• 보건의료산업학회지
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• 제13권3호
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• pp.13-26
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• 2019

Objectives: To investigate whether medical institutions can prevent accidents by analyzing the root cause of a medical accident and identifying the tendencies. Methods: A total of 345 medical cases were used for the RCA(Root Cause Analysis). The root causes were classified using the SHELL model. The suitability of the model was confirmed by SPSS's MDPREF and Euclidean distance. An SPSS20.0 hierarchical regression analysis was used as an influencing factor on the degree of injury resulting from medical accidents. Results: The SHELL model was suitable for classification. The rates of accident causes were LS49%, L34%, LL10.2%, LE3.7%, LH2.3%. The order in which the degree of a patient's injury was affected were: Risk Threshold (${\beta}=.180$), Time (${\beta}=.175$), Surgical stage (${\beta}=-.166$), Do not use procedure (${\beta}=.147$). Conclusions: Health care institutions should remove priorities through system improvement and training. For patients' safety, the five factors of the SHELL model should be managed in harmony.

• 한국인터넷방송통신학회논문지
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• 제14권6호
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• pp.281-288
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• 2014

QR 코드는 바코드보다 수백 배 많은 양의 데이터를 인코딩할 수 있도록 기능을 향상시킨 코드체계로서 이미지 훼손에 강하다. 이러한 이유로 QR 코드는 최근에 다양한 분야에서 사용되고 있다. 예를 들어 항공권 티켓 (보딩 통제 시스템), 푸드 (야채, 육류 이력) 추적 시스템, 콘택트렌즈 관리, 처방전 관리, 환자 손목밴드 (환자관리) 등에 사용된다. 본 논문에서는 이진 이미지에 대한 가역적인 데이터은닉 방법을 제안한다. 가역적인 데이터 은닉방법은 스테고 이미지로부터 데이터를 추출한 후 원본 이미지를 복원할 수 있기 때문에서 다양한 목적으로 활용될 수 있다. QR 코드는 누구나 코드를 생성할 수 있으므로 위조된 QR 코드를 이용하여 범죄에 사용할 수 있다. 본 논문에서는 이를 방지하기 위해서 이진 QR 코드 이미지에 인증 데이터를 은닉하여 위조여부를 확인할 수 있도록 하였다. 본 논문에서는 제안한 방법은 실험을 통해서 입증을 하였다.

• 한국병원경영학회지
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• 제22권4호
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• 디지털융복합연구
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• 제14권2호
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• pp.217-225
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• 2016

본 연구에서는 배회가능성이 있는 치매환자의 실종예방을 위하여 웨어러블 디바이스(Wearable Device) 형식의 블루투스 비콘을 활용한 치매환자의 실내위치기반 모니터링시스템을 제안하였다. 이 시스템은 치매환자의 관리범위내 존재유무를 확인해 주며 치매환자가 비콘의 신호수신 설정거리를 이탈하면 즉, 지정된 관리구역을 벗어나면 비상메시지가 보호자와 관리자의 스마트 디바이스로 전달되는 시스템이다. 이 시스템의 주요 특성은 비콘을 착용한 치매환자를 특정장소에 설치된 비콘 신호수신용 스마트 기기(AP)에서 신호를 감지하여 환자의 위치를 파악하는 가역적 방법을 적용한 것이다. 본 논문에서 제안하는 블루투스 비콘을 활용한 실내위치기반 치매환자 모니터링 시스템은 요양병원, 재가요양시설 등에서 생활하는 배회가능성이 있는 치매환자의 실종예방에 기여하는 효과적 시스템으로 생각된다.

• 보건교육건강증진학회지
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• 제30권2호
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• pp.23-39
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• 2013

Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

• 한국의학물리학회지:의학물리
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• 제17권3호
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• pp.144-152
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• 2006

네트워크기술을 이용한 서버-클라이언트 원격의료기술은 특히 의료시설이 낙후된 지방도시의 의료기관에 질 높은 의료서비스를 제공할 수 있는 기술이다. 이러한 기술은 중앙 집중 방식으로 진단과 검사용으로 사용되는 대형 컴퓨터 하드웨어와 소프트웨어를 매우 효율적이고 경제적으로 관리할 수 있게 하게 때문에 궁극적으로는 의료수가를 감소시키는데도 기여할 것이다. 각 환자에 대해 환자 맞춤형 방사선 치료계획은 매우 효율적인 암 치료를 가능하게 하기 때문에 환자와 의사 모두에게 매우 유익한 방법이다. 치료계획전문가들은 환자에게 너무 적은 선량을 주면 암이 계속 재발할 확률이 높고 너무 많은 선량을 주면 환자를 다치게 할 수도 있다는 것을 잘 이해한다. 최고의 해법은 가장 정확한 선량을 주는 것인데 이것은 각 환자의 CT 자료를 기반으로 정확한 선량계획 시뮬레이션 시스템을 사용하는 것이다. 우리는 네트워크 기반과 웹 기반을 이용한 환자 맞춤형 치료계획 시뮬레이션 시스템개발을 위해 관련된 4가지 컴퓨터 프로그램을 개발하고 있다. 환자의 CT자료를 이용하여 각 환자의 표적 자료를 만드는 프로그램, 이 표적자료를 바탕으로 방사선 선량 시뮬레이션을 하는 병렬 몬테카를로 프로그램, 선량주사변수들을 최적화시키는 프로그램, 그리고 계산결과를 시각화하는 프로그램들이다. 모든 소프트웨어는 약 100-200개의 개인컴퓨터로 구성된 클러스터에서 병렬모드로 운영이 된다. 이와 같이 방대한 하드웨어와 소프트웨어의 효과적인 관리를 각 병원에 맡기는 것은 효율적이지 못하기 때문에 이를 중앙에서 관리하면서 각 병원에서는 네트워크나 웹을 통하여 마치 모든 것이 자기 병원에 있는 것과 같이 편리하게 쓸 수 있게 하는 시스템으로 의사와의 계속적인 의사소통은 클라이언트-서버 시스템의 메신저 기능을 이용한다.

• 약학회지
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• 제59권5호
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• pp.235-244
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• 2015

The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제6권10호
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• pp.2708-2730
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• 2012

The growing concern for the protection of personal information has made it critical to implement effective technologies for privacy and data management. By observing the limitations of existing approaches, we found that there is an urgent need for a flexible, privacy-aware system that is able to meet the privacy preservation needs at both the role levels and the personal levels. We proposed a conceptual system that considered these two requirements: a graph-based, access control model to safeguard patient privacy. We present a case study of the healthcare field in this paper. While our model was tested in the field of healthcare, it is generic and can be adapted to use in other fields. The proof-of-concept demos were also provided with the aim of valuating the efficacy of our system. In the end, based on the hospital scenarios, we present the experimental results to demonstrate the performance of our system, and we also compared those results to existing privacy-aware systems. As a result, we ensured a high quality of medical care service by preserving patient privacy.

• 보건행정학회지
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• 제32권1호
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• pp.94-106
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• 2022

Background: The efforts to build more "people centered," "patient centered" health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called "Medical Service Experience Survey (MSES)." There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: "doctor experience," "nurse experience," "outpatient service experience," and "patient satisfaction." It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as "experiences on medical staffs considering physical exposure" or "experiences related to personal information exposure," were answered in conjunction with items of "nurse experience." Besides, patients responded that administrative elements of medical services, such as "experiences of comfort in medical institutions" and "experiences of satisfactory administrative services," were related to the items of "nurse experience." The answers of patients who visited traditional medical hospitals and clinics about "doctor experience" and "nurse experience" were not discerned statistically, and the answers to "doctor experience," "nurse experience," and "medical institution experience" were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.