• Title/Summary/Keyword: Patient management system

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The variability of tumor motion and respiration pattern in Stereotactic Body RadioTherapy(SBRT) for Lung cancer patients (RPM SystemTM을 이용한 호흡 관찰의 유용성 평가)

  • Park, hyun jun;Bae, sun myeong;Baek, Geum Mun;Kang, tae young;Seo, Dong Rin
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.17-25
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    • 2016
  • Purpose : The purpose of this study is to evaluate the variability of tumor motion and respiration pattern in lung cancer patients undergoing Stereotactic Body RadioTherapy(SBRT) by using On-Board imager (OBI) system and Real-time Position Management (RPM) System. Materials and Methods : This study population consisted of 60 lung cancer patient treated with stereotactic body radiotherapy (48 Gy / 4 fractions). Of these, 30 were treated with gating (group 1) and 30 without gating(group2): typically the patients whose tumors showed three-dimensional respiratory motion > 10 mm were selected for gating. 4-dimensional Computed Tomography (4DCT). Cone Beam CT (CBCT) and Fluoroscopy images were used to measure the tumor motion. RPM system was used to evaluate the variability of respiration pattern on SBRT for group1. Results : The mean difference of tumor motion among 4DCT, CBCT and Fluoroscopy images in the cranio-caudal direction was 2.3 mm in group 1, 2. The maximum difference was 12.5 mm in the group 1 and 8.5 mm in group 2. The number of treatment fractions that patient's respiration pattern was within Upper-Lower threshold on SBRT in group 2 was 31 fractions. A patient who exhibited the most unstable pattern exceeded 108 times in a fraction Conclusion : Although many patients in group 1 and 2 kept the reproducibility of tumor motion within 5 mm during their treatment, some patients exhibited variability of tumor motion in the CBCT and Fluoroscopy images. It was possible to improve the accuracy of dose delivery in SBRT without gating for lung cancer patient by using RPM system.

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Development of Information System in Nursing Practice;spinal cord injury patients (간호실무를 위한 정보체계 개발;척수손상 환자를 중심으로)

  • Kang, In-Soon;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.43-57
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    • 1996
  • The purpose of this research conducted has been an the development of a computer program to be used for nursing of spinal cord injury patients. The research is also intended to contribute by supplying the basic data, to the development of other programs in relevant areas where similar nursing information system is required. This research used System Development Life Cycle method. Results from the study were as follows : The scope of Information System in nursing practice were based on a wide range of mateials as charts at four hospitals in Pusan that cover the nursing period of spinal cord injury patients from admission to discharge and other sources of reference, the research is done for nursing diagnosis, nursing history, admission and discharge education, and the performing of doctor's order, which were divided into a subsystem that consisted of help, Patient Management, Performing of Docter's Order, and Basic Data Management and then these was analysed systematically using Hierachy Plus Input Process Output, necessary information, data flow diagram, and conceptual designs were developed for chosem system. Furthemore, the system has been programed by a conceptual design that includes the objects of the program and the origins of the sources. The oder to make sure of the proper function, the computer program was actually applied to a nursing practice that had been developed for a hypothetical situation through the two nurses who were in charge of spinal cord injury patients after they were trained to understand the structure and the contents of computer program about the nursing practice from using the computer program developed. Also, the compensatory strategy has been worked out against any problems to arise. It is expected that this kind of nursing practice information system to be used for the spinal cord injury patients that has been developed through the processes shown above will increase the satisfaction for both patients and nurses by enabling them to give more professional advice and service to the development of more information systems for many hospitals.

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An Efficient m-Healthcare Service Model using RFID Technique (RFID 기술을 이용한 효율적인 m-헬스케어 서비스 모델)

  • Jeong, Yoon-Su;Kim, Yong-Tae;Park, Gil-Cheol
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.149-156
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    • 2015
  • Due to a change of food culture, many patients suffering from various diseases such as hypertension, heart disease, stroke, cancer. However, it takes a long time in the hospital for many patients due to the administration before the patient care process. In this paper, we propose a m-Healthcare service model that patients can receive medical services without the inconvenience offers by reducing the administrative hospital treatment that can automatically recognize through the hospital installed RFID readers when the patient patients with various diseases are foreign to the hospital. In particular, the proposed model improves the operational efficiency of the existing healthcare system by shortening the treatment time for medical personnel to help patients in emergency situations can determine automatically the patient's status does not give the disease type and condition of the patient to health care personnel. Test results, service latency, efficiency, etc. patient satisfaction, and evaluate the existing health care system model results, the proposed method was improved service delay existing techniques average 16.5% efficiency was higher 27% of patients service satisfaction was improved by 22.4% on average.

Accuracy and radiation exposure from image-guidance in Tomotherapy Hi-Art System (토모테라피 Hi-Art System의 영상유도 정확성 평가와 환자 피폭에 관한 연구)

  • Jang, Jae-Uk;Lim, Hyun-Soo;Han, Man-Seok;Kim, Yong-Kyun;Jeon, Min-Cheol
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.577-584
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    • 2013
  • IGRT(Image Guided Radiation Therapy) in radiation therapy is a very useful technique in order to increase setup of patient and position reproducibility. Tomotherapy can increase accuracy of setup to take IGRT by MVCT, but it be for verified accuracy of Image guided, and MVCT occurs the exposure of patient. Through this study, IGRT accuracy of Tomotherapy is very accurate within 1.0mm. When MVCT using Tomotherapy phantom for QA, QC be taken, exposure dose is Fine(2mm Slice thickness) 3cGy, Normal(4mm Slice thickness) 1.5cGy, Corse(6mmSlice thickness) 1.0cGy. Measurement value of spatial resolution using AAPM CT performance phantom did't cause a big difference. As a result, ability of IGRT in Tomotherapy is very accurate. While obtaining image for IGRT, we should minimize expose range because patient's be exposed to radiation. We should make an effort to do accurate radiation therapy to minimize exposure of patient by selecting the appropriate thickness of MVCT depending on patient's body and treat area.

Differences of Satisfaction between Patients and Hospital Employees with Medical Care Services in the General Hospital (환자와 병원종사자간의 의료서비스 만족도 차이분석 -종합병원을 중심으로-)

  • 김순재
    • Journal of Families and Better Life
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    • v.17 no.1
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    • pp.73-86
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    • 1999
  • The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.

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Recurrent hemolytic uremic syndrome caused by DGKE gene mutation: a case report

  • Shin, Baek Sup;Ahn, Yo Han;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.58-62
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    • 2022
  • Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury without any association with preceding diarrhea. Dysregulation of the complement system is the most common cause of aHUS, and monoclonal humanized anti-C5 antibodies are now recommended as the first-line treatment for aHUS. However, if the complement pathway is not the cause of aHUS, C5 inhibitors are ineffective. In this study, we report the second reported case of aHUS caused by DGKE mutations in Republic of Korea. The patient was an 11-month-old infant who presented with prodromal diarrhea similar to typical HUS, self-remitted with conservative management unlike complement-mediated aHUS but recurred with fever. While infantile aHUS often implies genetic dysregulation of the complement system, other rare genetic causes, such as DGKE mutation, need to be considered before deciding long-term treatment with C5 inhibitors.

Detecting Bladder Biomarkers for Closed-Loop Neuromodulation: A Technological Review

  • Park, Eunkyoung;Lee, Jae-Woong;Kang, Minhee;Cho, Kyeongwon;Cho, Baek Hwan;Lee, Kyu-Sung
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.228-236
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    • 2018
  • Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient's state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.

A Study on Design of Agent based Nursing Records System in Attending System (에이전트기반 개방병원 간호기록시스템 설계에 관한 연구)

  • Kim, Kyoung-Hwan
    • Journal of Intelligence and Information Systems
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    • v.16 no.2
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    • pp.73-94
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    • 2010
  • The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

Impact of the Purchasing Price Reimbursement System for Insurance Drugs upon the Health Insurer's Financial Situation (실거래가상환제의 건강보험재정에 대한 영향)

  • Jeong, Hyoung-Sun;Lee, Eui Kyung;Kim, Eun Jung;Ryu, Gun-Chun;Song, Yang Min;Kim, Sun-Ju
    • Health Policy and Management
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    • v.15 no.3
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    • pp.40-59
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    • 2005
  • The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.

The Development of u-Drug Cap based on NFC for Medication Information Management (복약 정보 관리를 위한 NFC기반 u-Drug Cap 개발)

  • Yoon, Taebok;Lee, Jong-Hee;Lee, Kwang-Hyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.2165-2171
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    • 2015
  • Due to the development of improved living conditions and medical technology in recent periodic taking drugs is increasing through the outpatient rather than inpatient hospital care. Particularly in the case of patients suffering from geriatric diseases. This geriatric patients should have more attention to the taking medication management because it must keep the medication period. In this paper, we propose and describe an taking medicine information service system for the period and stable taking medicine in patients using the NFC-based u-Drug Cap and technology development and system test results. The developed system is through proper taking medicine information and alarm of geriatric patients or elderly patients. The patient's health can be maintained by preventing not taking and over taking of medicine.