OBJECTIVE: To identify the technical considerations in implementing a barcode-based medication system and propose practical solutions for successful implementation of the system. In order to reduce medical errors related to medication and blood transfusion, we analyze various factors that hinder the successful implementation of the barcode-based medication system and discuss issues involved in the effective adoption of such a system. METHODS: The barcode-based medication system of this research uses one-dimensional, barcode bands on patients' wrists and two-dimensional barcodes attached to drug bags and blood bags. PDAs with barcode reading capability and wireless networking function are used, which enables Point of Care. The business process for applying the developed system and the current status of the system usage are analyzed. RESULTS: The factors causing a variety of system failures in the demonstration and pilot periods were identified and categorized as including PDA malfunction, PDA battery discharge due to users' carelessness, confusion in reading barcodes and so on. CONCLUSIONS: It is expected that the analyzed obstructive factors and the proposed technical considerations addressed in this paper can help other hospitals implement similar barcode-based medication systems successfully. Ultimately, this research will contribute to reducing medical errors and improving quality of patient care.
Adoption ; Blood Transfusion ; Commerce ; Medical Errors ; Medication Errors ; Medication Systems ; Patient Care ; Wrist

OBJECTIVE: The Clinical Decision Support System (CDSS) for drug prescriptions was developed by integrating the computerized physician order entry (CPOE) system to support doctors and pharmacists in making correct decisions on prescribing drugs in line with the prescription guidelines by the Health Insurance Review Agency (HIRA). The objective of this study was to evaluate the performance of the CDSS with respect to system quality, information quality, and user satisfaction in reducing prescription errors. METHODS: The study was based on survey data from 38 hospitals that were using the CDSS for drug prescriptions. To identify factors influencing the performance of CDSS, multiple linear regression and chi-square analyses were performed. RESULTS: Regression analysis showed that the variables for system quality and information quality significantly influenced the overall system performance. Specifically, ease of understanding the results and terminology assystem quality measures significantly influenced user satisfaction. Furthermore, based on chi-square analysis, two independent variables (ease of understanding results and decision support functions) were statistically significant with respect to all four dependent variables (information satisfaction, system satisfaction, willingness to recommend to other hospitals, and drug safety). CONCLUSION: Based on this study, users should be educated to improve their understanding of the system,and system and information quality should be continuously monitored to improve user satisfaction.
Drug Prescriptions ; Humans ; Insurance, Health ; Linear Models ; Pharmacists ; Prescriptions

OBJECTIVE: To supplement a previous study on the management of medical records with a view to preparing a system capable of ensuring basic patient rights regarding the protection of confidential medical information. The study objectives are to provide detailed guidelines to regulate the access and protection of medical information by analyzing patients' understanding and views regarding the dissemination of medical records. METHODS: A self-administered questionnaire was administered to 781 patients who visited five University hospitals located in Seoul, Busan, Gyeonggi, Chungnam and Jeonnam from July to September, 2008 and asked for copies of medical records to be issued. Data were analyzed by using the statistical program SPSS 13.0. RESULTS: More than 70% of respondents wanted to access their medical records after confirming the required documents. The highest distribution in the range of persons able to receive copies of medical records without the individual patient's consent or required documents was 'only personally' in each variable. Copies of medical records were issued mostly within 1 hour, while the appropriate time of issuing the copies was within one day. Half of respondents approved of a subscription system that did not require a doctor consultation. The results regarding changes in the ways to request/issue copies of medical records to improve the convenience for applicants differed significantly according to age. CONCLUSION: Considering the sensitivity of personal health information, medical records should only be issued with the patient's consent and by confirming the identity of the designated person with required documents. Furthermore, people should be aware of the importance of protecting personal health information, and medical institutes should inform the requirements for bringing the relevant documents. Medical institutes play an important role in protecting personal records, which necessitates generalized guidelines.
Academies and Institutes ; Coat Protein Complex I ; Surveys and Questionnaires ; Hospitals, University ; Humans ; Medical Records ; Patient Rights

OBJECTIVE: The aim of the study was to identify factors influencing the willingness of healthcare consumers to use personal health records (PHR) and to investigate the requirements for PHR services. METHODS: A face-to-face interview was conducted with 400 healthcare consumers from the 3rd-18th of July 2008 using a structured questionnaire. To identity factors affecting the willingness to use PHR and to pay for PHR services, logistic regression analysis was performed. To investigate the requirements for PHR services according to the willingness of the consumers to use PHR and to pay for PHR services, t-test analysis was conducted. RESULTS: Of the 400 healthcare consumers, 239 (59.8%) were willing to use PHR and 111 (27.8%) were willing to pay for PHR services. The willingness to use PHR was higher in the elderly, those with a disease, and those with experience to use health information on the Internet, and the willingness to pay for PHR services was higher in those with a relatively high income (p<0.05). The willingness to use PHR was approximately 13.5 (95% CI=1.43-126.55) and 3 times (95% CI=1.18-8.74) higher in those with average monthly household incomes >6,000,000 won and 4,500,000-6,000,000 won, respectively, than in those earning <1,500,000 won, and approximately 1.96 times (95% CI=1.18-3.27) higher in those with experience using health information on the Internet than in those without experience. The willingness to pay for PHR services was approximately 5.9 times (95% CI=1.84-19.06) higher in those with an income of 4,500,000-6,000,000 won than in those with an income <1,500,000 won (p<0.05). Demands for test results, medication history, family history, problem list, genetic information, clinical trial information, and social history were significantly higher in those with a willingness to use PHR and those with a willingness to pay for PHR services than in those without willingness to use PHR and those without a willingness to pay for PHR services (p<0.05). Compared to those without a willingness to pay for PHR services, those with a willingness to pay for PHR services showed a significantly higher demand for all the functions (p<0.01). CONCLUSION: The results of this study suggest that healthcare consumers potentially have a considerable demand for PHR services, and although it is not recognized and used widely yet, PHR is an essential service. In order to enhance people's awareness of PHR and to promote people to use PHR services, we need efforts and initiatives to execute campaigns and education for people to ease access to the service, and to reduce the gap in service utilization skills.
Aged ; Delivery of Health Care ; Electronic Health Records ; Family Characteristics ; Health Records, Personal ; Humans ; Internet ; Korea ; Logistic Models ; Surveys and Questionnaires

OBJECTIVE: With the rapid growth of picture archiving and communication systems (PACS) in the healthcare industry, this article describes the users' satisfaction with PACS by employing functional PACS features and the two concepts of perceived ease-of-use (PEOU) and perceived usefulness (PU), based on the extended technology acceptance model (TAM). METHODS: A cross-sectional survey was conducted with dentists in 25 dental hospitals which were cluster sampled from the national registry of 132 dental hospitals. Of the 204 respondents (response rate 81.6%), the data of 159 PACS users were analyzed using the structural equation modeling method. RESULTS: The fitted model showed significant relations between the technical components and the TAM variables, via the following three significant paths: hardware to PEOU, and software to PEOU and also to PU. Moreover, the critical path of TAM variables was observed: PEOU-->PU-->SAT. Therefore, the model produced three significant routes: hardware-->PEOU-->PU-->SAT, software-->PU-->SAT, and software-->PEOU-->PU-->SAT. CONCLUSION: Contrary to expectations, the direct effect of PEOU on user satisfaction was not significant. The final model provided critical paths from technical components to user satisfaction, by utilizing PEOU and PU as intermediary, latent factors.
Computers ; Critical Pathways ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dentists ; Health Care Sector ; Humans ; Radiology Information Systems ; Software

OBJECTIVE: To define the healthcare information industry in order to propose a developmental direction for the industry, classify and analyze the healthcare information industry business models, and propose strategic guidelines for development of the healthcare information industry. METHODS: A survey was conducted to investigate the private companies that provide healthcare information. For in-depth investigation of the study subjects, they were categorized based on their means of service provision. Open colloquium participation requests were extended to the representative companies, and five open-colloquiums were held. Additional data were obtained through a structured questionnaire investigating the problems and complaints, followed by a discussion on strategies and future plans. RESULTS: Through a review of previous research on internet business model classification, four major model classification systems were chosen and the healthcare information business models were classified. Based on the composite opinions derived from the participating companies, policy guidelines were proposed. CONCLUSION: It is important to cooperate with experts from each field under governmental supervision and help the general public appreciate the value of healthcare information, thereby achieving the industrialization and development of the health information provision business.
Commerce ; Delivery of Health Care ; Internet ; Organization and Administration ; Surveys and Questionnaires ; Industrial Development

OBJECTIVE: An automatic detection tool was created for examining health-related webpage quality we went further by examining its feasibility and performance. METHODS: We developed an automatic detection system to auto-assess the authorship quality indicator of an health-related information webpage for governmental websites in Taiwan. The system was integrated with the Chinese word segmentation system developed by the Academia Sinica in Taiwan and the SVM(light), which serve as an SVM (Support Vector Machine) Classifiers and a method of information extraction and identification. The system was coded in Visual Basic 6.0, using SQL 2000. RESULTS: We developed the first Chinese automatic webpage classification and information identifier to evaluate the quality of web information. The sensitivity and specificity of the classifier on the training set of webpages were both as high as 100% and only one health webpage in the test set was misclassified, due to the fact that it contained both health and non-health information content. The sensitivity of our authorship identifier is 75.3%, with a specificity of 87.9%. CONCLUSION: The technical feasibility of auto-assessment for the quality of health information on the web is acceptable. Although it is not sufficient to assure the total quality of web contents, it is good enough to be used to support the entire quality assurance program.
Asian Continental Ancestry Group ; Authorship ; Humans ; Quality Indicators, Health Care ; Sensitivity and Specificity ; Taiwan

No abstract available.

OBJECTIVE: This study determines the usability of the experimental u-Healthcare services program by examining the prior experience of COPD patients. METHODS: A qualitative content analysis and in-depth interviews were conducted. A total of eight COPD patients with prior experience in u-Healthcare services were interviewed between August 12, 2009 and September 10, 2009. RESULTS: The participants were asked open questions on u-Healthcare services, including their general experience, major attributes, service expectations, future usage intentions, and education and training needs. The participants were also asked to indicate current healthcare inconveniences that u-Healthcare services might solve. CONCLUSION: The results of this study based on patient experience suggest the potential viability of u-Healthcare services.
Delivery of Health Care ; Humans ; Intention ; Pulmonary Disease, Chronic Obstructive

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 1.04+/-0.15 mm and the width of patients with rheumatoid arthritis was 0.94+/-0.15 mm. The Homogeneity of normal was 16568.83+/-2669.83 and invariant moments were 6843.45+/-2937.55. 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.
Arthritis, Rheumatoid ; Finger Joint ; Hand ; Humans ; Joints