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

OBJECTIVE: The purpose of this study was to analyze current status of the web sites dealing with asthma in the Internet, and to evaluate their technical aspects and contents. METHODS: The evaluation tool consisted of four areas(construction, operation, accessibility, and content) with twenty-six items. Four sites including the contents related with symptoms of asthma, consultation of health professionals, and treatment and nursing for asthma were selected to be analyzed. RESULTS: The results of the analysis were as follows: 1) there was no web site dealing with asthma managed by public institutions 2) the only 5% of the top 100 sites were found to be related with the asthma by exploring the top five search engines in Korea and 3) the evaluation scores four web sites were 6-11 out of 18 in the category of construction, 10-21 out of 24 in operation, 5-10 out of 15 in accessibility, and 8-18 out of 21 in content. CONCLUSION: In conclusion, it will be possible to prevent asthma at first through web sites, which will be one of the most beneficial aspects of web site, so the system to evaluate web sites should be developed to provide high-quality information about asthma.
Asthma ; Health Occupations ; Internet ; Korea ; Nursing ; Search Engine

OBJECTIVE: In the mobile computing environments, doctors or patients with mobile devices can access services at any time, any place. It makes chronic diseases, such as asthma care successively and in long-term. This paper presents a new multiagent system using data mining technique for the management of asthma in mobile computing environments. METHODS: In mobile computing environments, mobile communication is prone to disconnection. To use the services when disconnected, we locally store the recommendation information in mobile devices. Then, when user reconnects network, the new information is delivered in mobile devices. Because mobile devices have a limitation of resource, we store only patterns and recent data. We adopted data mining technique from the large pool of accumulated patients data can be utilized to summarize observed correlations and trends. RESULTS: We propose multiagent system composed of a Pattern Agent, a Selection Agent and a Recommendation Agent. They make asthmatic-caring system access effectively in mobile computing environments. We describe the underlying architecture and the process. Then we make a prototype with asthmatic patients data in the Severance Hospital in Korea. CONCLUSION: The results of our study can be contributed to aid management of asthma in mobile computing environments.
Asthma* ; Chronic Disease ; Data Mining* ; Humans ; Korea ; Telemedicine

OBJECTIVE: To provide medicare services for patients demands satisfyingly, immediate introduction of the Customer Relationship Management(CRM) is raised inevitable. In this paper we proposed that the minimizing the hospital losses by cut down the rate of cancelation of the hospital reservation, to secure patients as clients. METHODS: And to implement the data mining-based healthcare customer relationship management system applied from the back propagation algorithm of the artificial neural networks technique and the Feature GENeration(FGEN) algorithm of the decision tree technique. RESULTS: In this paper we divided a patient to an appropriate group through a data mining process and classified more correct customer through a campaign process. CONCLUSION: These results would be essential for new patients to enhance hospital reliability, for hospital to select profitable patients with high loyalty and to manage patients efficiently.
Data Mining* ; Decision Trees ; Delivery of Health Care* ; Humans ; Medicare

OBJECTIVE: For the effective retrieval of clinical information, the elaborate indexing is essential. Two major types of indexing are the human indexing and the automatic or machine indexing. Human indexing shows higher quality but is time consuming, labor-intensive and inconsistent in term assignment activity. METHODS: Using the Unified Medical Language System (UMLS) MetaMap program, we mapped the free text from the diagnosis section of radiology reports into UMLS concepts. To improve the precision of UMLS concept indexing by MetaMap, we evaluated the UMLS subset mapping and semantic type filtering methods, determining the best combination for improved precision. RESULTS: After calculating the candidates from subset combinations, we obtained more enhanced results by semantic-type filtering. CONCLUSION: The results may be improved for the complete automation of indexing process.
Abstracting and Indexing as Topic* ; Automation ; Diagnosis ; Humans ; Semantics ; Unified Medical Language System*

OBJECTIVE: For disease prevention and health promotion, it is important that individual health information is managed continuously and can be retrieved easily when necessary. We propose a model for integrated management of diverse individual health information that is generated and managed in heterogeneous Health Information System(HIS)s at hospitals or health centers. METHODS: We use XML and relational database together to represent the health information structurally and manage it flexibly. In order to show the effectiveness of our method, we developed a prototype of Intermediate System for integration and analysed the result. RESULTS: The Intermediate System for integration provides the schema of health information, represents the information in forms of XML strings by the subjects, and stores each XML string as one field of relational database. In each heterogeneous HIS, there is an adaptor that transforms the health information into XML according to the schema. The messages for transmission between each HIS and Intermediate System are represented in XML. CONCLUSION: The experimental study shows that using relational database and XML together provides a flexible, extensible and structured way of representing complex, dynamic, structurally-variant and large-scale information, on the premise that the database tables are partitioned or distributed according to the status of server.
Health Promotion

OBJECTIVE: For the ubiquity of medical service, when user who has proper authority want to access medical data, user accessability should be assured. And the security of the disclosed medical data is important. This paper presents single user access interface on multiple patient reservoirs and elaborate access control using the Role-Based Access Control(RBAC) system. METHODS: Proposed system consists of 4-tier architecture that is client application, Access Control Central(ACC) agent, Local Access Control(LAC) agent and Hospital Information Systems(HIS). User requests medical data with client application. ACC notarizes user identity and controls access of user request and selectively encrypts medical data. LAC charges data conversion for communication between ACC and HIS. HIS has repositories of medical datum. System provides security service with digital certificate, X.509v3, of user. RESULTS: User requests medical data of several HIS approaching single ACC not by each HIS. Through conversion process of LAC, data that is described XML and is used for communication inter system enables information exchange with single common data format that is independent to several HIS. CONCLUSION: In the proposed system, user accesses medical datum of several HIS regardless of location and has consistent access interface. And using independent format against each HIS makes easy information exchange between several HIS. Transferred data maintains security about significant datum by selective encryption and increases encryption efficiency. Unified access control about multiple patient reservoirs that are scattered in other places provides unified and precise diagnosis of patient information. And it functions the portal of collaborate treatment in inter-HIS.
Computer Security ; Delivery of Health Care, Integrated ; Diagnosis ; Health Services Accessibility ; Hospital Information Systems ; Humans

OBJECTIVE: To evaluate of virtual angioscopy was implemented using MR(magnetic resonance) angiography image of carotid artery. METHODS: The endoscopy system provides a 3D volume rendered image as a navigation map and has the multi planar reformation image along the path and a 2D axial image as a reference image. We segmented the common carotid artery and internal, external carotid artery from the MR angiography image. We used the coordinates as a navigation path for virtual camera that were calculated from medial axis transformation. We used the perspective projection and marching cube algorithm to render the surface from volumetric MR angiography image data. RESULTS: The virtual angioscopy is highly recommended as a diagnosis tool with which the specific place of stenosis can be identified and the degree of stenosis can be measured qualitatively. CONCLUSION: Virtual angioscopy is one of the powerful tool for non-invasive carotid artery and many in-vitro, in-vivo studies have shown the artery stenosis detection. Inside of the carotid artery is one of the body region not accessible by real optical endoscopy but can be visualized with virtual endoscopy.
Angiography* ; Angioscopy* ; Arteries ; Axis, Cervical Vertebra ; Body Regions ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, External ; Carotid Stenosis ; Constriction, Pathologic ; Diagnosis ; Endoscopy

OBJECTIVE: A sleep apnea is the most frequent symptom among sleep disorders. As the number of aged people are increasing, research activities are also increasing to monitor sleeping disorders of the elderly who lives alone. We proposed a new processing algorithm to measure the quantity of breaths accurately. METHODS: We improved the conventional center-of-mass method and further apply the projection profile method. RESULTS: In this study a system that can monitors respiration non-invasively and automatically, by identifying the movement of the chest and abdomen using image processing technique during sleep, was implemented. We can see breathing status in real time based on the acquired breathing waves. To verify the designed system, the values from the polysomnography were compared and analyzed to validate the system accuracy. As a result, the mean accuracy is 96%. CONCLUSION: We can simply monitor the sleep apnea with no sleep interferences.
Abdomen ; Aged ; Humans ; Polysomnography ; Respiration ; Sleep Apnea Syndromes* ; Sleep Wake Disorders ; Thorax