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Technical Considerations for Successful Implementation of a Barcode-based Medication System in Hospital.

Journal of Korean Society of Medical Informatics.2009;15(3):303-312. doi:10.4258/jksmi.2009.15.3.303

OBJECTIVE: To identify the technical considerations in implementing a barcode-based medication system and propose practical solutions for successful implementation of the system. In order to reduce medical errors related to medication and blood transfusion, we analyze various factors that hinder the successful implementation of the barcode-based medication system and discuss issues involved in the effective adoption of such a system. METHODS: The barcode-based medication system of this research uses one-dimensional, barcode bands on patients' wrists and two-dimensional barcodes attached to drug bags and blood bags. PDAs with barcode reading capability and wireless networking function are used, which enables Point of Care. The business process for applying the developed system and the current status of the system usage are analyzed. RESULTS: The factors causing a variety of system failures in the demonstration and pilot periods were identified and categorized as including PDA malfunction, PDA battery discharge due to users' carelessness, confusion in reading barcodes and so on. CONCLUSIONS: It is expected that the analyzed obstructive factors and the proposed technical considerations addressed in this paper can help other hospitals implement similar barcode-based medication systems successfully. Ultimately, this research will contribute to reducing medical errors and improving quality of patient care.
Adoption ; Blood Transfusion ; Commerce ; Medical Errors ; Medication Errors ; Medication Systems ; Patient Care ; Wrist

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Evaluation of CDSS for Drug Prescriptions Based on Success Measures.

Jinwoo PARK ; Young Moon CHAE ; Young Taek LEE ; Koungwon CHO ; Junghee KIM ; Byung Hwa LEE

Journal of Korean Society of Medical Informatics.2009;15(3):293-301. doi:10.4258/jksmi.2009.15.3.293

OBJECTIVE: The Clinical Decision Support System (CDSS) for drug prescriptions was developed by integrating the computerized physician order entry (CPOE) system to support doctors and pharmacists in making correct decisions on prescribing drugs in line with the prescription guidelines by the Health Insurance Review Agency (HIRA). The objective of this study was to evaluate the performance of the CDSS with respect to system quality, information quality, and user satisfaction in reducing prescription errors. METHODS: The study was based on survey data from 38 hospitals that were using the CDSS for drug prescriptions. To identify factors influencing the performance of CDSS, multiple linear regression and chi-square analyses were performed. RESULTS: Regression analysis showed that the variables for system quality and information quality significantly influenced the overall system performance. Specifically, ease of understanding the results and terminology assystem quality measures significantly influenced user satisfaction. Furthermore, based on chi-square analysis, two independent variables (ease of understanding results and decision support functions) were statistically significant with respect to all four dependent variables (information satisfaction, system satisfaction, willingness to recommend to other hospitals, and drug safety). CONCLUSION: Based on this study, users should be educated to improve their understanding of the system,and system and information quality should be continuously monitored to improve user satisfaction.
Drug Prescriptions ; Humans ; Insurance, Health ; Linear Models ; Pharmacists ; Prescriptions

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An Awareness Survey on the Protection and Use of Personal Health Information Focused on Applicants for Copies of the Medical Record.

Eun mi CHOI ; Sun won SEO ; Woo sung PARK ; Mee Jeong LEE ; Yea eun KIM ; Ok nam KIM

Journal of Korean Society of Medical Informatics.2009;15(3):285-292. doi:10.4258/jksmi.2009.15.3.285

OBJECTIVE: To supplement a previous study on the management of medical records with a view to preparing a system capable of ensuring basic patient rights regarding the protection of confidential medical information. The study objectives are to provide detailed guidelines to regulate the access and protection of medical information by analyzing patients' understanding and views regarding the dissemination of medical records. METHODS: A self-administered questionnaire was administered to 781 patients who visited five University hospitals located in Seoul, Busan, Gyeonggi, Chungnam and Jeonnam from July to September, 2008 and asked for copies of medical records to be issued. Data were analyzed by using the statistical program SPSS 13.0. RESULTS: More than 70% of respondents wanted to access their medical records after confirming the required documents. The highest distribution in the range of persons able to receive copies of medical records without the individual patient's consent or required documents was 'only personally' in each variable. Copies of medical records were issued mostly within 1 hour, while the appropriate time of issuing the copies was within one day. Half of respondents approved of a subscription system that did not require a doctor consultation. The results regarding changes in the ways to request/issue copies of medical records to improve the convenience for applicants differed significantly according to age. CONCLUSION: Considering the sensitivity of personal health information, medical records should only be issued with the patient's consent and by confirming the identity of the designated person with required documents. Furthermore, people should be aware of the importance of protecting personal health information, and medical institutes should inform the requirements for bringing the relevant documents. Medical institutes play an important role in protecting personal records, which necessitates generalized guidelines.
Academies and Institutes ; Coat Protein Complex I ; Surveys and Questionnaires ; Hospitals, University ; Humans ; Medical Records ; Patient Rights

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The Consumers' Perceptions and Requirements for Personal Health Records in Korea.

Sun Young KIM ; Hye Ryung KIM ; Jae Bong BAE ; Yoon KIM

Journal of Korean Society of Medical Informatics.2009;15(3):273-284. doi:10.4258/jksmi.2009.15.3.273

OBJECTIVE: The aim of the study was to identify factors influencing the willingness of healthcare consumers to use personal health records (PHR) and to investigate the requirements for PHR services. METHODS: A face-to-face interview was conducted with 400 healthcare consumers from the 3rd-18th of July 2008 using a structured questionnaire. To identity factors affecting the willingness to use PHR and to pay for PHR services, logistic regression analysis was performed. To investigate the requirements for PHR services according to the willingness of the consumers to use PHR and to pay for PHR services, t-test analysis was conducted. RESULTS: Of the 400 healthcare consumers, 239 (59.8%) were willing to use PHR and 111 (27.8%) were willing to pay for PHR services. The willingness to use PHR was higher in the elderly, those with a disease, and those with experience to use health information on the Internet, and the willingness to pay for PHR services was higher in those with a relatively high income (p<0.05). The willingness to use PHR was approximately 13.5 (95% CI=1.43-126.55) and 3 times (95% CI=1.18-8.74) higher in those with average monthly household incomes >6,000,000 won and 4,500,000-6,000,000 won, respectively, than in those earning <1,500,000 won, and approximately 1.96 times (95% CI=1.18-3.27) higher in those with experience using health information on the Internet than in those without experience. The willingness to pay for PHR services was approximately 5.9 times (95% CI=1.84-19.06) higher in those with an income of 4,500,000-6,000,000 won than in those with an income <1,500,000 won (p<0.05). Demands for test results, medication history, family history, problem list, genetic information, clinical trial information, and social history were significantly higher in those with a willingness to use PHR and those with a willingness to pay for PHR services than in those without willingness to use PHR and those without a willingness to pay for PHR services (p<0.05). Compared to those without a willingness to pay for PHR services, those with a willingness to pay for PHR services showed a significantly higher demand for all the functions (p<0.01). CONCLUSION: The results of this study suggest that healthcare consumers potentially have a considerable demand for PHR services, and although it is not recognized and used widely yet, PHR is an essential service. In order to enhance people's awareness of PHR and to promote people to use PHR services, we need efforts and initiatives to execute campaigns and education for people to ease access to the service, and to reduce the gap in service utilization skills.
Aged ; Delivery of Health Care ; Electronic Health Records ; Family Characteristics ; Health Records, Personal ; Humans ; Internet ; Korea ; Logistic Models ; Surveys and Questionnaires

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Application of the Extended Technology Acceptance Model to Picture Archiving and Communication Systems in Dental Hospitals.

Hyejung CHANG

Journal of Korean Society of Medical Informatics.2009;15(3):265-272. doi:10.4258/jksmi.2009.15.3.265

OBJECTIVE: With the rapid growth of picture archiving and communication systems (PACS) in the healthcare industry, this article describes the users' satisfaction with PACS by employing functional PACS features and the two concepts of perceived ease-of-use (PEOU) and perceived usefulness (PU), based on the extended technology acceptance model (TAM). METHODS: A cross-sectional survey was conducted with dentists in 25 dental hospitals which were cluster sampled from the national registry of 132 dental hospitals. Of the 204 respondents (response rate 81.6%), the data of 159 PACS users were analyzed using the structural equation modeling method. RESULTS: The fitted model showed significant relations between the technical components and the TAM variables, via the following three significant paths: hardware to PEOU, and software to PEOU and also to PU. Moreover, the critical path of TAM variables was observed: PEOU-->PU-->SAT. Therefore, the model produced three significant routes: hardware-->PEOU-->PU-->SAT, software-->PU-->SAT, and software-->PEOU-->PU-->SAT. CONCLUSION: Contrary to expectations, the direct effect of PEOU on user satisfaction was not significant. The final model provided critical paths from technical components to user satisfaction, by utilizing PEOU and PU as intermediary, latent factors.
Computers ; Critical Pathways ; Cross-Sectional Studies ; Surveys and Questionnaires ; Dentists ; Health Care Sector ; Humans ; Radiology Information Systems ; Software

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Analysis of the Types of e-Business of the Healthcare Information Provision Service on the Internet.

Jeongeun KIM ; Sunyoung LEE ; Sukwha KIM

Journal of Korean Society of Medical Informatics.2009;15(3):255-263. doi:10.4258/jksmi.2009.15.3.255

OBJECTIVE: To define the healthcare information industry in order to propose a developmental direction for the industry, classify and analyze the healthcare information industry business models, and propose strategic guidelines for development of the healthcare information industry. METHODS: A survey was conducted to investigate the private companies that provide healthcare information. For in-depth investigation of the study subjects, they were categorized based on their means of service provision. Open colloquium participation requests were extended to the representative companies, and five open-colloquiums were held. Additional data were obtained through a structured questionnaire investigating the problems and complaints, followed by a discussion on strategies and future plans. RESULTS: Through a review of previous research on internet business model classification, four major model classification systems were chosen and the healthcare information business models were classified. Based on the composite opinions derived from the participating companies, policy guidelines were proposed. CONCLUSION: It is important to cooperate with experts from each field under governmental supervision and help the general public appreciate the value of healthcare information, thereby achieving the industrialization and development of the health information provision business.
Commerce ; Delivery of Health Care ; Internet ; Organization and Administration ; Surveys and Questionnaires ; Industrial Development

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The Feasibility of Using Classification and Identification Techniques to Auto-Assess the Quality of Health Information on the Web.

Polun CHANG ; Fan Pin HUANG ; Min Ling LAI

Journal of Korean Society of Medical Informatics.2009;15(3):247-254. doi:10.4258/jksmi.2009.15.3.247

OBJECTIVE: An automatic detection tool was created for examining health-related webpage quality we went further by examining its feasibility and performance. METHODS: We developed an automatic detection system to auto-assess the authorship quality indicator of an health-related information webpage for governmental websites in Taiwan. The system was integrated with the Chinese word segmentation system developed by the Academia Sinica in Taiwan and the SVM(light), which serve as an SVM (Support Vector Machine) Classifiers and a method of information extraction and identification. The system was coded in Visual Basic 6.0, using SQL 2000. RESULTS: We developed the first Chinese automatic webpage classification and information identifier to evaluate the quality of web information. The sensitivity and specificity of the classifier on the training set of webpages were both as high as 100% and only one health webpage in the test set was misclassified, due to the fact that it contained both health and non-health information content. The sensitivity of our authorship identifier is 75.3%, with a specificity of 87.9%. CONCLUSION: The technical feasibility of auto-assessment for the quality of health information on the web is acceptable. Although it is not sufficient to assure the total quality of web contents, it is good enough to be used to support the entire quality assurance program.
Asian Continental Ancestry Group ; Authorship ; Humans ; Quality Indicators, Health Care ; Sensitivity and Specificity ; Taiwan

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The Study on Subject Words of Korean Medical Informatics by Expanded MeSH: Based on Journal of Korean Society of Medical Informatics.

Ae Kyung KWON ; Young Moon CHAE

Journal of Korean Society of Medical Informatics.2002;8(4):91-98.

In order to maintain a uniformity and consistency in terminology for constructing and searching a literature database, controlled vocabularies should be used as key words in the journal. While most of medical academic societies have recommended MeSH be used as key words, only 23 societies published terminology or index books. We reviewed 172 journals of JKOSMI published during the period from 1995 to 2000, using MeSH brower. Only 11.72% of key words were completely consistent with MeSH terminolgy and 25.56% were partially consistent. Purposes of this study are to examine a current status of using MeSH in the Journal of Korean Society of Medical Informatics(JKOSMI) and to develop a Korean terminology book on medical informatics.
Classification ; Medical Informatics* ; Vocabulary, Controlled

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Development of a Measurement Tool System in Health and Medical Areas via the World Wide Web.

Young Sook LEE ; Keum Seong JANG ; Mi Jung SIM ; Nam Hee HONG

Journal of Korean Society of Medical Informatics.2002;8(4):81-89.

Scientific information databases produce insufficient and unsatisfactory levels of data for the specialized needs of researchers. Especially in the health and medical areas, researchers are looking for a measurement tool on the web that allows interaction between the database and the researcher for the production of new information through searching, accumulating, modifying, and deleting data. In this research paper, first a concrete explanation of the informational items in databases such as the types of measurement tool in the health and medical areas, their usage methods, their reliability and validity. Secondly, this report developed the service system of the measurement tool in the health and medical areas including functions of searching and answers of measurement information, functions in writing up information measurements from the web, and the user's friendly system according to their accessing levels. This measurement tool system can be applied for digital data collection and analysis rapidly via the web.
Data Collection ; Information Systems ; Internet* ; Reproducibility of Results ; Writing

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Public opinion and demands on joint purchasing for health services.

Yunhee CHO ; Jiseon NA ; Miyoung JEON ; Hyejung CHANG

Journal of Korean Society of Medical Informatics.2002;8(4):69-79.

As the rapid growth of internet users, the implementation of e-commerce and e-community are becoming popular also in health fields. Especially, the marketing strategy through joint purchasing for health services such as lasik, plastic surgery, etc. has increasingly been an important issue in clinics and health portals. Therefore, this study purposes to investigate the current status of joint purchasing for health services and estimate the demand on them. Since the university students use an internet most frequently and tend to purchase the goods and services actively through it, the intention for health services were targeted to university students. Only 29% of respondents acknowledged the joint purchasing system for health services. And the purchasing intention was higher in the university students who experienced the joint purchasing for general goods than those who did not experience. Non-surgery items such as stress clinic, dental scaling showed higher intention. Meanwhile when respondents purchase the health services through an internet, they consider the reliability of quality for health services at most. Considering this, if the legal regulations and ethical standards for reliable health services are systematically prepared, positive attitudes and behavioral intention on joint purchasing for health services will be increased and the market of joint purchasing will be enlarged.
Surveys and Questionnaires ; Dental Clinics ; Group Purchasing* ; Health Services* ; Humans ; Intention ; Internet ; Joints* ; Keratomileusis, Laser In Situ ; Marketing ; Public Opinion* ; Social Control, Formal ; Surgery, Plastic

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