In this paper, ethical principles and practice guidelines concerning the usage of public database for medical researches were developed and proposed. Although there are several personal health databases with comprehensive information of each individual, researches aiming at public good are often hindered because of legal, managerial and technical barriers to the usage of public databases. Ethical principles and guidelines are indispensible to promote medical research that will benefit society while protecting personal information from bleaching and abuse. These principles and guidelines should be a basis of trust and supports from society. For this purpose, the meaning of public good was given, and the current status of the linkage and usage of public databases were explored. As a result, three ethical principles-guaranteeing public good, protecting personal information, and transparency were established and eight recommendations were proposed.
Codes of Ethics ; Database Management Systems ; Ethics, Medical ; Humans ; Medical Record Linkage

A new algorithm to generate the medical record report based on XML and linked list is proposed in this paper. It decomposes and abstracts the content of report. Reporter can search and reuse the resources quickly, when writing or modifying the report. The experiment results prove that the algorithm reduces the reporting time and standardizes the content of report.
Algorithms ; Humans ; Medical Record Linkage ; Medical Records Systems, Computerized ; Programming Languages

The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional clinical data repository (CDR).
Humans ; Information Dissemination ; methods ; Medical Informatics ; organization & administration ; Medical Record Linkage

OBJECTIVE: This study was conducted to automatically improve the completeness and validity of the Daegu Cancer Registry, using cross record linkage of many data sources, and to develop a computerized patient enrollment system for efficient communication among cancer researchers via the internet. METHOD: We analyzed 10,229 cancer patients who were reported in the National Cancer Registry, and from pathological reports, health insurance cancer claims lists, cancer patient records at hospital information centers and death certificates from the Korea National Statistical Office. RESULT: We confirmed 4,624 cancer patients and found 897 of new cases from a review of medical chart. The new cases were detected efficiently using cross record linkage. We developed a computerized patient enrollment system, based on a client-server model, for the input of cancer patients, and then developed a web-based reporting homepage and patient enrollment system for the internet. CONCLUSION: This system could manage cancer databases systematically, and could be given to other researchers as a basic database.
Daegu* ; Information Storage and Retrieval ; Death Certificates ; Humans ; Information Centers ; Insurance, Health ; Internet ; Korea ; Medical Record Linkage ; Registries

OBJECTIVE: This study was conducted to automatically improve the completeness and validity of the Daegu Cancer Registry, using cross record linkage of many data sources, and to develop a computerized patient enrollment system for efficient communication among cancer researchers via the internet. METHOD: We analyzed 10,229 cancer patients who were reported in the National Cancer Registry, and from pathological reports, health insurance cancer claims lists, cancer patient records at hospital information centers and death certificates from the Korea National Statistical Office. RESULT: We confirmed 4,624 cancer patients and found 897 of new cases from a review of medical chart. The new cases were detected efficiently using cross record linkage. We developed a computerized patient enrollment system, based on a client-server model, for the input of cancer patients, and then developed a web-based reporting homepage and patient enrollment system for the internet. CONCLUSION: This system could manage cancer databases systematically, and could be given to other researchers as a basic database.
Daegu* ; Information Storage and Retrieval ; Death Certificates ; Humans ; Information Centers ; Insurance, Health ; Internet ; Korea ; Medical Record Linkage ; Registries

Stroke registries are observational databases focusing on the clinical information and outcomes of stroke patients. They play an important role in the cycle of quality improvement. Registry data are collected from real-world experiences of stroke care and are suitable for measuring quality of care. By exposing inadequacies in performance measures of stroke care, research from stroke registries has changed how we manage stroke patients in Taiwan. With the success of various quality improvement campaigns, mortality from stroke and recurrence of stroke have decreased in the past decade. After the implementation of a nationwide stroke registry, researchers have been creatively expanding how they use and collect registry data for research. Through the use of the nationwide stroke registry as a common data model, researchers from many hospitals have built their own stroke registries with extended data elements to meet the needs of research. In collaboration with information technology professionals, stroke registry systems have changed from web-based, manual submission systems to automated fill-in systems in some hospitals. Furthermore, record linkage between stroke registries and administrative claims databases or other existing databases has widened the utility of registry data in research. Using stroke registry data as the reference standard, researchers have validated several algorithms for ascertaining the diagnosis of stroke and its risk factors from claims data, and have also developed a claims-based index to estimate stroke severity. By making better use of registry data, we believe that we will provide better care to patients with stroke.
Cooperative Behavior ; Diagnosis ; Electronic Health Records ; Humans ; Medical Record Linkage ; Mortality ; Quality Improvement ; Recurrence ; Registries ; Risk Factors ; Stroke* ; Taiwan*

Stroke registries are observational databases focusing on the clinical information and outcomes of stroke patients. They play an important role in the cycle of quality improvement. Registry data are collected from real-world experiences of stroke care and are suitable for measuring quality of care. By exposing inadequacies in performance measures of stroke care, research from stroke registries has changed how we manage stroke patients in Taiwan. With the success of various quality improvement campaigns, mortality from stroke and recurrence of stroke have decreased in the past decade. After the implementation of a nationwide stroke registry, researchers have been creatively expanding how they use and collect registry data for research. Through the use of the nationwide stroke registry as a common data model, researchers from many hospitals have built their own stroke registries with extended data elements to meet the needs of research. In collaboration with information technology professionals, stroke registry systems have changed from web-based, manual submission systems to automated fill-in systems in some hospitals. Furthermore, record linkage between stroke registries and administrative claims databases or other existing databases has widened the utility of registry data in research. Using stroke registry data as the reference standard, researchers have validated several algorithms for ascertaining the diagnosis of stroke and its risk factors from claims data, and have also developed a claims-based index to estimate stroke severity. By making better use of registry data, we believe that we will provide better care to patients with stroke.
Cooperative Behavior ; Diagnosis ; Electronic Health Records ; Humans ; Medical Record Linkage ; Mortality ; Quality Improvement ; Recurrence ; Registries ; Risk Factors ; Stroke ; Taiwan

Referring to XDS-I and RIM of ebXML, we have built a registry system for electronic medical records sharing which is introduced, in this paper.
Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Medical Record Linkage ; methods ; Medical Records Systems, Computerized ; Multimedia ; Radiology Information Systems ; Software ; User-Computer Interface

PURPOSE: To estimate the reporting rate of tuberculosis in one medium-sized city in Korea. METHODS: Data claimed by national health insurance corporationand notification data of KTBS (Korea Tuberculosis Surveillance System) were compared through medical record-linkage method. Regarding the cases that were claimed medical care fee as tuberculosis but not notified to KTBS, we reviewed medical charts of the patients and investigated the reasons of failure to notify. RESULTS: Number of cases claimed health insurance fee as tuberculosis occurrences in Cheonan was 2,331 in 2007, while 956 cases were matched as notified cases to KTBS after electronic record-linkage by personal identifier. Among remaining 1,375 cases that were not matched, real missed cases through medical record review survey were found to be 104. The reasons of failure to notify were because of 'not tuberculosis patients' (500, 36.4%), 'notified in 2006' (421, 30.6%), 'diseases coding error' (341, 24.8%) and 'notified as other diseases' (9, 0.7%). Therefore, the corrected reporting rate was calculated at 93% (95% CI: 91.6% - 94.2%). Notably, reporting rate of clinics (58.1%) was significantly lower than those of hospitals (93.4%) or general hospitals (96.6%). CONCLUSIONS: All cases of tuberculosis diagnosis, which were claimed and not notified, were verified, the reporting rate was not as low as that of the data known through media. However, to reach the goal of tuberculosis elimination (reporting rate over 95%), more effort into improvement of the reporting system is necessary.
Clinical Coding ; Disease Notification ; Electronics ; Electrons ; Fees and Charges ; Hospitals, General ; Humans ; Insurance, Health ; Mandatory Reporting ; Medical Record Linkage ; Medical Records ; National Health Programs ; Private Sector ; Tuberculosis

While Korea had the highest rate of increase in per capita health expenditures from 1997 to 2007 among The Organization for Economic Cooperation and Development (OECD) countries, it is necessary in all countries to establish sustainable health care systems that efficiently use the existing effective treatment methods. For dealing with the overwhelming health care crisis, the European Union and the United States (US) have launched Health Technology Assessment (HTA) and Comparative Effectiveness Research (CER) programs, respectively. Further, the Federal Coordinating Council for Comparative Effectiveness Research in US has considered the development of the CER data infrastructure to be the primary investment needed in order to reform the national health care system. The main reason is that investment in data infrastructure can potentially generate significant additional investment in CER. In addition, the Council stressed the need for coordination between CER and health information technology through a distributed network of electronic health records. These directions and decisions on driving CER in the US may provide an invaluable lesson on solving some healthcare problems in Korea. However, barriers to the potential contribution of the existing databases to CER must be overcome, including interoperability, privacy protection and confidentiality, and active participation of the holders of the related databases.
Biomedical Technology ; Comparative Effectiveness Research ; Confidentiality ; Delivery of Health Care* ; Electronic Health Records ; European Union ; Health Expenditures ; Investments ; Korea ; Medical Informatics ; Medical Record Linkage ; Medical Records Systems, Computerized ; Privacy ; United States