A prescription issuing system is computerized in so many hospital. While the shareable and usability of an electronic prescription is increased by computerized materials, it can be serious for an information about a patient to be exposed in public. In this paper, the proposed system to issue an electronic prescription is aimed to keep using the existing paper-based prescription issuing system and extend the system using by IC card. It is developed for the secure method of an electronic prescription to transfer between hospital and pharmacy. For this, in this paper, it is defined for the standard minimal data set of a prescription information and developed the method to store the electronic prescription to IC card. It is set the access authority to access the electronic prescription stored in IC card by classifying the access authority group. Since the security and certificate authority center is established using Windows 2000, the electronic prescription stored in IC card can be secured and certificated by an encryption, decryption and digital signature. Lastly, the terminal and server system transferred an electronic prescription of a hospital and a pharmacy is implemented. The proposed system in this paper is simulated in some hospital and pharmacy. On the result of simulation, it is hoped for increasing the prescription transferring service, because the proposed transfer system of an electronic prescription using IC card is stable, secure, available, and creditable.
Dataset ; Electronic Prescribing* ; Hope ; Humans ; Pharmacy ; Prescriptions

Several years has passed to begin a new paradigm, job separation of a physician and a pharmaceutist, and a electronic prescription becomes common in large scale hospitals. However, the current prescription information system retains some problems such as insufficient patient usability, labor saving techniques and security. This paper is addressed to implement a voice prescription service system to solve the preceding problems. Several suggestions are presented to use voice recognition, voice compression, computer telephony and fingerprint authentication technology for the problems. Lab experimental results show that the processing time to identify drug items is reduced by 80% compared with conventional mouse usage and voice recording is more effective to direct drug usage in a complicated prescriptions. Online fingerprint authentication furnishes evidence of a patient permission and a physician prescription. This feature provides safer security than the current security system.
Animals ; Dermatoglyphics* ; Electronic Prescribing ; Humans ; Information Systems ; Mice ; Prescriptions* ; Voice*

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

OBJECTIVES: This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. METHODS: Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). RESULTS: Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. CONCLUSIONS: Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future.
Certification ; Commerce ; Electronic Health Records ; Electronic Prescribing ; Immunization ; Korea ; Medical Informatics ; Patient Safety ; Quality of Health Care

OBJECTIVES: Open-source Electronic Health Record (EHR) systems have gained importance. The main aim of our research is to guide organizational choice by comparing the features, functionality, and user-facing system performance of the five most popular open-source EHR systems. METHODS: We performed qualitative content analysis with a directed approach on recently published literature (2012–2017) to develop an integrated set of criteria to compare the EHR systems. The functional criteria are an integration of the literature, meaningful use criteria, and the Institute of Medicine's functional requirements of EHR, whereas the user-facing system performance is based on the time required to perform basic tasks within the EHR system. RESULTS: Based on the Alexa web ranking and Google Trends, the five most popular EHR systems at the time of our study were OSHERA VistA, GNU Health, the Open Medical Record System (OpenMRS), Open Electronic Medical Record (OpenEMR), and OpenEHR. We also found the trends in popularity of the EHR systems and the locations where they were more popular than others. OpenEMR met all the 32 functional criteria, OSHERA VistA met 28, OpenMRS met 12 fully and 11 partially, OpenEHR-based EHR met 10 fully and 3 partially, and GNU Health met the least with only 10 criteria fully and 2 partially. CONCLUSIONS: Based on our functional criteria, OpenEMR is the most promising EHR system, closely followed by VistA. With regards to user-facing system performance, OpenMRS has superior performance in comparison to OpenEMR.
Electronic Health Records ; Electronic Prescribing ; Meaningful Use ; Medical Order Entry Systems ; Medical Records

OBJECTIVE: The aim of this study was to examine whether or not levofloxacin has any relationship with QT prolongation in a real clinical setting by analyzing a clinical data warehouse of data collected from different hospital information systems. METHODS: Electronic prescription data and medical charts from 3 different hospitals spanning the past 9 years were reviewed, and a clinical data warehouse was constructed. Patients who were both administrated levofloxacin and given electrocardiograms (ECG) were selected. The correlations between various patient characteristics, concomitant drugs, corrected QT (QTc) prolongation, and the interval difference in QTc before and after levofloxacin administration were analyzed. RESULTS: A total of 2,176 patients from 3 different hospitals were included in the study. QTc prolongation was found in 364 patients (16.7%). The study revealed that age (OR 1.026, p < 0.001), gender (OR 0.676, p = 0.007), body temperature (OR 1.267, p = 0.024), and cigarette smoking (OR 1.641, p = 0.022) were related with QTc prolongation. After adjusting for related factors, 12 drugs concomitant with levofloxacin were associated with QTc prolongation. For patients who took ECGs before and after administration of levofloxacin during their hospitalization (n = 112), there was no significant difference in QTc prolongation. CONCLUSIONS: The age, gender, body temperature, cigarette smoking and various concomitant drugs might be related with QTc prolongation. However, there was no definite causal relationship or interaction between levofloxacin and QTc prolongation. Alternative surveillance methods utilizing the massive accumulation of electronic medical data seem to be essential to adverse drug reaction surveillance in future.
Body Temperature ; Data Mining ; Drug Toxicity ; Electrocardiography ; Electronic Prescribing ; Electronics ; Electrons ; Hospital Information Systems ; Hospitalization ; Humans ; Long QT Syndrome ; Ofloxacin ; Smoking

INTRODUCTIONElectronic prescribing has been proposed as an important strategy to reduce medication errors, improve the quality of patient care and create savings in health care costs. Despite these potential advantages, user satisfaction plays a significant role in the success of its implementation. Hence, this study aims to examine users' satisfaction and factors associated with satisfaction regarding an electronic prescription system implemented in the National Healthcare Group Polyclinics in Singapore.

MATERIALS AND METHODSAn anonymous survey was administered in October 2007 to all physicians, pharmacists and pharmacy technicians working in the 9 National Healthcare Group Polyclinics.

RESULTSRespondents included 118 doctors and 61 pharmacy staff. The overall level of satisfaction with electronic prescribing was high. Doctors and pharmacists reported a high degree of agreement that electronic prescribing reduces prescribing errors and interventions, and they did not want to go back to the paper-based system. Users were generally satisfied with the functionality of the system but there was some degree of workflow interference particularly for the pharmacy staff. Only 56.9% of the pharmacy respondents expressed satisfaction with the review function of the electronic prescription system and only 51.8% and 60% were satisfied when processing prescriptions that included items to be purchased from an external pharmacy or prescriptions with amendments. The results also revealed that satisfaction with the system was more associated with users' perceptions about the electronic prescription system's impact on productivity than quality of care.

CONCLUSIONThe survey results indicate that the implementation of the electronic prescription system has gone reasonably well. The survey findings provide opportunities for system and workflow enhancement, which is important as these issues could affect the acceptability of a new technology and the speed of diffusion within an organisation.

Consumer Behavior ; Cross-Sectional Studies ; Diffusion of Innovation ; Electronic Prescribing ; Health Care Surveys ; Humans ; Medical Order Entry Systems ; Pharmaceutical Services ; Pharmacists ; psychology ; Physicians ; psychology ; Singapore

INTRODUCTIONThere are growing concerns that the use of proton pump inhibitors (PPIs) may be inappropriate in instances that do not conform to evidence-based indications. This point-prevalence study aimed to investigate the frequency, indications and appropriateness of use of PPIs in hospitalised patients on a randomly chosen day.

METHODSOn a randomly chosen day, all inpatients were documented, and those on any form of PPIs on that day were determined. Indications for maintaining these patients on PPIs were obtained from the electronic medical records, which were then recorded and cross-referenced against a list of accepted indications adapted from the US Food and Drug Administration (FDA)-approved list.

RESULTSIn all, 1,025 inpatients were documented. Of the 477 (46.5%) inpatients using PPIs, only 219 (45.9%) fulfilled the FDA-approved indications, while the majority (n = 258, 54.1%) did not. Overall, PPIs were not strictly indicated for use in 206 (43.2%) inpatients, according to FDA criteria. Of the 477 inpatients on PPIs, 52 (10.9%) had borderline indications based on expert consensus/guidelines other than FDA criteria.

CONCLUSIONAlthough the use of PPIs is prevalent in hospitals, less than half of the hospitalised patients using PPIs in our study had evidence-based indications that supported such use. The overuse of PPIs has a negative impact on healthcare costs and may lead to adverse effects. Steps to curb the inappropriate use of PPIs should address factors such as indications for the initiation of PPIs, and reassessment of the need for ongoing PPI use in inpatients upon discharge and during outpatient reviews.

Anemia ; drug therapy ; Dyspepsia ; drug therapy ; Electronic Health Records ; Hospitalization ; Humans ; Inappropriate Prescribing ; statistics & numerical data ; Platelet Aggregation Inhibitors ; therapeutic use ; Practice Guidelines as Topic ; Prevalence ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Singapore ; Stomach Diseases ; drug therapy ; United States ; United States Food and Drug Administration