OBJECTIVE: To determine the differences between the patient's and physicians' views of the effects of internet health information 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 beneficial effects on the quality of care, physician-patient relationship, and health service utilization.
Ambulatory Care ; Surveys and Questionnaires ; Dietary Sucrose ; Health Care Costs ; Health Services ; Humans ; Internet ; Schools, Medical

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.
Electronic Health Records ; Electronic Prescribing ; Expert Testimony ; Humans ; Jurisprudence ; Ownership ; Privacy ; Public Opinion ; Telemedicine

No abstract available.
Humans ; Informatics*

OBJECTIVE: To investigate a belt-type, biomedical mobile device capable of measuring patients' biomedical signals and sending the biomedical data to a remote medical server. This device was designed to measure and record ECG and motion signals continuously for a moving subject and, on in the event of an emergent situation, to notify a remote doctor of the situation by transmitting data on the emergent situation to a remote server through a CDMA network. METHODS: The developed system is composed of three parts: biomedical signal acquisition, biomedical data recording, and data transmission. We conducted four types of experiment in order to evaluate the developed system's accuracy, reliability, operability, applicability to daily life, and SMS alarm function. First, we tested the accuracy of the R-R interval by comparing the signals measured via the developed system with those via a commercialized ECG system while the subjects were sitting, standing, lying or cycling. Second, we tested the reliability of the transmitted data to the remote server when two types of emergent events are generated in the developed system using a patient simulator, and measured the battery life to determine the system life. Third, we experimentally examined the accuracy of the corresponding data transmitted to the remote server via the CDMA network when two types of event are generated for each of seven types of action (sitting, standing, standing up from the seat, ordinary walking, fast walking, cycling, and running) during daily life. Lastly, we tested the SMS alarm function. RESULTS: The acquisition and comparison of the subjects' biomedical signals and motion signals confirmed the accuracy, reliability, operability and applicability of the developed system to daily life. The ability of the system to monitor the ECG signals and motion signals during daily life was also demonstrated. CONCLUSION: The system was demonstrated to be very applicable to subjects requiring continuous monitoring for chronic disease and health management. Therefore, the developed system is expected to play an important role in building ubiquitous healthcare systems in Korea in the near future.
Chronic Disease ; Deception ; Delivery of Health Care ; Electrocardiography ; Humans ; Korea ; Organothiophosphorus Compounds ; Walking

OBJECTIVE: The development of information communication technology (ICT) and the demand for managing the healthy lives of individuals are accelerating the informatization of the health and medical field. Considering this environment and the needs of the individual, this paper has designed and developed a web and mobile storage device-based personal health record (PHR) system that individuals can manage by themselves anywhere, anytime, whether on-line or off-line. Based on the experience of implementing the system, its development method, results, and relevant technical issues are described. SYSTEM DESIGN AND DESCRIPTION: This system is implemented to manage PHR, including vital signs and ingested/consumed calories for a lifetime by connecting a PHR-integrated web server to each hospital's information system, and the PHR programs installed in the individual's PC or USB flash memory drive. To achieve this, an interface module, web server system, and PHR viewer program for individuals are developed. RESULTS: When it is off-line, the PHR program is operated to inquire the data saved in the DB, and the self-measured information can be inputted. When it is on-line, it calls the web service function to inquire the medical information, including hospital visit history, prescription history, diagnosis result, image inspection result and medical treatment result. CONCLUSION: This system connects home and mobile healthcare to hospitals but minimizes information leakage because the data is not accumulated. By loading a plug & play, PHR viewer to an easy-to-carry mobile storage device, the systems supports a sustainable health management.
Access to Information ; Delivery of Health Care ; Health Records, Personal ; Humans ; Information Systems ; Medical Records ; Memory ; Prescriptions ; Vital Signs

OBJECTIVE: The purpose of this paper was to quantify both the output and the impact of the relationship between Korean medical schools and their human resource departments and their ability to support the basic data for research goals of Korean medical schools. METHODS: The SCOPUS database was used to identify SCIE (scientific citation index expanded) articles produced by Korean medical schools between 1997 to 2008. The SCIE criteria, impact factors, and citation numbers were classified according to the database of Thomson Scientific Company. The human resources of medical schools were collected, such as the number of professors, graduate students, clinical fellows, residents, interns, and research assistants, through use of the medical deans' association biannual report. RESULTS: There was a significant difference across Korean medical schools in the number of the SCIE articles and citation numbers, resulting in only a few institutions producing most of the impact. Among the variables, the proportion of professors of basic medical science (p<.01) and the number of research faculties per professor (p<.01), were related significantly to the SCIE per professor. The only factor affecting both SCIE number and SCIE per professor was the number of research faculties per professor. The number of graduate students in the medical school had no impact on productivity. CONCLUSION: For the medical schools with restricted resources, the strategic plans for proper management of human resources are needed to promote scientific publication.
Efficiency ; Humans ; Korea ; Publications ; Schools, Medical

OBJECTIVE: Patients are becoming more active in communicating with doctors, forming e-communities, and participating in decision-making process of their treatment plans. However, only a few studies have examined how digitalized healthcare affects patients' and doctors' attitudes towards medical care services and deliverance structure, and the problems that might stem from these changes. In this study, we 1) explored the current changes in patients' healthcare utilization patterns and delivery structures, 2) examined the emerging behaviours and awareness of the participants, and 3) proposed how to prepare for such changes. METHODS: Face-to-face interviews and a group discussion with both Korean and US experts on consumer health informatics were conducted. Interview guidelines were developed based on reviews of recent studies on consumer health informatics. RESULTS: While the American scholars had larger expectations about the scope of the changes in the health care system induced by the digitalization of healthcare, compared to the Korean scholars, the interviewees and group discussion participants from both countries all agreed on the changes in medical environment and the increasing importance of medical information. The changes induced by the digitalization of healthcare were categorized as follows: (1) in the structure and location of healthcare service delivery, (2) in the doctor-patient communication methods, and (3) in the role of patients and increasing emphasis in empowerment. CONCLUSION: We expect that digitalized healthcare will continue to affect the doctor-patient relationship and change the deliverance structure. In order to better prepare for the fundamental paradigm shift in the healthcare system and increase the benefits to society of these changes, continuous and concerted policy efforts to protect the privacy and security of private information, alleviate the digital divide, and secure the quality of digitalized clinical knowledge will be required.
Delivery of Health Care ; Humans ; Informatics ; Power (Psychology) ; Privacy

No abstract available.
Delivery of Health Care*

OBJECTIVE: Breast cancer represents themost frequently diagnosed cancer in women. In order to reduce mortality, early detection of breast cancer is important, because diagnosis is more likely to be successful in the early stages of the disease. On the average, the reader's sensitivity can be increased by 10%with the assistance of computer-aided diagnosis (CAD) system. This paper presents a CAD system for the automatic detection of clustered micro-calcifications in digitized mammograms. METHODS: The proposed system consists of three main steps. First, breast region is segmented from original mammogram using contrast property of grey level co-occurrence matrix(GLCM). Second, potential micro-calcification pixels in the mammograms are detected by foveal method. Third, in order to reduce false-positive rate, individual micro-calcifications are detected by a set of 8 features extracted from the potential individual micro-calcification objects. RESULTS: In the result, Specificity and sensitivity are used to evaluate the detection performance of micro-calcifications.(sensitivity : 93.1%, specificity : 87.5%). CONCLUSION: This study could be a useful method for diagnosis of breast cancer as a CAD system.
Breast ; Breast Neoplasms ; Diagnosis ; Female ; Humans ; Mortality ; Sensitivity and Specificity

OBJECTIVE: This study aims to investigate the needs, uses and evaluation of Internet health information among students in a provincial university. METHODS: Nine hundred and sixty one student from seven different classes of S University located in Chungnam province participated in this study from 2nd to 9th May, 2005. A self-reported questionnaire was used to collect data. Collected data were analyzed on SPSS 11.0. RESULTS: 58.2% of them have needed some health information before and 84.6% of them needed the health information offered by a University. 67.2% of them use the Internet more than any other resource to acquire Health Information. 90.9% of them used a search engines to get health information on the Internet. 57.6% of them have searched for Internet health information to get information about specific disease or medical problem. The most frequently searched topics were LASIK(laser in-situ Keratomileusis), diabetes, and contraception. 39.6% of them evaluated the Internet health information was reliable and 55.8% of them satisfied with the Internet health information. CONCLUSION: Universities and their in-campus health centers are needed to offer the trustworthy Internet health informtaion on their official homepages so that the student can refer to the reliable and qualified Internet health information.
Chungcheongnam-do ; Community Health Centers ; Consumer Health Information ; Contraception ; Humans ; Internet* ; Search Engine ; Student Health Services