. 왕복성 악관절음이 있다고 인정되는 혼자군에서, 개구시 평균 최대 단위는 18.6(%)$\pm$15.6(%), 폐구시 평균 최대 진폭은 16.6(%)$\pm$17.4(%) 이었으며, 개폐구간 진폭의 차이에는 유의성이 없었다. (p>0.05). 3. 악관절음을 미약한 소리, 중간소리, 큰소리로 분류할 수 있었으며 각각 110, 79,21회의 발생을 기록하였다. 4. (>300Hz)/(<300Hz)의 비율이 0인 경우는 34회 였고, 300Hz 이상의 주파수가 관찰된 경우는 176회였다. 5. Transcranial TMJ projection series 와 파노라마상의 판독 결과 하악과두의 골 변화가 인정된 환자군에서 SonoPAK 기록의 평균 주파수 비율((>300Hz)/(<300Hz))은 0.387$\pm$0.284이었고 골 변화가 인지되지는 않았으나 주파수 비율이 0.01 이상인 환자군의 평균은 0.286$\pm$0.227이었다.

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The Development of Discharge Analysis Educational Program on NCS-Based for Medical Information Management (NCS 기반 의료정보관리를 위한 퇴원분석 교육프로그램 개발)

  • Choi, Joon-Young
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.5
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    • pp.957-964
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    • 2017
  • In this study, It developed a program to carry out the training courses for NCS based medical information management tasks and to can understand the practical working knowledge of learners. This program is an educational program that can generate medical information by analyzing data of medical records after generating and storing data of medical records. Because the contents of the medical records vary and there are quantitative differences in the medical records, the contents of the medical records can be summarized and stored in the discharge analysis program for the standard of educational data. The medical terminology DB, medical terminology related DB, medical care related DB by the NCS ability unit element can be constructed and managed using the program. The following are the contents that can be learned through operation of the program. first, it's can understand Medical information DB management regulations through understanding sturucture of database. Second, it can understand the structure and function of the diagnostic code and medical practice code that are input to the discharge analysis program. The diagnostic codes and medical practice codes entered in the discharge analysis program can be searched and analyzed by each fields. Third, It can be advance medical information management ability by inputting and extracting data and generating medical information. In this study, It developed program that Students can be obtained Knowledge of medical information management and improved management competency by generate and analyze medical record data using discharge analysis program.

Analysis of a Suicide Attempt Patients Admitted to an Emergency Medical Center (일 응급의료센터에 내원한 자살시도 환자에 대한 분석)

  • Han, Ye-Jin;Jung, Hong-Ryang
    • Proceedings of the Korea Contents Association Conference
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    • 2015.05a
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    • pp.169-170
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    • 2015
  • 본 연구는 2013년 7월부터 2014년 6월까지 충남 S지역 응급의료센터에 내원한 자살시도환자 의 의무기록을 기반으로 한 일반적 특성, 응급진료결과 등을 조사하였다. 분석 결과 성별, 연령별, 자살시도환자의 전원율은 여성이 남성보다 높은 것으로 나타났으며, 사망률은 남성과 여성의 비율이 비숫하게 나타났고,연령에 있어서는 30-39세에서 가장 높게 나타났다. 본 연구는 자살률을 낮추기 위한 연령대에 맞는 효율적인 자살예방프로그램의 정책적 도입을 통하여 공중보건비용을 줄이는 사업계획에 활용하고자 한다.

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