OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.
Classification ; Hospital Information Systems* ; Humans ; Information Centers

BACKGROUND: The Laboratory Information Management System (LIMS) requires instrument interfacing for good efficiency. However, most instrument interfacing cannot be used easily because instruments have different interface protocols and database systems are different in each hospital LIMS. Therefore, it is necessary to establish flexible interface software that would be useful for various instrument interfacing and can be handled by laboratory workers. METHODS: We categorized the raw data acquisition format of instruments into 7 classification according to the field delimiter, the field position and the test ID, and created software so that anyone could make the interface protocols for any instrument that supports the unidirectional or ASTM interface protocol, according to classification. The software also provides various functions, such as host communications and printing. RESULTS: With this software, we have interfaced 23 instruments without program languages (C, C++, Basic, Pascal, etc.) coding. It took about 1-4 hours for each instrument interface. The software supports a maximum of 8 simultaneous instrument connections with one personal computer. Also, it is possible to retrieve acquisition data from instruments with Microsoft Excel without LIMS. CONCLUSTIONS: The advantages of this software are as follows; 1. Markedly shortens the input time for data generated from automated instruments and reduces errors of manual data entry, 2. Effective increase in host computer performance, 3. Significantly saves time and cost for instrument interfacing. Therefore, this software was considered to be very useful for laboratory instrument interfacing.
Classification ; Clinical Coding ; Information Management ; Microcomputers

PURPOSE: Every country has a unique emergency medical system (EMS), as well as a medical service system. In Korea, relationship or cooperation between layperson, firehouse rescue and hospital is weak, and lack of involvement of emergency doctor in prehospital emergency medical system is one of the main cause of the phenomenon. There is possibility of improving prehospital EMS by the role of Emergency Medical Information Center (EMIC). Thus, the authors made a through investigation to improve the role of EMIC. METHODS: Questions concerning the following were sent to firehouse EMTs: 1) general matters related to communication, possibility of management after hospital arrival, rescue activities, etc., 2) educational matters about classification of severity, etc., and 3) matters about recognition and utilization of the EMIC. RESULTS AND CONCLUSION: An index guide for emergent management at the very spot where the accident took place is needed and should be published. Also, the EMIC must store more accurate information on emergency medical institutes, allowing firehouse rescue and hospitals to be more closely connected with each other by way of the EMIC.
Academies and Institutes ; Classification ; Emergencies ; Information Centers* ; Korea

OBJECTIVES: Classification of data elements (DEs), which is used in clinical documents is challenging, even in across ISO/IEC 11179 compliant clinical metadata registries (MDRs) due to no existence of reliable standard for identifying DEs. We suggest the Clinical Data Element Ontology (CDEO) for unified indexing and retrieval of DEs across MDRs. METHODS: The CDEO was developed through harmonization of existing clinical document models and empirical analysis of MDRs. For specific classification as using data element concept (DEC), The Simple Knowledge Organization System was chosen to represent and organize the DECs. Six basic requirements also were set that the CDEO must meet, including indexing target to be a DEC, organizing DECs using their semantic relationships. For evaluation of the CDEO, three indexers mapped 400 DECs to more than 1 CDEO term in order to determine whether the CDEO produces a consistent index to a given DEC. The level of agreement among the indexers was determined by calculating the intraclass correlation coefficient (ICC). RESULTS: We developed CDEO with 578 concepts. Through two application use-case scenarios, usability of the CDEO is evaluated and it fully met all of the considered requirements. The ICC among the three indexers was estimated to be 0.59 (95% confidence interval, 0.52-0.66). CONCLUSIONS: The CDEO organizes DECs originating from different MDRs into a single unified conceptual structure. It enables highly selective search and retrieval of relevant DEs from multiple MDRs for clinical documentation and clinical research data aggregation.
Abstracting and Indexing as Topic* ; Classification ; Data Collection ; Information Dissemination ; Information Storage and Retrieval ; Registries* ; Semantics

The purpose of the study is to develop a Web-based health information service system for the disabled. To identify users' information needs, we conducted an online and offline survey of the disabled and their caregivers as well as welfare institutes' staff. Based on the user's information needs, a Web-site was developed. The Web-site was evaluated by users for their satisfaction with the Web-site and by experts for the quality of the site. Content of the Web-site includes information on rehabilitation, welfare, and diseases causing the disability, definition and classification of disability, prevention from disability, management of the disabled, and disability related policies. Besides this information, FAQ on the disabled, statistics, links to the disabled institutes and Web sites, risk factor appraisal tool, and aiding tools for the disabled are added. The Web site is a subsystem of the Healthguide. Users rated efficiency, convenience, and design of the site highly in their satisfaction rating. Staff at welfare institutes rated design, efficiency, and relevance of the site highly in their satisfaction rating. Experts rated easiness, reliability, clearness and appropriateness of the site highly in their site evaluation. It is expected that this Web-based health information service system for the disabled will contribute to the disabled's health promotion as well as provide a community for the disabled related researchers, professionals and experts to share information on the disabled's health.
Academies and Institutes ; Caregivers ; Classification ; Health Promotion ; Humans ; Information Services ; Information Systems ; Internet ; Rehabilitation ; Risk Factors

The nursing process, composed of diagnosis, intervention and outcome, is practical and scientific approach. In addition, many studies on the nursing process have been performed. However, the nursing process has not applied to clinical fields. Therefore, we developed a nursing information system that supports nurses nursing diagnosis and intervention management. This system provides expected nursing diagnoses and interventions for subjective patients automatically so that nurses can make more accurate diagnoses and perform more adequate interventions. For that purpose, we have analyzed the relations of medical diagnoses and standardized nursing classifications and developed the outputs into a database system. In this study, we performed clinical tests for the system and verify the usefulness of the system with case database accumulated through the tests. We expect the system can be used in many hospitals efficiently after some upgrade based on the results of this study is completed.
Classification ; Diagnosis* ; Humans ; Information Systems ; Nursing Diagnosis* ; Nursing Process ; Nursing*

The large amount of hospital dat makes management complicated and nowadays the data can barely be managed without computerization. The authors classified and encoded the neurosurgical diseases to develop the "Autocode System", the automatic code transformation system using Fox-ProR, which is a database management program. Any diagnostic entity which is input by the user is transformed into a specific code automaticall. Such a procedure excludes the input error originating from mistyping or naming an unclassified entity. This program is not perfect yet, but it is thought to be effective in the neurosurgical department for data storage and searching. Further modification, functional improvement, and ultimately, unifying the system among the hospitals can make cooperative study and systematic data analysis possible.
Classification* ; Humans ; Information Storage and Retrieval ; Microcomputers* ; Neurosurgery ; Statistics as Topic

The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE III and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE III developed by Knaus and thePatient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, X2, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing. 1) This paper was awarded the first prize at the Seoul National Hospital Nursing Department Research Contest.
APACHE* ; Awards and Prizes ; Classification* ; Humans ; Information Dissemination ; Mortality ; Nursing ; Seoul

Thymic epithelial tumors are treated with reference to the Masaoka staging system. In 1999, the World Health Organization published a histologic classification of thymomas. The WHO classification was revised in 2004. There is a general consensus that it is as important a prognostic factor in primary thymoma and thymic carcinoma patients as the Masaoka staging system. In the present study, a total of 25 cases of thymic epithelial tumors (21 thymoma cases and 4 thymic carcinoma cases) treated from 1991 through 2005 in our hospital were reclassified based on the new WHO classification. The thymoma cases consisted of four at Masaoka's stage I, 11 cases at stage II and six cases at stage III, whereas according to the WHO classification they were categorized into seven B1 type tumors, eight B2 type, four B3 type and two unclassifiable cases. Of the four thymic carcinoma cases, one belonged under Masaoka's stage II, another under stage III and two under stage IV. One thymic carcinoma case resulted in death. There were no fatalities from thymomas. Most of the thymomas at Masaoka's stage III came under WHO type B2 and B3, showing a high incidence of local infiltration. Since either the WHO classification or the Masaoka staging system is an important factor for determining the course of treatment, we concluded that both should be utilized clinically.
Diagnostic Neoplasm Staging ; Classification of information ; seconds ; Carcinoma ; Thymic

The rapid change of hospital environment emphasizes the importance of hospital information system. To be effective, the definitions and codes of data which will be required by the health professionals workstation should be standardized. In Korea, many hospitals are implementing order communication system in order to expedite the patient management process, to enhance the service, and for effective management of medical information. Various codes those are in use in hospitals should be standardized for effective interdepartmental and interhospital communication. This paper shows the current status of implementing order communication system in hospitals which have more than 400 beds in Korea, application status of operation an procedure classification systems, e.g., International Classification of Procedures in Medicine, and International Classification of Diseases-9th-Clinical Modification. 22 hospitals (29.0%) are implementing inpatient OCS and 29 hospitals(38.2%) for outpatient OCS. 46 hospitals(60.5%0 are applying ICPM and among them 23 hospitals(50.0%) showed dissatisfaction for that classification system. 30 hospitals(39.5%) are applying ICD-9-CM and none of them revealed dissatisfaction for that classification system. 64 hospitals(84.2%) want new classification system for operation and procedures and 58 hospitals(76.3%) revealed the necessarily of standardization of code of physicans, clinical departments and administrative departments.
Classification ; Health Occupations ; Hospital Information Systems ; Humans ; Inpatients ; International Classification of Diseases ; Korea ; Outpatients