• 경영정보학연구
• /
• 제25권1호
• /
• pp.165-187
• /
• 2023

기대수명의 지속적인 증가와 건강에 대한 높은 관심은 인터넷과 스마트폰의 대중화로 일반인들의 건강정보에 대한 이용에 큰 변화를 가져왔다. 모바일 헬스 환경으로 의료시장이 확대되면서 많은 건강관련 앱이 만들어져 유통되고 있지만, 각종 규제로 서비스 제공이 어려워지면서 그 수용속도가 더딘 상황이다. 이에, 본 연구는 프라이버시 계산모형을 바탕으로 개인건강기록 앱 수용저항에 영향을 미치는 요인으로 지각된 가치와 지각된 위험요인(심리적 위험, 시간손실 위험, 제도적 위험) 및 지각된 혜택요인(유용성, 상호작용성, 자율성)을 도출하고 이들 간의 영향 관계를 검증하였다. 또한, 제조사에 대한 신뢰의 조절효과를 분석하여 지각된 위험과 지각된 혜택이 지각된 가치에 미치는 영향이 어떻게 달라지는지를 추가적으로 살펴보았다. 개인건강기록 앱을 인지하면서도 사용하지 않는 국내 대학생을 대상으로 설문조사를 진행한 후, 구조방정식모형을 활용하여 분석을 진행하였다. 가설검증 결과, 지각된 가치는 수용저항에 부(-)의 영향을, 지각된 위험(시간손실 위험)은 지각된 가치에 부(-)의 영향을 미치고, 지각된 혜택(유용성, 상호작용성, 자율성)은 지각된 가치에 정(+)의 영향을 미치는 것으로 확인되었다. 또한, 제조사에 대한 신뢰는 지각된 위험(제도적 위험)이 지각된 가치에 미치는 영향력을 약화시켰다. 본 연구결과는 개인건강기록 앱의 수용저항을 줄이기 위한 세부기준을 확인하고 제안함으로써, 개인건강기록 앱 시장 환경에서 경쟁우위를 확보하기 위한 지침 마련에 기여할 수 있을 것으로 기대한다.

• Child Health Nursing Research
• /
• 제7권1호
• /
• pp.85-95
• /
• 2001

The purpose of this study was to reveal what influences the divergent methodological researches have brought the nursing practice in during the past 3 decades. The nursing record sheets ie, the nursing discourses were analyzed to know the knowledges that were recorded, accepted and communicated in nursing practice at pediatric intensive care units, and unclosed the philosophical and methodological position of that knowledges. The texts were 13 sheets, 3 kinds of nursing record(7 24hours flow charts, 4 nursing information record sheets and 2 transfer record sheets) used at 4 hospitals. The unit of analysis was 'word'. First, all words of the sheets were listed up, clustered into categories based on their contents. And then, the larger conceptual themes were drawn to elucidate the effect of the knowledge/power and the philosophical and methodological position of that knowledges. To enhanced the validity of the analysis, the data were analyzed by two researchers. The 'words' were classified into 3 categories; 'general information', 'assessment' and 'inter-vention'. The conceptual themes of the texts were 'the gaze for quantification and objectification' and 'technical/assimilated caring'. This themes reflected the logic positivistic and biomedical view that had dominated at clinical practice. Nursing has endeavored to resist the logic-positivistic knowledge/power and to established the nursing knowledge/power based on multiple philosophies and methodologies, especially phenomenological-interpretative. But the results of this study revealed that such efforts in nursing theory and research couldn't influenced the knowledge of practice. Logic positivism was yet so strong and the biomedical model yet dominated in the clinical practice. It identified that the borrowed theory and the knowledge from the received view gave nursing the power. But they were modalities that reinforced the dominant, medical power. Nursing has investigate the other positions (feminism, Habermas' critical social theory and Foucault's discourse theory). This positions suggest different assumptions but share the common concepts; equality, emancipation and freedom. The important point is how make these concepts the practical for nursing knowledge/power in practice. We must recognize that the praxis at clinical setting take place at the field unlike theoretical praxis. The change of clinical practice is the social, economic and political change.

• 한국의료질향상학회지
• /
• 제27권2호
• /
• pp.57-72
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제10권2호
• /
• pp.13-32
• /
• 1998

A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).

• 한국컴퓨터정보학회논문지
• /
• 제15권8호
• /
• pp.89-98
• /
• 2010

인터넷을 기반으로 하는 웹의 급속한 발전으로 의료 환경에 중요한 변화를 가져오고 있다. 서로 다른 병원시스템을 가진 병원들이 의료 정보를 효율적으로 공유하고 교환할 수 있는 시스템이 요구되고 있다. 시스템 간 의료정보를 전달하기 위해서는 의료 데이터를 의료정보 교환 프로토콜인 HL7에 맞춰 변환시켜주는 인터페이스 엔진이 필요하다. HL7은 의료 정보 시스템간 데이터 교환을 위한 표준 프로토콜이다. 본 논문에서는 HL7에서 정의한 메시지 구조를 바탕으로 요양기관의 치매환자를 위한 인터페이스 엔진을 구현하였다. 인터페이스 엔진은 클라이언트와 서버 모듈로 구성하였다. 클라이언트 시스템에서는 환자의 의료 데이터 입력과 메시지를 생성하여 서버 시스템으로 전달하도록 하였고, 서버 시스템에서는 메시지를 세그먼트, 필드 단위로 파싱하여 메시지의 이상 유무를 클라이언트 시스템으로 전송하도록 구현하였다. 구현 언어로는 Java와 JavaCC를 사용하였다. 본 연구로 인하여 평생전자의무기록과 원격진료시스템, 다양한 의료기관 간 의료 정보를 공유할 수 있는 기반이 될 것이다.

• 디지털산업정보학회논문지
• /
• 제11권4호
• /
• pp.25-31
• /
• 2015

Smart healthcare environments which merge medical and IT technology are getting ready for the third generation centering EHR from current second generation. As a basic technology for the introduction and activation of EHR systems it requires heterogeneous network interworking techniques between various wired and wireless medical devices. Interworking technology for heterogeneous network among various medical devices is needed to introduce EHR system. The heterogeneous network interworking technology is needed for construction of a reliable data system to convert each of unstructured data into structured data. Therefore, in this paper, we identify the domestic and international trends of smart medical field and analyze the characteristics of wired and wireless communication technology that is used in a heterogeneous network. and also suggest requirements needed for interworking technology and provide interworking technology based on them. we expect that proposed method which is designed for smart healthcare environments would provide a basic architecture needed for third smart medical technology generation.

• 한국기록관리학회지
• /
• 제13권3호
• /
• pp.151-171
• /
• 2013

본 연구는 서울 시내 5개 대학병원의 의무기록 관리자들이 생각하는 전자의무기록시스템 구현 시 기록관리 메타데이터 표준 요소의 중요도를 설문조사하였다. SPSS 20.0(ver)을 이용하여 중요도 점수는 5점 척도의 평균으로 도출하여 순위를 정하였고 응답자 특성에 따른 중요도 차이를 분석하였다. 90%의 응답자가 국가기록원에서 기록관리 메타데이터 표준을 고시하고 있음을 모르고 있었다. 가장 중요도가 높은 요소는 '비밀등급 설정' 이었으며 '의무기록 접근행위종류', '내부직원 권한 설정', '의무기록 이용접근자' 요소가 그 다음 순위를 보여 기록정보보호 측면에서의 관리 기능 강화를 필요로 함을 알 수 있다. 개인 프라이버시 보호를 위하여 '외부공개'는 중요도가 낮은 관리요소로 평가되었으나, 전자의무기록 도입 7년 이상인 기관의 관리자들은 7년 미만의 관리자 보다 유의하게 이 세 가지 요소의 중요도를 높게 평가하였다. 이는 정보 축적에 따라 의학연구, 의학교육 등에서의 정보 이용에 대한 관리 기준과 시스템상의 적용이 필요함을 보여준다.

• 한국정보처리학회:학술대회논문집
• /
• 한국정보처리학회 2022년도 추계학술발표대회
• /
• pp.520-522
• /
• 2022

의료 인공지능은 특정 진단에서 높은 정확도를 보이지만 모델의 신뢰성 문제로 인해 활발하게 쓰이지 못하고 있다. 이에 따라 인공지능 모델의 진단에 대한 원인 설명의 필요성이 대두되었고 설명가능한 의료 인공지능에 관한 연구가 활발히 진행되고 있다. 하지만 MRI 등 의료 영상 인공지능 분야에서 주로 진행되고 있으며, 이미지 형태가 아닌 전자의무기록 데이터 (Electronic Health Record, EHR) 를 기반으로 한 모델의 설명가능성 연구는 EHR 데이터 자체의 복잡성 때문에 활발하게 진행 되지 않고 있다. 본 논문에서는 전자의무기록 데이터인 MIMIC-III (Medical Information Mart for Intensive Care) 를 전처리 및 그래프로 표현하고, GCT (Graph Convolutional Transformer) 모델을 학습시켰다. 학습 후, 어텐션 흐름 그래프를 시각화해서 모델의 예측에 대한 직관적인 설명을 제공한다.

• International Journal of Fuzzy Logic and Intelligent Systems
• /
• 제14권4호
• /
• pp.268-275
• /
• 2014

In future, hospitals are expected to automatically issue remote transcriptions. Many general hospitals are planning to encrypt their medical database to secure personal information as mandated by law. The electronic medical record system, picture archiving communication system, and the clinical data warehouse, amongst others, are the preferred targets for which stronger security is planned. In the near future, medical systems can be assumed to be automated and connected to remote locations, such as rural areas, and islands. Connecting patients who are in remote locations to medical complexes that are usually based in larger cities requires not only automatic processing, but also a certain amount of security in terms of medical data that is of a sensitive and critical nature. Unauthorized access to patients' transcription data could result in the data being modified, with possible lethal results. Hence, personal and sensitive data on telemedicine and medical information systems should be encrypted to protect patients from these risks. Login passwords, personal identification information, and biological information should similarly be protected in a systematic way. This paper proposes the use of electronic acupuncture with a built-in multi-pad, which has the advantage of being able to establish a patient's physical condition, while simultaneously treating the patient with acupuncture. This system implements a sensing pad, amplifier, a small signal drive circuit, and a digital signal processing system, while the use of a built-in fuzzy technique and a control algorithm have been proposed for performing analyses.

• Journal of information and communication convergence engineering
• /
• 제8권6호
• /
• pp.690-696
• /
• 2010

Web-based virtual collaboration is increasingly gaining popularity in almost every area in our society due to the fact that it can bridge the gap imposed by time and geographical constraints. However, in medical field, such collaboration has been less popular than other fields. Some of the reasons were timeliness, security, and preciseness of the information they are dealing with. In this paper, we are proposing a web-based distributed medical collaboration system called Virtual Collaboration System for Medicine (VCSM) for medical doctors that meet the needs. The proposed system consists of two parts - multimedia presentation and recordable virtual collaboration. The former supports synchronized multimedia presentation using Synchronous Multimedia Integration Language (SMIL.) It allows synchronization of the contents of a PowerPoint presentation file and a video file. The presentation may be provided to the participants before the discussion begins. Next, in the virtual collaboration stage, participants can use text along with associated symbols during the discussion over the presented medical images. The symbols such as arrows or polygons can be set or removed dynamically to represent areas of interest in digital images using so called layered architecture that separates image layer from annotation layer. XML files are used to record participants' opinions along with the symbols over some particular images