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

Sternal metastasis of poorly differentiated thyroid carcinoma (PDTC) is rare, and only a few cases have been reported in the literature. Here, we report a case of sternal metastasis of PDTC in an 83-year-old woman, 2 years after right hemithyroidectomy, treated with sternal resection and reconstruction.

Purpose: The gradual increase in the number of children with disabilities in Korea highlights the necessity for further research on the role of school health teachers in their care. This study explored the specific experiences of school health teachers in special schools through individual in-depth interviews. Methods: In this study, 11 school health teachers participated, and data were collected through individual in-depth interviews. Thematic analysis was employed to analyze the collected data. Results: The experiences of health teachers at special schools were classified into 5 themes and 13 subthemes. These included "concerns about working in special schools and attachment after working," "management of diverse diseases and ongoing, careful observation," "ambivalence regarding students with disabilities," "competences needed to care for students with disabilities," and "enhancing care education for students with disabilities: demanding institutional support." Conclusion Effective student health management depends on open communication channels and the establishment of strong connections among health teachers, school personnel, and parents of impaired students. To enhance the quality of care for children with disabilities, specialized education programs to improve teachers' healthcare competency should be developed. Additionally, specific guidelines for the range of medical treatments provided by health instructors, should be devised.

This study was conducted to examine trends in research about nurse educators in Korean hospitals. The methodological framework consisted of previous work by Arksey and O’Malley. A literature search was performed of electronic databases, such as RISS, KISS, CINAHL, and PubMed, from January 2000 to June 2022. Each study was collated and analyzed, and the studies’ data were abstracted into the following categories: publication year, study design, study participants, and education program details. Eight studies were reviewed. Most of the studies were published after 2020 (87.5%). The most frequently used design was quasi-experimental (50.0%). There were three studies whose subjects were nursing educators and five studies were conducted on programs in which nurse educators participated. In Korean medical institutions, clinical nurse educators have various roles, including the development and operation of programs and serving as facilitators and evaluators. In most studies, knowledge and skills were measured as outcome variables of educational programs led by nurse educators. The roles of nurse educators were diverse in Korean medical institutions. Therefore, a program to enhance the competency of nurse educators is needed. Judging from the effects of nurse educators in Korean medical institutions, it is necessary to expand the nurse educator system, and additional research on nurse educators should be conducted.

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%–58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%–33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as “preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee,” and 19.7% were “preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time.” These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.
Education ; Education, Nursing ; Hospitals, General ; Joints ; Long-Term Care ; Nursing ; Preceptorship ; Tertiary Care Centers

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

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

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*