• Title/Summary/Keyword: Clinical Interchange

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The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research (일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-)

  • Park, Jong-Ku;Kang, Myung-Guen;Lee, Seong-Soo;Kim, Dal-Rae;Choi, Seo-Young;Han, Chang-Ho;Yoo, Jun-Sang;Kim, Min-Gi;Kim, Chun-Bae
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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Clinical Information Interchange System using HL7-CDA

  • Jung, Yong Gyu;Lee, Young Ho
    • International journal of advanced smart convergence
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    • v.1 no.2
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    • pp.47-51
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    • 2012
  • In highly developed society, information and communication technologies are widely used for better medical services. These information and communication technologies should be more and more acceptable in all hospitals for exchange medical records. EMR becomes more convenient than the previously used paper charts. It will be able to record medical institutions every time and dual treatment. Each is different specifications for each medical institution to use the program or document to exchange it. The personal clinic records still does not exchange well. To solve this gap between medical alienation, this paper describes the concepts of HL7-CDA and proposes types of telemedicine system. To resolve time and space constraints, new form of treatment methods presents in future directions after described about related systems. CDA enables electronic medical records to the each medical center and gradually expanded by exchanging the patient's medical records. This paper is using XML-based CDA documents as a hierarchical for medical information exchange standards compliant HL7-CDA documents. It could be possible currently used structural variety of multimedia data. Thus It is able to send and receive HL7-CDA-based medical information and clinical information to identify the medical institutions of medical information with interchange system design and building standards, and through mutual exchange of clinical information.

Understanding the Conception of Stress regard in the Oriental Medicine (스트레스의 개념에 대한 한의학적 해석)

  • Ahn, Sang-Woo
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.119-151
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    • 1997
  • Conclusions for the relationship between a conceptional model of stress theory and its examination based on the Oriental medicine; 1. It was considered that a general conception of stress is included into the meaning of Ki in the Oriental medicine. 2. The response-based model to stress could be comparable to a conception of Ki-pathogens interchange In the Onental medicine. 3. The stimulus-based model may be explained as a modern conception of immoderation feeling related with an internal etiological factor, specially injury of seven emotions, among three groups of etiological factors for disease. 4. The feedback conception based on the interaction model could explain the principal of reversible emotion therapy in the nine Ki. 5. In the Oriental medicine, a study to clarify a emotional etiologic factor and its pathophysiologlcal mechanism has been continued for long time before establishment of stress theory.

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The role of Medical Officers and Confucian Doctors in the 18th Century in Joseon (18세기 조선통신사 의관(醫官)과 유의(儒醫)의 역할 - 의학문답(醫學問答)을 중심으로 -)

  • Ham, Jeong-Sik;Kim, Nam-Il;Ahn, Sang-Woo;Park, Sang-Young;Cha, Wung-Seok
    • Korean Journal of Oriental Medicine
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    • v.13 no.1 s.19
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    • pp.19-27
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    • 2007
  • In the 18th Century, those who played most important role in international interchange of medical science between Korea and Japan were skillful doctors and doctors of Joseontongsinsa(Correspondents of Joseon called on Japan as a mission). But they have been truly neglected by researchers on history of Korea, even on history of Korean medical science. They were received warm treatment from Japanese. But They were at the most middle-class in social standing in Joseontongsinsa. Though they played important role, they were underpriced and their brilliant achievements were faded out. It is on account of their low social position in Joseon Dynasty, a strict class society. Samsa, Jesulkuan, and Seogi were members of Joseontongsinsa those who were high class in social standing and were good at writing. In general, they were also Confucian doctors in Joseon. In the case of Samsa, there was Seo Myungung who was famous Confucian doctor. And since 'dispatch principle of Jesulkuan' had been prepared, Jesulkuans had paticipated in questions and answers on clinical problems. In a broad sense, We can regard Lihyun, a Jesulkuan in 1711's mission, Shinyuhan, a Jesulkuan in 1719's mission, and Seogies of Samsa as Confucian doctors. Though they were not medical specialist, but we can find them as Confucian doctors through the questions and answers on clinical problems they were participated in.

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Development and Lessons Learned of Clinical Data Warehouse based on Common Data Model for Drug Surveillance (약물부작용 감시를 위한 공통데이터모델 기반 임상데이터웨어하우스 구축)

  • Mi Jung Rho
    • Korea Journal of Hospital Management
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    • v.28 no.3
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    • pp.1-14
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    • 2023
  • Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.

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CDISC Extension for Supporting Multinational Clinical Trials (다국적 임상시험 지원을 위한 CDISC 표준의 확장)

  • Yeom, Ji-Hyeon;Chai, In-Young;Kim, Suk-Il;Kim, Hyeak-Man
    • Journal of KIISE:Computing Practices and Letters
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    • v.15 no.8
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    • pp.566-575
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    • 2009
  • Clinical Data Interchange Standards Consortium (CDISC) developed global and platform-independent data standards to improve ineffective processes of clinical trial studies. Regardless of its objective toward global cooperation, the current version of the CDISC standard cannot describe clinical trial data in various languages for multi-national investigators or reviewers. This problem applies not only to tabulated datasets in Study Data Tabulation Model (SDTM) but also to extensible markup language representation of the datasets in Operational Data Model (ODM) instances. In order to address this issue, we propose to extend the current version of SDTM and ODM to collect clinical data for multi-national clinical trials. SDTM needs to have new special-purpose domain for multi-language representation purpose. Additionally, ODM is recommended to extend its XML schema using subtyping or type inheritance mechanism respectively. Our extension of SDTM and ODM enable to represent any granule of study data tabulation model or XML data entities to describe in efficient languages. This result will contribute to collect multi-language data easily for multi-national clinical trials.

A Study on System for International Standard(IS) based Clinical Information Management (국제표준 기반의 임상정보 관리체계 구축에 관한 연구)

  • Choi, Yongjung
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2014.01a
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    • pp.429-432
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    • 2014
  • 국내 제약산업의 경쟁력을 제고시키기 위해서는 신약의 심사/허가 기간을 단축시켜 급변하게 변하는 글로벌 제약시장에서 경쟁 우위적 위치를 선점할 수 있도록 기회를 제공할 수 있도록 체계 개선이 시급하다. 신약허가를 위해서는 임상시험 결과에 대한 안전성과 유효성 등에 대한 심사가 수행되게 된다. 하지만 현재 신약허가를 위해서 제약사와 임상시험수탁기관(Contract Research Organization, CRO)에서 데이터 정보체계인 Domain, Variable 및 Parameter 등의 표준을 따르지 않고 다양한 유형의 임상정보데이터를 심사기관에 제출하고 있어 이로 인한 심사기간 증가와 심사업무 비효율성을 야기시키고 있다. 따라서 본 연구에서는 국제민간기구인 CDISC (Clinical Data Interchange Standards Consortium)에서 제정한 글로벌 임상데이터 표준인 CDISC 표준을 준용한 국내 임상시험정보관리 체계 (eCTD 시스템)및 의약품 전주기적 관리체계를 제시하고자 하며, 본 연구를 통한 기대효과로는 국제표준의 임상정보관리 인프라 구축으로 인한 국내 신약개발 및 해외 진출 환경을 마련하여 글로벌 시장선점의 기회를 제공할 수 있고, 규제기관 차원에서는 의약품 허가, 심사업무의 효율성 증가는 물론 전주기적 의약품 안전관리체계를 마련할 수 있을 것으로 사료된다.

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Nursing Education between South and North Korea through Verbal Evidence from Defecting North Korean Medical Personnels (탈북 의료인의 증언을 바탕으로 본 북한 간호교육의 제도와 교과과정 조사 연구)

  • 신경림;김일옥
    • Journal of Korean Academy of Nursing
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    • v.31 no.2
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    • pp.169-179
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    • 2001
  • Recently, there has been an increasing interchange between South Korea and North Korea. Accordingly, there has been active research to understand the society and culture of North Korea, it has been attempted to have comparative study about nursing education to increase understanding between South and North Korea. In the current educational system, 12 years of education is required for entering a nursing college or university in South Korea, but there are only 10 years for entering nursing college in North Korea. After finishing undergraduate studies one can enter graduate school for a masters degree and or a doctoral degree, but there is a longitudinal relation to medical education in North Korea. Regarding the number of nursing educational institutions, there are 50 BSN programs & 61 Diploma programs in South Korea and 11 Diploma programs in North Korea. In regards to curriculum, South Korea has diverse subjects for general education for freshmen, then is subjects to basic specialities sophomore year, and speciality subject and clinical practices from junior year corresponding to the student's intentions. North Korea has minor subjects for general education and basic specialities in freshmen, speciality subjects sophomore year, speciality subjects and clinical practice in the junior year that may not correspond with the student's intentions. The most outstanding difference in the curriculum is North Korea has various subjects for oriental medicine with clinical application. North Korea also does not teach computer science and English is at a very low level. In clinical practice, South Korea has various settings for clinical practice including community health institutions under the nursing professor or clinical instructor. However, North Korea has limited settings for clinical practice (general hospitals) under a doctor's instruction. Also both South and North Korea have a similar licensing system. Therefore, there must be many more studies regarding North Korea, especially in nursing and nursing education in order to decrease differences and confusion between the Koreas and to prepare for a future unification.

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The Development of Evaluation Criteria Model for Discriminating Specialized General Hospital (종합전문요양기관 인정기준 모형 개발)

  • Chun Ki Hong;Kang Hye-Young;Kang Dae Ryong;Nam Chung Mo;Lee Gye-Cheol
    • Health Policy and Management
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    • v.15 no.4
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    • pp.46-64
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    • 2005
  • This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.