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Development of Korean Rare Disease Knowledge Base.

Heewon SEO ; Dokyoon KIM ; Jong Hee CHAE ; Hee Gyung KANG ; Byung Chan LIM ; Hae Il CHEONG ; Ju Han KIM

Healthcare Informatics Research.2012;18(4):272-278. doi:10.4258/hir.2012.18.4.272

OBJECTIVES: Rare disease research requires a broad range of disease-related information for the discovery of causes of genetic disorders that are maladies caused by abnormalities in genes or chromosomes. A rarity in cases makes it difficult for researchers to elucidate definite inception. This knowledge base will be a major resource not only for clinicians, but also for the general public, who are unable to find consistent information on rare diseases in a single location. METHODS: We design a compact database schema for faster querying; its structure is optimized to store heterogeneous data sources. Then, clinicians at Seoul National University Hospital (SNUH) review and revise those resources. Additionally, we integrated other sources to capture genomic resources and clinical trials in detail on the Korean Rare Disease Knowledge base (KRDK). RESULTS: As a result, we have developed a Web-based knowledge base, KRDK, suitable for study of Mendelian diseases that commonly occur among Koreans. This knowledge base is comprised of disease summary and review, causal gene list, laboratory and clinic directory, patient registry, and so on. Furthermore, database for analyzing and giving access to human biological information and the clinical trial management system are integrated on KRDK. CONCLUSIONS: We expect that KRDK, the first rare disease knowledge base in Korea, may contribute to collaborative research and be a reliable reference for application to clinical trials. Additionally, this knowledge base is ready for querying of drug information so that visitors can search a list of rare diseases that is relative to specific drugs. Visitors can have access to KRDK via http://www.snubi.org/software/raredisease/.
Databases, Genetic ; Humans ; Information Storage and Retrieval ; Knowledge Bases ; Korea ; Online Systems ; Rare Diseases

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Monitor Preference for Electronic Medical Record in Outpatient Clinic.

Kee Hyuck LEE ; Woo Kyung BAE ; Jong Soo HAN ; Sooyoung YOO ; Jon Soo KIM ; Jonghoar YUN ; Hyun Young BAEK ; Rong Min BAEK ; Hee HWANG

Healthcare Informatics Research.2012;18(4):266-271. doi:10.4258/hir.2012.18.4.266

OBJECTIVES: The objective of this paper is to assess which wide type monitor configurations are preferred when physicians use an Electronic Medical Record (EMR) system in an outpatient clinic setting. METHODS: We selected three kinds of monitor configurations available for adoption at outpatient clinics with reference to monitor market trends. Fifteen attending physicians of the Seoul National University Bundang Hospital used each monitor configuration in their outpatient clinics. After completing the outpatient sessions, they selected the best monitor configuration for criteria described in five questionnaire items. We counted the number of votes and reviewed opinions of participants. RESULTS: The Wide Quad High Definition (WQHD) 27-inch single monitor configuration was most preferred for all questionnaire items. All participants answered that the WQHD 27-inch single monitor configuration was the best for desk space utilization. Eleven out of fifteen participants chose the WQHD 27-inch single monitor configuration as the most suitable monitor for outpatient practice. CONCLUSIONS: This study found that physicians preferred the WQHD 27-inch single monitor configuration in outpatient clinic settings. Healthcare organizations need to consider this finding when they purchase wide type monitors for EMR systems instead of the standard type monitor.
Adenine ; Adoption ; Ambulatory Care Facilities ; Carbamates ; Computer Terminals ; Delivery of Health Care ; Deoxycytidine ; Drug Combinations ; Electronic Health Records ; Electronics ; Electrons ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination ; Humans ; Organophosphonates ; Organothiophosphorus Compounds ; Outpatients ; Personal Satisfaction ; Quinolones ; Thiazoles ; User-Computer Interface ; Surveys and Questionnaires

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Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital.

Sooyoung YOO ; Seok KIM ; Taegi KIM ; Jon Soo KIM ; Rong Min BAEK ; Chang Suk SUH ; Chin Youb CHUNG ; Hee HWANG

Healthcare Informatics Research.2012;18(4):259-565. doi:10.4258/hir.2012.18.4.259

OBJECTIVES: The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. METHODS: Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. RESULTS: Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. CONCLUSIONS: Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation.
Adoption ; Androsterone ; Electronic Health Records ; Empirical Research ; Field Hospitals ; Hospital Information Systems ; Humans ; Hypogonadism ; Inpatients ; Mitochondrial Diseases ; Ophthalmoplegia ; Patient Satisfaction ; Privacy

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Expert System Shells for Rapid Clinical Decision Support Module Development: An ESTA Demonstration of a Simple Rule-Based System for the Diagnosis of Vaginal Discharge.

Maged N KAMEL BOULOS

Healthcare Informatics Research.2012;18(4):252-258. doi:10.4258/hir.2012.18.4.252

OBJECTIVES: This study demonstrates the feasibility of using expert system shells for rapid clinical decision support module development. METHODS: A readily available expert system shell was used to build a simple rule-based system for the crude diagnosis of vaginal discharge. Pictures and 'canned text explanations' are extensively used throughout the program to enhance its intuitiveness and educational dimension. All the steps involved in developing the system are documented. RESULTS: The system runs under Microsoft Windows and is available as a free download at http://healthcybermap.org/vagdisch.zip (the distribution archive includes both the program's executable and the commented knowledge base source as a text document). The limitations of the demonstration system, such as the lack of provisions for assessing uncertainty or various degrees of severity of a sign or symptom, are discussed in detail. Ways of improving the system, such as porting it to the Web and packaging it as an app for smartphones and tablets, are also presented. CONCLUSIONS: An easy-to-use expert system shell enables clinicians to rapidly become their own 'knowledge engineers' and develop concise evidence-based decision support modules of simple to moderate complexity, targeting clinical practitioners, medical and nursing students, as well as patients, their lay carers and the general public (where appropriate). In the spirit of the social Web, it is hoped that an online repository can be created to peer review, share and re-use knowledge base modules covering various clinical problems and algorithms, as a service to the clinical community.
Archives ; Caregivers ; Decision Making, Computer-Assisted ; Decision Support Systems, Clinical ; Expert Systems ; Humans ; Knowledge Bases ; Peer Review ; Product Packaging ; Software Design ; Students, Nursing ; Tablets ; Uncertainty ; Vaginal Discharge

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Ubiquitous Health in Korea: Progress, Barriers, and Prospects.

Yountae LEE ; Hyejung CHANG

Healthcare Informatics Research.2012;18(4):242-251. doi:10.4258/hir.2012.18.4.242

OBJECTIVES: Korea has one of the most advanced information technology (IT) infrastructures in the world, and the application of IT in health systems is rapidly progressing from computerization to information systems, ubiquitous systems, and smart systems. This study aims to analyze Korean environments in regards to the development of their u-Health industry and propose directions for u-Healthcare services based on this analysis. METHODS: This paper reviews the background, progress history, and current status of u-Health in Korea, and suggests strategies for the u-Health industry based on an analysis of its barriers and obstacles. RESULTS: When u-Health was introduced to Koreans, their policies and approaches focused mainly on environmental factors, yet these efforts have not progressed further to impact the u-Healthcare service industry itself. To develop the u-Healthcare industry, four points need to be considered: the development and support of the practical service model, institutional support, support of core technology and industry, and the institutionalization of health management service. CONCLUSIONS: Korea is at a strategic point to start building u-Healthcare service delivery models. u-Healthcare is a healthcare service that provides added value through u-Health environments. By identifying critical success factors in u-Healthcare, we can strengthen the u-Health industry and implement policies to coordinate our efforts in the process of value chains to which we belong.
Consumer Health Information ; Delivery of Health Care ; Health Information Management ; Information Systems ; Institutionalization ; Korea ; Telecommunications ; Telemedicine ; Wireless Technology

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Human Factors Engineering in HI: So What? Who Cares? and What's in It for You?.

Peter L ELKIN

Healthcare Informatics Research.2012;18(4):237-241. doi:10.4258/hir.2012.18.4.237

OBJECTIVES: Human factors engineering is a discipline that deals with computer and human systems and processes and provides a methodology for designing and evaluating systems as they interact with human beings. This review article reviews important current and past efforts in human factors engineering in health informatics in the context of the current trends in health informatics. METHODS: The methodology of human factors engineering and usability testing in particular were reviewed in this article. RESULTS: This methodology arises from the field of human factors engineering, which uses principles from cognitive science and applies them to implementations such as a computer-human interface and user-centered design. CONCLUSIONS: Patient safety and best practice of medicine requires a partnership between patients, clinicians and computer systems that serve to improve the quality and safety of patient care. People approach work and problems with their own knowledge base and set of past experiences and their ability to use systems properly and with low error rates are directly related to the usability as well as the utility of computer systems. Unusable systems have been responsible for medical error and patient harm and have even led to the death of patients and increased mortality rates. Electronic Health Record and Computerized Physician Order Entry systems like any medical device should come with a known safety profile that minimizes medical error and harm. This review article reviews important current and past efforts in human factors engineering in health informatics in the context of the current trends in health informatics.
Cognitive Science ; Computer Systems ; Electronic Health Records ; Humans ; Informatics ; Knowledge Bases ; Medical Errors ; Medical Order Entry Systems ; Patient Care ; Patient Safety ; Practice Guidelines as Topic

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Looking Back, Looking Forward.

Hyejung CHANG

Healthcare Informatics Research.2012;18(4):235-236. doi:10.4258/hir.2012.18.4.235

No abstract available.

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Smart Information System for Gachon University Gil Hospital.

Dong Kyun PARK ; Eun Young JUNG ; Byung Hui JEONG ; Byung Chan MOON ; Hyung Wook KANG ; Hann TCHAH ; Gi Seong HAN ; Woo Sung CHENG ; Young Ho LEE

Healthcare Informatics Research.2012;18(1):74-83. doi:10.4258/hir.2012.18.1.74

OBJECTIVES: In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. METHODS: This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. RESULTS: The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. CONCLUSIONS: Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.
Delivery of Health Care ; Electronic Health Records ; Emergency Medical Services ; Health Records, Personal ; Hospital Information Systems ; Humans ; Information Systems ; Management Information Systems ; Quality of Health Care

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An Evaluation of Multiple Query Representations for the Relevance Judgments used to Build a Biomedical Test Collection.

Borim RYU ; Jinwook CHOI

Healthcare Informatics Research.2012;18(1):65-73. doi:10.4258/hir.2012.18.1.65

OBJECTIVES: The purpose of this study is to validate a method that uses multiple queries to create a set of relevance judgments used to indicate which documents are pertinent to each query when forming a biomedical test collection. METHODS: The aspect query is the major concept of this research; it can represent every aspect of the original query with the same informational need. Manually generated aspect queries created by 15 recruited participants where run using the BM25 retrieval model in order to create aspect query based relevance sets (QRELS). In order to demonstrate the feasibility of these QRELSs, The results from a 2004 genomics track run supported by the National Institute of Standards and Technology (NIST) were used to compute the mean average precision (MAP) based on Text Retrieval Conference (TREC) QRELSs and aspect-QRELSs. The rank correlation was calculated using both Kendall's and Spearman's rank correlation methods. RESULTS: We experimentally verified the utility of the aspect query method by combining the top ranked documents retrieved by a number of multiple queries which ranked the order of the information. The retrieval system correlated highly with rankings based on human relevance judgments. CONCLUSIONS: Substantial results were shown with high correlations of up to 0.863 (p < 0.01) between the judgment-free gold standard based on the aspect queries and the human-judged gold standard supported by NIST. The results also demonstrate that the aspect query method can contribute in building test collections used for medical literature retrieval.
Genomics ; Humans ; Information Storage and Retrieval ; Judgment ; Statistics as Topic ; Track and Field

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Comparing the Certification Criteria for CCHIT-Certified Ambulatory EHR with the SNUBH's EHR Functionalities.

Eun Young HEO ; Hee HWANG ; Eun Hye KIM ; Eun Young CHO ; Kee Hyuck LEE ; Tae Hun KIM ; Ki Dong KIM ; Rong Min BAEK ; Sooyoung YOO

Healthcare Informatics Research.2012;18(1):57-64. doi:10.4258/hir.2012.18.1.57

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

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