{"title":"Assessing the Quality of Structured Data Entry for the Secondary Use of Electronic Medical Records","authors":"Insook Cho","doi":"10.4258/JKSMI.2009.15.4.423","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.423","url":null,"abstract":"Objective: The raw material of quality improvement is information, whose building block is data. Data in an electronic medical record system have many secondary uses beyond their primary role in patient care, including research and organizational management. This study investigates the data quality of clinical observations recorded using a structured data entry format and assesses the impact of erroneous data. Methods: A total of 4,580,846 input events from 3,348 inpatients, gathered over a three year period in a teaching hospital, were analyzed by using a 2-by-2 conceptual matrix framework for he appropriateness of data types and semantics. The data were classified into three categories: fully usable, partially usable, and not usable. Results: The fully usable data constituted 88.6% of the correctly entered data the remaining 11.4% were erroneous. Among the erroneous data, 0.8% were partially usable (n=3,929), and the remaining 99.2% (n= 510,437) were identified as needing further assessment to improve their quality. Conclusion: Clinical information systems have increasingly used structured data entry or record templates, but the low quality of collected data has severely limited their secondary use potential.","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124693116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development and Validation of Archetypes for Nursing Problems in Breast Cancer Patients","authors":"Y. Min, Hyeoun-Ae Park","doi":"10.4258/JKSMI.2009.15.4.393","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.393","url":null,"abstract":"Objective: Archetypes as structured models of clinical content are considered to be the key broker between the reference models and terminology. This study developed and validated archetypes for nursing problems with breast cancer patients. Methods: Archetypes were developed with the focuses and characterizing categories to describe the nursing problems identified from the perioperative nursing records of breast cancer patients, a literature review and experts’ survey. The archetypes were validated by experts and applied to the clinical cases. Results: Forty seven focuses and 22 characterizing categories of nursing problems were identified. Forty five archetypes, except for the symptoms of URI and vital signs, could be grouped into 16 different types. The symptoms of URI and vital signs were modeled by a combination of other archetypes. The experts’ evaluation and application to clinical cases demonstrated the validity of the archetypes developed. Conclusion: Archetypes for nursing problems developed in this study can ensure interoperability and contribute to the exchange and sharing of the high quality structured data and information. (Journal of Korean Society of Medical Informatics 15-4, 393-401, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117202508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Kang, Kwang Gi Kim, J. Bae, Chang-Bu Jeong, Sungjun Kim
{"title":"A Study of Joint Space Narrowing and Erosion in Rheumatoid Arthritis","authors":"H. Kang, Kwang Gi Kim, J. Bae, Chang-Bu Jeong, Sungjun Kim","doi":"10.4258/JKSMI.2009.15.4.483","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.483","url":null,"abstract":"Objective: This study was conducted to measure radiographic joint space width and to estimate erosion in the hands of patients with rheumatoid arthritis. It showed that joint space width, homogeneity, and invariant moments are parameters to discriminate between the normal and the rheumatoid joint. Methods: In order to measure the joint space width and to estimate erosion in the finger joint, 32 radiographic images were used - 16 images for training and 16 images for testing. The joint space width was measured in order to quantify the joint space narrowing. Also, homogeneity and invariant moments was computed in order to quantify erosion. Finally, artificial neural networks were constructed and tested as a classifier distinguishing between the normal and the rheumatoid joint. Results: The joint space width of normal was 1.040.15 mm and the width of patients with rheumatoid arthritis was 0.940.15 mm. The Homogeneity of normal was 16568.832669.83 and invariant moments were 6843.452937.55. They were statistically difference (p<.05). Using these characteristics, artificial neural networks showed that they discriminate between normal and rheumatoid arthritis (AUC=0.91). Conclusion: Measuring joint space width, estimating homogeneity, and invariant moments provide the capability to distinguish between a normal joint and a rheumatoid joint.","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121894755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Comparison of the Nursing Records of Hysterectomy Patients: Pre and Post Implementation of an ICNP Based Electronic Nursing Record System","authors":"W. Choi, Young Sook Park, Insook Cho","doi":"10.4258/JKSMI.2009.15.4.455","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.455","url":null,"abstract":"Objective: This study compared the abilities of electronic nursing records, which are based on standard nursing terminology, and paper-based nursing records to support the nursing process. Methods: The nursing records of 38 pairs of inpatients admitted to a gynecology nursing unit were selected. The data from the paper records were obtained manually by a chart review as single statement units. The electronic records were extracted from a computerized system. The statements were categorized using the NANDA diagnosis and the modified Clinical Care Classification. Based on a semantic analysis of the components of the nursing process, the completeness of the nursing records was classified into complete and incomplete patterns according to the presence and relevancy of the assessment, the diagnosis, the intervention and the outcome. Results: The numbers of nursing diagnoses used and the unique nursing diagnoses were both higher in the electronic records than those in the paper records. The number of statements of nursing assessments/outcomes, and nursing interventions was 1.4-fold higher in the electronic records than that in the paper records respectively. The proportion of complete patterns of the nursing process was 3.4% in the paper records and 25.7% in the electronic records. Conclusion: These results suggest that electronic records are better than paper records to support the nursing process in terms of the quantitative and qualitative aspects of nursing documentation. (Journal of Korean Society of Medical Informatics 15-4, 455-464, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"714 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133051165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Jung, R. W. Park, Y. Lim, Hee-Jung Hwang, Young-Ho Lee, K. Jeong, Dong-Kyun Park
{"title":"Development and Application of the RFID System for Patient Safety","authors":"E. Jung, R. W. Park, Y. Lim, Hee-Jung Hwang, Young-Ho Lee, K. Jeong, Dong-Kyun Park","doi":"10.4258/JKSMI.2009.15.4.433","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.433","url":null,"abstract":"Objective: A system for reinforcing the patient safety has been established based on RFID (Radio Frequency Identification) technology in order to minimize a variety of potential medical errors which can take place in hospitals. The system is intended to prevent simple errors or misunderstandings attributed to manifold surgery, transfusion, and medication errors. Methods: The RFID system was developed and established in one general hospital. The system was applied to managing the patient in the run-up to surgery during anesthesia preparation, transfusion, and anticancer medications, of which procedure information and the patient information are rechecked for assurance, respectively. Results: With regard to the technological aspects, the system used 13.56 MHz of spectrum bandwidth and tags complying with ISO 15693 standard. The tag readers varied with the work, PDAs in the intensive care unit, and laptop computers in the anesthesiology department and on the general wards. After applying the system, we surveyed user's usage and satisfaction. Conclusion: The results of our survey indicated a high level of satisfaction with the RFID system in terms of reinforcing the patient's safety in medical environments. Respondents stated that patients were likely to wear an electronic bracelet, even if inconvenient, with their information revealed on the wrist and while going through extended medical procedures. Nurses had intentions to utilize the RFID system for managing hospital assets and tracking patients. A revitalization of the RFID system would be network stability, including the network environment, as well as quantitative effectiveness analysis. (Journal of Korean Society of Medical Informatics 15-4, 433-444, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"95 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124746206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Simulation of a Multiversion Medical Data Management System for Medical Information Security","authors":"H. Jeong","doi":"10.4258/JKSMI.2009.15.4.403","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.403","url":null,"abstract":"Objective: If medical information is integrated for management purposes, the efficiency of the system may increase. In addition, diagnostic abilities of physicians may be improved through the increased speed and accuracy of information processing. Medical databases must ensure high performance in terms of speed and reliability. In addition, access to medical information must be restricted to persons with proper authorization to ensure the privacy of patients. Methods: Thus, the security of medical database systems with multiversion data requires both the existing management system and security policies. Results: This study simulates the performance of a dynamic multiversion data management system in terms of security levels and update operations. Conclusion: The results show that a dynamic multiversion data management system increases disk availability more than a double version system. In addition, if the number of security levels is small, throughput will be improved because the security overhead will be low. However, frequent update operations will decrease throughput whenever versions are created at each interval. (Journal of Korean Society of Medical Informatics 15-4, 403-410, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125940743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeongeun Kim, Sun-Young Lee, Sun-Young Park, Meihua Piao, Jeeyoung Joo, Sukwha Kim
{"title":"Comparison of Physicians' and Patients' Perception on the Effect of Internet Health Information","authors":"Jeongeun Kim, Sun-Young Lee, Sun-Young Park, Meihua Piao, Jeeyoung Joo, Sukwha Kim","doi":"10.4258/JKSMI.2009.15.4.373","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.373","url":null,"abstract":"Objective: To determine the differences between the patient's and physicians' views of the effects of internet health infor- mation on the physician-patient relationship. Methods: An online survey was carried out with 25 items developed by revising the questionnaire of Direct-to-Consumer Advertising to accommodate the internet health information. The respondents were 671 patients who were active participants in online patient communities and 493 physicians who were the professors of medical schools and practicing physicians. Results: Most of the patients were positive toward the Internet Health Information saying that it gives them advice from a doctor with self-confidence, allows them to follow their doctor's directions well, obtain more medical treatment after retrieving the information, etc. In contrast, physicians perceived that the internet health information may have variety of negative effects, such as increasing the healthcare cost, unnecessary clinic visits and undermining of the doctor-patient relationship. There were significant differences in the perspectives between the physicians and patients. Conclusion: It will be necessary to ensure experts provide internet health information, which will have bene- ficial effects on the quality of care, physician-patient relationship, and health service utilization. (Journal of Korean Society of Medical Informatics 15-4, 373-379, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117261921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Yun, Mi-Jung Kim, SunJu Ahn, Misook Kwak, Y. Kim, H. Kim
{"title":"The Development of Clinical Terminology Dictionary for Integration and Management of Clinical Terminologies in EMR Systems","authors":"J. Yun, Mi-Jung Kim, SunJu Ahn, Misook Kwak, Y. Kim, H. Kim","doi":"10.4258/JKSMI.2009.15.4.411","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.411","url":null,"abstract":"Objective: The development of a dictionary of clinical terminology based on medical concepts is essential for understanding the precise meanings of the clinical terminologies used in EMR systems. For an unambiguous presentation and retrieval of the terminologies in practical data entry, this study propose a clinical terminology dictionary, which integrates and manages the wide range of data in EMR Systems. Methods: The structure of the system and attributes were defined. The structures should satisfy the following: all terminologies should be consistent with the medical concepts, all concepts have multiple relationships, all concepts have many synonyms, all concepts can be mapped to concepts in an external medical terminology system, and all concepts can be grouped as value sets by setting the \"domain\". Results: With the derived entity objects and attributes, the physical clinical terminology database was constructed and an editor was developed using MySQL 5.0.45 and JAVA Swing. To verify the structure and contents of the developed clinical terminology dictionary, the terminology experts used the editor to search and register the medical concepts. Conclusion: Although the contents refinement and complements are an unsolved problem, it is anticipated that the proposed research will provide unambiguous meanings of the clinical terminology and be applicable to many services in EMR systems. (Journal of Korean Society of Medical Infor- matics 15-4, 411-421, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122522617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Legislation Direction for Health Information Privacy in the Telemedicine Era","authors":"Eun Ja Lee, So Yoon Kim, Y. Chae","doi":"10.4258/JKSMI.2009.15.4.361","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.361","url":null,"abstract":"The Korean law on medicine was amended in 2003 to introduce new provisions for telemedicine, electronic medical record, and electronic prescription. However, this has not satisfied the realities of the increased demand on medical services and related technology development, resulting in calls for a legislative amendment. In this regard, recent active promotion projects and the advance notice proposing a new amendment by the Ministry of Health, Welfare, and Family Affairs have raised the need for active discussions on telemedicine because the current law on medicine and its amendment do not adequately address the individual privacy protection aspect in the telemedicine environment. In this regard, this study examines current domestic and foreign legal systems on telemedicine and privacy protection, drawing and reviewing subjects to be discussed for individual privacy protection in telemedicine, and proposes plans that may improve Korea’s legal system. The domestic and foreign literature on telemedicine and privacy protection was reviewed, recent legislations on telemedicine and views of interest groups were considered, and expert opinions were collected. In addition, the main discussions on privacy protection in telemedicine were identified and reviewed, including information ownership, the scope of privacy protection, the right to review and request correction, and privacy protection matters related to foreign patients. The recent amendment to tele medicine contains a provision only on penalties for privacy protection violations. The main discussions in this study on privacy protection are expected to be reflected in future amendments to enforcement rules and sub-ordinances such as the enforcement ordinance.","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131303325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Korean Version of the WHO International Classification for Patient Safety: A Validity Study","authors":"Jeongeun Kim, Jaeho Lee, Sunyoon Lee","doi":"10.4258/JKSMI.2009.15.4.381","DOIUrl":"https://doi.org/10.4258/JKSMI.2009.15.4.381","url":null,"abstract":"Objective: The conceptual framework for the international classification for patient safety (ICPS) was released in January 2009. Since then, a Korean version of ICPS was developed. This paper describes the translation process and evaluates the validity of the Korean version. Methods: Two research groups were involved in the development of the Korean version of ICPS. The draft of the Korean version was developed through intensive consultations with experts and extensive consensus building efforts. Subsequently, a modified Delphi method was used to develop the final version. Twenty-one experts, in- cluding professors in medicine and nursing, quality experts, and clinical experts, had been engaged in the process. A back translation was also done to evaluate the validity of the final Korean version. The level of agreement between the original version and the back translated version in terms of 48 key concepts was evaluated. The levels were classified as complete, partial, and no agreement. Results: Thirty concepts (62.5%) agreed completely, 11 concepts (22.9%) agreed partially, and seven concepts (14.6%) had no agreement. Overall, the agreement between the original and the back translation was 85.4%. Conclusion: Because no standard classification currently exists for patient safety in Korea, this Korean version of ICPS can be used as a standard. However, the relevance and utility of this classification must be further evaluated through clinical field tests. (Journal of Korean Society of Medical Informatics 15-4, 381-392, 2009)","PeriodicalId":255087,"journal":{"name":"Journal of Korean Society of Medical Informatics","volume":"261 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115012718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}