• Journal of Sasang Constitutional Medicine
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• v.27 no.2
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• pp.222-230
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• 2015

Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.

• Korean Journal of Clinical Pharmacy
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• v.16 no.1
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• pp.9-13
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• 2006

Patient counseling is emerging as one of the most important roles of community pharmacists because the information on the standard labeling for the prescription drug is not sufficient to ensure the correct use of the drug. However, excessive workload of the community pharmacists in Korea discourages the provision of the effective patient counseling. The use of auxiliary label may be an efficient tool to help patients correctly use the prescription drug in this situation. As a preliminary study to encourage the use of auxiliary label, we have performed a survey analysis of familiarity and willingness of community pharmacists to use the auxiliary label. About three quarters of the participating community pharmacists have heard of the auxiliary label, however, there was not a single pharmacist who uses the label. Furthermore, only one fifth of the participating pharmacists were willing to use the label if they have to purchase. Therefore, it is recommended that governmental and non-profit organizations such as Korean Pharmaceutical Association educate community pharmacists regarding usefulness of the auxiliary label with focus on enhancing patient compliance and constrainment of healthcare expense.

• Journal of Korean Medical classics
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• v.24 no.6
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• pp.101-110
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• 2011

There are not a few cases in Oriental medicine where a different prescription should be given to some of the patients whose symptoms are similar to each other. In other words, there might happen a misdiagnosis due to an extremely delicate difference in symptoms of the same diseases, causing a patient's condition to get worse or to be even on the brink of death. In such a context, the records in "WooJam JabJeo(愚岑雜著)" are worthwhile to do in-depth research on. Jang-Taegyung described his first-hand experience in major medical treatment very vivaciously during his ages between 25 and 42. Particularly, most of the prescriptions recorded in this book include not only his empirical prescriptions on the patients who life was almost on the brink of death but it also so plentifully contained the process of overcoming the side effect caused by other clinics' misdiagnosis; thus, that this book is drawing attention in that it could be indispensable materials not only in the research on medical history but also for clinical treatment. Particularly, as regards two cases of insanity, this book mentions the reason for using totally different prescription on one case from the other case even though the two cases had a similar symptom, through which we can acquire somewhat concrete experience in curing scenes though indirectly during the period of the Joseon Dynasty. We were able to get the result from the analysis of the two cases of insanity as follows: 1. WooJam, in treating the two cases of insanity due to the severe exacerbation of yang energy, managed to treat the one case by inducing a bowel movement and the other case by inducing urination. Such a different treatment seems to be greatly attributable to the constitutional factor of the two patients. Such an Oriental-medicine-based method of diagnosis and prescription as WooJam's is rarely found in Western medicine-i.e., that's why more thorough research on Oriental medicine is deeply required. 2. In case of the second patient, the patient arrived at insanity due to another clinic's treatment on perspiration on the patient with severe mouth thirst. This medical story once again highlights the importance of a diagnosis in today's Oriental medicine and at the same time it's a good example showing how big the side effect caused by the abuse of medicinal herbs is. The second patient's body fluids ran dry and finally his yang energy got exacerbated all the more due to the treatment by perspiration.

• Journal of Pharmacopuncture
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• v.22 no.4
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• pp.260-268
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• 2019

Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

• The Korean Society of Law and Medicine
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• v.22 no.1
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• pp.3-23
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• 2021

Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.118-142
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• 2003

This study is aimed at evaluating the financial structure of hospitals before and after the separation of prescription and drug dispensing policy started to be implemented in July 2000 and at making a suitable hospital managerial strategy through the verification of the factors which have effect on their profitability. This study investigated the hospitals which have passed the accredition review to be designated as a accredited training hospital each year for three years from 1999 to 2001. Those hospitals were selected from members of the Korea Hospital Association. 106 hospitals were targeted for analysis except for the hospitals whose financial statements and managerial performance were not reported faithfully. The financial indicators used in this study were stability indicators(liability to total assets, ratio of debt to fund balance, fixed ratio), liquidity indicators(current ratio, quick ratio), activity indicators(total assets turnover, fixed assets turnover), profitability indicators(net profit to total assets, net profit to net worth, operating margin), and operating expenses to patient revenues indicators(drug and supplies costs/payroll/overhead expenses). The result of this study are as follows: First, the analysis of the increase of loss-making hospitals before and after. The separation of prescription and drug dispensing policy shows that the number of loss-making hospitals increase after the separation(22.6% before the separation; 31.1% after the separation). However, there was no significant statistical difference. Second, the analysis of operating expenses to patient revenues indicators showed that the ratio of drug and supplies cost became lower in all hospitals but the ratio of payroll/overhead expenses became higher. Additionally, the factor which have the greatest effect on profitability was operating expenses to patient revenues indicators (drug and supplies costs/payroll/overhead expenses). Third, the analysis of managerial performance by four types of loss-loss, loss-profit, profit-loss and profit-profit compared the results before the separation with those after the separation revealed as follows : Reliance on liability to total assets became higher in the profit-loss type($56.2%{\rightarrow}66.4%$), lower in the loss-profit type($82.7%{\rightarrow}74.5%$). Total assets turnover became higher in the profit-profit type($1.3{\rightarrow}1.5$), but lower in the loss-profit type($0.8{\rightarrow}0.7$). Operating margin decreased to minus 5.9% from 4.3% in the profit-loss type, but increased to 7.2% from minus 7.8% in the loss-profit type. Forth, operating expenses to revenues indicators showed that the increase of payroll was the biggest in the profit-loss type($39.2%{\rightarrow}49.9%$) and that overhead cost decreased in the loss-profit type but that rather increased in other types.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.207-212
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• 2016

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.213-222
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• 2013

Purpose: The aim of this study was to investigate the current state of antidepressant prescriptions in breast cancer patients and factors affecting the prescription of antidepressants. Methods: This study targeted female breast cancer patients who were prescribed antidepressants by a psychiatrist at least once between August 2010 and July 2011 at the Asan Medical Center in Seoul. The prescription history of each study subject was investigated to analyze the current state of antidepressant prescriptions in breast cancer patients. Results: The analysis of the prescription histories of 136 subjects in the antidepressant group determined that escitalopram, mirtazapine, and trazodone were the three most commonly prescribed medications with an average of 1.54 antidepressants prescribed per patient. A logistic regression analysis showed a statistically significant increase in antidepressant prescriptions in patients who were divorced or widowed, had sleep disturbances, or had undergone oncologic surgery for the breast cancer (p<0.050). In contrast, the prescription rate was lower for patients with tumour sizes greater than 50 mm (p<0.050). Conclusion: The sociodemographic factor of marital status, clinical factors of sleep disorders and tumour size, and a treatment-specific factor of the use of surgical therapy were identified as affecting the prescription of antidepressants in female breast cancer patients.

• Journal of Digital Contents Society
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• v.4 no.1
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• pp.57-66
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• 2003

This paper presents the content regarding electronic medical examination chart and data treatment for efficient medical examination and prompt treatment by realizing mutual conversation type remote medical examination system among 3 parties(patient, doctor, pharmacist) on internet base. This is an intelligence type remote medical examination system for both on-line and off-line mode to transcend time and space on the web being participated by anybody, which is cheap type to solve problems in existing remote medical examination system such as high price based on hardware, incompatibility, and so on. By interconnecting ASP and SQL on IIS 4.0 web server, database enables system integration for efficient data processing, on-line consultation between patient and doctor, medical examination on off-line, transmission of medical prescription to pharmacist designated by patient and preparation of medicine, semi-eternal storage of medical examination data owing to storage and search of medical examination data, exact medical examination and prescription using this medical examination data by patient and doctor, and so on.

• Convergence Security Journal
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• v.5 no.1
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• pp.19-27
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• 2005

This paper presents the content regarding electronic medical examination chart and data processing for efficient medical examination and fast treatment by realizing remote medical examination system of mutual conversation type among 3 parties(patient, doctor, pharmacist) on internet base, and establishment of database enabled system integration for efficient data processing in both on-line and off-line mode by interconnecting ASP and SQL on IIS 4.0 web server, consultation between patient and doctor, medical examination on off-line mode, transmission of prescription sheet to the pharmacist designated by patient, preparation of medicine, semieternal storage of medical examination data owing to storage and check of medical examination data, more accurate medical examination and prescription using this medical examination data by patient and doctor, and so on. And, data processing between doctor and pharmacist is differently performed based on class such as general member and charge member, and service access right pursuant to this is endowed, so that certification of each member must follow by all means.