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No abstract available.
Cooperative Behavior ; Electronic Health Records ; Electronics ; Electrons ; Medical Informatics ; Wine

OBJECTIVE: Even though abundant studies and models have tried to explain and predict the adoption and use of new information systems, the research on the adoption of Diabetes Management Systems in multiple clinical settings is relatively scarce. This paper addresses this issue by outlining Georgetown University's experience with implementing its MyCareTeam diabetes telemedicine application, which is a web.based, interactive diabetes management application. METHODS: Case study is used to explore the influencial factors on web.based diabetes telemedicine systems in multiclinical setting. The experience of the Georgetown University deploying MyCareTeam system in six different geographical areas was analyzed by secondary literature review and interviews. RESULTS: This study finds several problems and possible resolutions to expand the telemedicine systems of single institution into the multiple clinical settings. The application systems must be able to transfer data from diverse medical devices and integrate with web.based diabetes management application. Therefore, the system needs to support diverse data transfer type, diverse cable, and different network environment. In addition, there is a need for more dedicated technical and operational support, to prevent frequent turnover among the overburdened nurses who currently interact remotely with telemedicine patients. CONCLUSIONS: To apply currently developed telemedicine technology into the real clinical settings, the proposed technical as well as organizational infrastructure should be established. The findings of this study will be guideline for multi.center diabetes management system in Korea.
Diabetes Mellitus ; Humans ; Information Systems ; Korea ; Telemedicine*

The Arden Syntax is a language for expressing computable medical decisions. It was developed and published under the direction of Health Level Seven, Inc (HL7), and is a standard of the American National Standards Institute (ANSI). It is used to construct executable Medical Logic Modules (MLMs) that represent individual clinical decisions. The authors introduced brief explanation of the Arden Syntaxand gave an example to help readers understand it with easy. Although Arden Syntax is the HL7 standard, there are problems related to the adoption of Arden Syntax as the standard tool for describing medical logic: the curly-braces problem, and the compiler problem. GELLO as well as virtual Medical Record based on the HL7 Reference Information Model (RIM) may provide solutions to the former problem. The latter problem would be resolved by introducing XML based expression of Arden Syntax, the ArdenML: the next generation of Arden Syntax. Unfortunately, Korean hospital information systems are not yet ready to adopt clinical decision support system including Arden Syntax. However, when Arden Syntax version 3.0 (ArdenML) with Korean rule-base engines is introduced into the hospital information system, it would be easier to build up clinical decision support system in Korea.
Adoption ; Health Level Seven ; Hospital Information Systems ; Korea ; Logic ; Medical Records

OBJECTIVE: As the accelerated development and use of Electronic Health Record have grown exponentially, the possible disclosure of patient healthcare information is increased. The purpose of this study is to examine the perception gap on disclosure of EHR information among the patient/guardian group, healthcare provider group, and administration group. METHODS: A questionnaire survey from a hospital located in Incheon City of Korea was conducted and over 200 responses were collected. Outcome measures include healthcare information protection, disclosure of unidentifiable information, possible losses from the disclosure of healthcare information, and the ownership of healthcare information. RESULTS: Regarding healthcare information protection, three groups have a general consensus over some issues. In contrast, the healthcare providers and the administration group have a higher consideration regarding possible losses resulting from the disclosure of healthcare information than the patient group. In addition, the healthcare provider group considered the ownership of healthcare information to belong to the hospital in contrast with the patients' view that the ownership and disclosure rights belong to the patient. CONCLUSION: These findings indicate that the high level of interest and concern that our results revealed, suggests that more attention should be directed toward designing and developing policy, organization and legislative systems.
Computer Security ; Consensus ; Delivery of Health Care* ; Disclosure ; Electronic Health Records* ; Health Personnel* ; Human Rights ; Humans ; Incheon ; Korea ; Outcome Assessment (Health Care) ; Ownership ; Privacy* ; Surveys and Questionnaires

Recently, there have been many studies in medicine related to genetic analysis. Many genetic studies have been performed to find genes associated with complex diseases. To find out how genes are related to disease, we need to understand not only the simple relationship of genotypes but also the way they are related to phenotype. Multi-block data, which is a summation form of variable sets, is used for enhancing the analysis of the relationships of different blocks. By identifying relationships through a multi-block data form, we can understand the association between the blocks in comprehending the correlation between them. Several statistical analysis methods have been developed to understand the relationship between multi-block data. In this paper, we will use generalized canonical correlation methodology to analyze multi-block data from the Korean Association Resource project, which has a combination of single nucleotide polymorphism blocks, phenotype blocks, and disease blocks.
Genome-Wide Association Study ; Genotype ; Phenotype ; Polymorphism, Single Nucleotide

OBJECTIVES: The objective of this research is to introduce the unique approach of the Catholic Medical Center (CMC) integrate network hospitals with organizational and technical methodologies adopted for seamless implementation. METHODS: The Catholic Medical Center has developed a new hospital information system to connect network hospitals and adopted new information technology architecture which uses single source for multiple distributed hospital systems. RESULTS: The hospital information system of the CMC was developed to integrate network hospitals adopting new system development principles; one source, one route and one management. This information architecture has reduced the cost for system development and operation, and has enhanced the efficiency of the management process. CONCLUSIONS: Integrating network hospital through information system was not simple; it was much more complicated than single organization implementation. We are still looking for more efficient communication channel and decision making process, and also believe that our new system architecture will be able to improve CMC health care system and provide much better quality of health care service to patients and customers.
Decision Making ; Delivery of Health Care ; Hospital Information Systems ; Humans ; Information Systems ; Quality of Health Care

Customer relationship management (CRM) is a valuable method for establishing long-term customer relationships across different business areas. CRM system stores and analyzes a vast amount of customer information and provides alternatives to meet customer expectations using data warehouse and on-line analysis processing technology. Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of CRM systems to meet diverse customer satisfaction. Leading the adoption of information technology in the healthcare businesses has enabled the use of CRM technology to develop close patient-provider relationship. Especially, healthcare centers are using CRM system to provide better healthcare services as well as customer management services. This study aims to explore the current status and influential factors that will stimulate and drive the successful use of CRM system in healthcare centers. For this purpose, a survey has been conducted for CRM system users in 13 healthcare centers to investigate the current status of CRM system and the influential factors for successful use. The evaluation criteria include four categories; system quality, information quality, service quality and perceived usefulness. These criteria have been developed based on previous researches, especially DeLone & McLean information system success model. In addition, the system output is evaluated by user satisfaction, personal performance and organizational performance. The study showed that users evaluated information quality and service quality positively and to be higher than other factors in terms of influence. And the user evaluation proved that CRM system provides increased user satisfaction, organizational performance, and especially, individual performance. This is clear evidence that CRM system will improve organizational efficiency and effectiveness, which in turn, can provide competitive advantage for the healthcare centers.
Adoption ; Commerce ; Delivery of Health Care ; Efficiency, Organizational ; Health Care Sector ; Imidazoles ; Information Systems ; Nitro Compounds ; Personal Satisfaction

OBJECTIVE: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. METHODS: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki's suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. RESULTS: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. CONCLUSION: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
Bipolar Disorder ; Cause of Death ; Depression ; Female ; Humans ; Logistic Models ; Mood Disorders ; Observational Study ; Prevalence* ; Psychopathology ; Risk Factors* ; Social Class ; Suicidal Ideation ; Suicide*

OBJECTIVES: To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti- accination community members on the internet. METHODS: An online survey of 245 parents from three pro-vaccination communities and 92 parents from one antivaccination community was conducted from June 7 to June 23, 2006. RESULTS: Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. CONCLUSIONS: On-line communities concerned with vaccination are getting popular. The influence of antivaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.
Adult ; Child, Preschool ; Female ; Health Education/*methods ; *Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Infant ; Internet/*utilization ; Male ; Parents ; Socioeconomic Factors ; *Vaccination