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Medical Informatics 20/20: Quality and Electronic Health Records through Collaboration, Open Solutions, and Innovation by Douglas Goldstein, Peter J. Groen, Suniti Ponkche, Marc Wine, 2007.

Inyoung CHOI

Journal of Korean Society of Medical Informatics.2008;14(4):485-486.

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

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Unfolding for Color Volume Dataset Using the Difference of Segmented Contours.

Yihwa KANG ; Byeong Seok SHIN ; Dong Sun SHIN

Journal of Korean Society of Medical Informatics.2008;14(4):471-483.

OBJECTIVE: Unfolding is a rendering method to visualize organs at a glance by virtually incising them. Although conventional methods exploit gray-scale volume datasets such as CT or MR images, we use the Visible Korean Human dataset preserving actual color. This can be helpful for the study of anatomical knowledge. Segmented images of Visible Korean Human dataset store the boundary of organs. Since medical experts manually perform the segmentation from anatomical color images, it is very time-consuming. In general, therefore, some images selectively sampled with interval from entire color images are segmented. When we generate a segment volume dataset with the selected images, final results are deteriorated due to lack of segmentation information for missed images. In this paper, we solve this problem by generating intermediate images without performing a manual segmentation. METHODS: Firstly, after comparing differences of organ's contours in between two consecutive segmented images, we represent the differences as a user-defined value in the intermediate images. This procedure is repeated for all pairs of manually segmented images to reconstruct entire volume data consist of manually segmented images and their intermediate images. In rendering stage, we perform the radial volume ray casting along with the central path of target organ. If a ray reaches to a region having the user-defined values, we advance over the region without compositions to the boundary of that region. Then the color composition is begun by performing backtracking, since the advanced region is regarded to the thickness of it. RESULTS: As a result, we can produce high quality unfolding images for the stomach, colon, bronchus, and artery of the Visible Korea Human dataset. CONCLUSION: Since our approach can be applied to virtual dissection including actual human colors, it is helpful for the endoscopy and anatomy studies.
Arteries ; Bronchi ; Colon ; Endoscopy ; Humans ; Korea ; Stomach

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The Interchange of Radiological Reports Using Clinical Document Architecture Standards.

Myoung Ju JEON ; In Young KIM ; Sun I KIM

Journal of Korean Society of Medical Informatics.2006;12(1):105-112.

OBJECTIVE: We developed a Clinical Document Architecture(CDA) Generator module based on CDA standard for the interchange of radiological reports. METHODS: This paper describes CDA standard, the template of radiological report, CDA Generator module, and the Web-form report using an Extensible Stylesheet Language(XSL) style-sheet. And the CDA Generator module is integrated into a existing Picture Archiving Communication System(PACS) Viewer. RESULTS: Radiological reports based on CDA standard are used to interchange between different health institutions, and also presented in an Extensible Markup Language (XML) compatible web browser. CONCLUSION: The proposed module and concept in this paper may be a utility in improving health care delivery and can also be used to integrate with other Digital Imaging and Communication in Medicine(DICOM) Structured Report (SR) compliant PACS systems.
Delivery of Health Care ; Web Browser

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Development Environment for Automatic Generation of Clinical Data Acquisition System.

Dong Jin KIM ; Seon Ho KIM ; Kyung Mo PARK ; Sun Mi CHOI

Journal of Korean Society of Medical Informatics.2006;12(1):95-104.

OBJECTIVE: This paper discusses the development environment that automatically generates software intended to execute arbitrarily defined functions. Software that we develop can be regarded as a kind of development environment or development platform, and its purpose is the automatic generation of the clinical data acquisition system that supports arbitrary clinical researches. METHODS: Basically, the clinical data acquisition system consists of the interface, the data storage and the clinical research protocols. Our development environment generates these components automatically according to the ontology written by the end user, e.g. a clinical researcher. A clinical data acquisition system is then generated. RESULTS: Our development environment consists of the interface generation module, the database generation module, the temporary data storage generation module for CDA (clinical document architecture), and the ontologies. Ontology is a method of expressing structured information and can be regarded as a knowledge base serialized by XML format. These ontologies are constructed by domain experts who want a clinical research support system. Ontology describes clinical data items, the interface design and the database schema of a clinical data acquisition system. The development environment parses these ontologies and secures the information on how to generate a clinical data acquisition system. CONCLUSION: This study can be utilized to develop the clinical data acquisition system in oriental medicine.
Clinical Protocols ; Information Storage and Retrieval ; Knowledge Bases ; Medicine, East Asian Traditional

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Nurses' Experience: Impact of Hospital Information Systems on Nursing Care.

Jee In HWANG ; Hyeoun Ae PARK

Journal of Korean Society of Medical Informatics.2006;12(1):83-94.

OBJECTIVE: The purposes of this study were to understand nurses' experience after the computerization of nursing care as a part of hospital information systems and to explore the change in nursing care time. METHODS: This study used a qualitative approach. The subjects were ten nurses by purposeful snowball sampling. In-depth interview was performed. All interviews were tape-recorded and transcribed verbatim. The data were analyzed using qualitative theme analysis. RESULTS: Nurses took into account the computerization as a 'benefit'. Their experiences after computerization were categorized into process and outcome impact. The emerged themes in nursing care process were 'accuracy', 'rapidness', and 'time saving in indirect nursing care'. Those in nursing care outcome included 'leisure', 'satisfaction', 'burden', and 'threatening privacy'. In addition, nurses' personal characteristics was the most important factor affecting the efficient use of saved time due to decrease of indirect nursing time to increase direct nursing care. CONCLUSION: Maximizing the positive impact of computerization requires redesign of nursing job description and work pattern, and education of efficient time management for individual nurse.
Education ; Hospital Information Systems* ; Humans ; Job Description ; Nursing Care* ; Nursing Staff ; Nursing* ; Time Management

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Bayesian Network Approaches to Health Services Research.

Sun Mi LEE

Journal of Korean Society of Medical Informatics.2006;12(1):71-81.

OBJECTIVE: To explore the feasibility of using the Bayesian network approach to study health outcomes and evaluate its predictive performance. METHODS: The Human immuno-deficiency virus Cost and Services Utilization Study (HCSUS) baseline dataset consisting of 2,864 human immuno-deficiency virus positive adults was used. The Hugin Researcher 6.2TM was used to develop the Bayesian network and Na?ve Bayes models. The SAS/STAT PROC LOGISTIC was used to develop the logistic regressions. RESULTS: The area under the receiver operating characteristic curve of the Bayesian network model was statistically higher than that of the Na?ve Bayes model, but no higher than that of the logistic regression model using the 8 variables from a previous study. In a second analysis using the 10 most influential predictors discovered by the Bayesian network approach, the Na?ve Bayes and the logistic regression performance improved. CONCLUSION: The BN approaches contributed to the discovery of additional influential predictors that lead to an increase of the models' predictive performance. When attempting to discover unknown relationships that might be missed by traditional analysis methods alone, the use of the Bayesian network as complementary methods may add value.
Adult ; Bays ; Data Mining ; Dataset ; Health Services Research* ; Health Services* ; Humans ; Logistic Models ; ROC Curve

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Needs Assessment for Functionalities in Electronic Health Record Systems in General Hospitals.

Jee In HWANG ; Seung Jong YU ; Ho Jun CHIN ; Jeong Wook SEO

Journal of Korean Society of Medical Informatics.2006;12(1):57-70.

OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

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User's Satisfaction on the Electronic Medical Record System in Seoul National University Bundang Hospital.

Eun Young CHOI ; Yoon Seok CHANG ; Ho Jun CHIN ; Eun Ja CHUNG ; Nam Soo BYEUN ; Dong Hyun YOO ; Sunny BAE ; Kyoo Seob HA

Journal of Korean Society of Medical Informatics.2006;12(1):45-55.

OBJECTIVE: Seoul National University Bundang Hospital is the first full digital hospital with electronic medical record(EMR) system in Korea. We evaluated the user's satisfaction on the EMR system at 15 months from its beginning. METHODS: A total of 105 doctors and 503 nurses participated in this study. The questionnaire was composed of four domains: user satisfaction between paper records and EMR, User perceived improvement of work efficiency with EMR, user interface satisfaction and advantage/ disadvantage of EMR. A Likert-type 5-point scale was used for the degree of satisfaction, with 5 indicating 'very satisfied'. RESULTS: Doctors were more satisfied with EMR system than paper records, especially on editing (3.33 vs. 2.73, p<0.05) and retrieval (3.68 vs. 2.23, p<0.05). However, the degree of satisfaction was not significantly different from that of paper records in terms of input (3.22 vs. 3.03, p>0.05). Nurses were more satisfied with EMR system than paper records, e.g., editing (3.51 vs. 2.74, p<0.05), retrieval (4.07 vs. 2.51, p<0.05) and input (3.82 vs. 2.90, p<0.05). Also, doctors and nurses showed satisfaction for most of user interfaces. CONCLUSION: Users seem to be satisfied with the EMR system. EMR system should have a flexible system to improve the input system, the structured forms, and the standardized terminology according to the need of users.
Electronic Health Records* ; Electronics, Medical ; Korea ; Surveys and Questionnaires ; Seoul*

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Classification and Conceptualization of Clinical Documents using Formal Concept Analysis.

Myeng Ki KIM ; Suk Hyung HWANG ; Hong Gee KIM ; Yu Kyung KANG ; Hee Chul CHOI ; Dong Soon KIM

Journal of Korean Society of Medical Informatics.2006;12(1):31-43.

OBJECTIVE: Ontology is becoming a core research field in the realm of medical informatics. The objective of our ongoing research is to explore the potential role of Formal Concept Analysis(FCA) in a context-based ontology building support in a medical domain. The concept hierarchy plays an important role as the backbone of ontology, but its construction is a complex and time-consuming process. We present a novel approach to the automatic acquisition of taxonomies or concept hierarchies from clinical documents. METHODS: Our approach is based on FCA, a mathematical tool used in data analysis and knowledge engineering. It provides methods to group objects and attributes into concepts, pairs of object-sets(clinical documents) and attribute-sets(fields contained in the clinical documents), such that the binary relation can be presented in a concept lattice. Based on the FCA, we have applied out approach for 8 clinical documents used in a university hospital. As a result of our experiments, we can extract 15 concepts with 7 common fields that can be shared with 8 clinical documents. RESULTS: We show how FCA can be used to classify clinical documents and acquire a concept hierarchy for the medical domain out of the clinical documents with maximal property factorization. CONCLUSION: The whole of our work is based on the concept lattice of which allows to construct a "well defined" ontological concept hierarchy. As an application of this approach, we presented some results of classification of clinical documents with maximally factorized common fields. We have shown that FCA can be useful method to classify and analyze various medical data by constructing concept hierarchy. From that concept hierarchy, we can acquire well-structured facts and knowledges in medical domain.
Classification* ; Medical Informatics ; Statistics as Topic

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Development of a Medical Ontology Library: Analysis of the Clinical Terms in the Medical Records of a COPD Patient.

Kyoung Jin LEE ; Jieun CHOI ; Sung Chul HWANG ; Byung Hyun HA ; Eui Jun PARK ; Jae Il LEE ; Myeng Ki KIM ; Rae Woong PARK

Journal of Korean Society of Medical Informatics.2006;12(1):21-29.

OBJECTIVE: The medical records of a patient with chronic obstructive pulmonary disease(COPD) were analyzed to extract medical concepts and their relationships in order to construct a basic medical ontology. METHODS: The medical records included the admission note, vital signs record, doctors' order sheets, progress notes, emergency notes, discharge summary, surgical record, and anesthesia record. RESULTS: A total of 396 concepts, 16 relationships, and 460 connections were created. Fourteen top-level concepts, such as body, sign, and procedure, were found. The most common relationship was 'isA' and the second was 'isPartOf'. All the relationships between the concepts were displayed using the graphic tool GraphViz. CONCLUSION: A pilot ontology on COPD was constructed through a medical record analysis. The asynchronous cooperation using a web interface for the ontology construction was helpful.
Anesthesia ; Emergencies ; Humans ; Medical Records* ; Pulmonary Disease, Chronic Obstructive* ; Vital Signs

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