Objectives: In the Fourth Industrial Revolution, there is a focus on managing diverse medical data to improve healthcare and prevent disease. The challenges include tracking detailed medical records across multiple institutions and the necessity of linking domestic public medical entities for efficient data sharing. This study explores MyHealthWay, a Korean healthcare platform designed to facilitate the integration and transfer of medical data from various sources, examining its development, importance, and legal implications. Methods: To evaluate the management status and utilization of MyHealthWay, we analyzed data types, security, legal issues, domestic versus international issues, and infrastructure. Additionally, we discussed challenges such as resource and infrastructure constraints, regulatory hurdles, and future considerations for data management. Results: The secure sharing of medical information via MyHealthWay can reduce the distance between patients and healthcare facilities, fostering personalized care and self-management of health. However, this approach faces legal challenges, particularly relating to data standardization and access to personal health information. Legal challenges in data standardization and access, particularly for secondary uses such as research, necessitate improved regulations. There is a crucial need for detailed governmental guidelines and clear data ownership standards at institutional levels. Conclusions This report highlights the role of Korea's MyHealthWay, which was launched in 2023, in transforming healthcare through systematic data integration. Challenges include data privacy and legal complexities, and there is a need for data standardization and individual empowerment in health data management within a systematic medical big data framework.

OBJECTIVES: The objective of this study was to investigate the clinical decision support (CDS) functions and digitalization of clinical documents of Electronic Medical Record (EMR) systems in Korea. This exploratory study was conducted focusing on current status of EMR systems. METHODS: This study used a nationwide survey on EMR systems conducted from July 25, 2018 to September 30, 2018 in Korea. The unit of analysis was hospitals. Respondents of the survey were mainly medical recorders or staff members in departments of health insurance claims or information technology. This study analyzed data acquired from 132 hospitals that participated in the survey. RESULTS: This study found that approximately 80% of clinical documents were digitalized in both general and small hospitals. The percentages of general and small hospitals with 100% paperless medical charts were 33.7% and 38.2%, respectively. The EMR systems of general hospitals are more likely to have CDS functions of warnings regarding drug dosage, reminders of clinical schedules, and clinical guidelines compared to those of small hospitals; this difference was statistically significant. For the lists of digitalized clinical documents, almost 93% of EMR systems in general hospitals have the inpatient progress note, operation records, and discharge summary notes digitalized. CONCLUSIONS: EMRs are becoming increasingly important. This study found that the functions and digital documentation of EMR systems still have a large gap, which should be improved and made more sophisticated. We hope that the results of this study will contribute to the development of more sophisticated EMR systems.
Appointments and Schedules ; Decision Support Systems, Clinical ; Electronic Health Records ; Health Information Exchange ; Hope ; Hospitals, General ; Humans ; Inpatients ; Insurance, Health ; Korea ; Medical Informatics ; Medical Records ; Medical Records Systems, Computerized ; Surveys and Questionnaires

OBJECTIVES: The objective of this study was to investigate the relationship between the level of Electronic Medical Record (EMR) system adoption and healthcare information technology (IT) infrastructure. METHODS: Both survey and various healthcare administrative datasets in Korea were used. The survey was conducted during the period from June 13 to September 25, 2017. The chief information officers of hospitals were respondents. Among them, 257 general hospitals and 273 small hospitals were analyzed. A logistic regression analysis was conducted using the SAS program. RESULTS: The odds of having full EMR systems in general hospitals statistically significantly increased as the number of IT department staff members increased (odds ratio [OR] = 1.058, confidence interval [CI], 1.003–1.115; p = 0.038). The odds of having full EMR systems was significantly higher for small hospitals that had an IT department than those of small hospitals with no IT department (OR = 1.325; CI, 1.150–1.525; p < 0.001). Full EMR system adoption had a positive relationship with IT infrastructure in both general hospitals and small hospitals, which was statistically significant in small hospitals. The odds of having full EMR systems for small hospitals increased as IT infrastructure increased after controlling the covariates (OR = 1.527; CI, 1.317–4.135; p = 0.004). CONCLUSIONS: This study verified that full EMR adoption was closely associated with IT infrastructure, such as organizational structure, human resources, and various IT subsystems. This finding suggests that political support related to these areas is indeed necessary for the fast dispersion of EMR systems into the healthcare industry.
Dataset ; Delivery of Health Care* ; Electronic Health Records* ; Health Care Sector ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Surveys and Questionnaires

OBJECTIVE: CDA is a standard for the exchange and sharing of clinical documents among all entities in the healthcare domain. As it proliferates, the number of CDA documents will increase exponentially and it will require huge storage spaces to store them. The main goal of this study is to devise an efficient compression method optimized for CDA documents so that the storage requirement can be lowered. METHODS: The method proposed in this paper is based on a compression method called Xmill which has been designed specifically for XML documents at large, which requires human intervention for the effective compression, especially, of CDA. Our proposed method, CDACOM, automatically extracts type information from CDA documents to infer the data type, assigns data values of the same type to the same data container, and applies an optimized encoder to the container so that a better compression rate can be achieved. RESULTS: Experiments with various types of CDA documents were performed to evaluate the effectiveness of CDACOM over Xmill. The results show that CDACOM indeed outperforms Xmill and can decrease the output file size by about 24.1% on average, compared to Xmill. If documents are combined and compressed together, the gap gets even bigger to about 50%. CONCLUSION: The proposed compression method, CDACOM, is very effective and promising. It will help lowering the cost for systems to transmit and store CDA documents and, hence, expediting the adoption of the standard in the healthcare domain.
Adoption ; Delivery of Health Care ; Humans

BACKGROUND AND OBJECTIVES: Chronobiological rhythms have been shown to influence the occurrence of a variety of cardiovascular disorders, including acute myocardial infarction (AMI). The present study investigated whether the onset of acute aortic syndrome (AAS) has unique chronobiological rhythms in Korean populations. SUBJECTS AND METHODS: The clinical data of 371 consecutive AAS patients, admitted between 1993 and 2003, were retrospectively analyzed; 310 AMI patients, who underwent primary percutaneous angioplasty in the hyperacute phase between 1998 and 2001, were also selected. RESULTS: In the AAS group, the final diagnoses were aortic dissection (AD) and aortic intramural hematoma (AIH) in 212 and 159 patients, respectively Similar to AMI, AAS showed a significantly higher occurrence from 6 AM to noon compared with other time periods (p=0.0013). AAS showed a second peak occurrence from 6 PM to midnight, which was not observed in the AMI group. A subgroup analysis revealed that younger patients (age < 60 years) and those with a past medical history of hypertension had the highest occurrence from 6 PM to midnight, which was quite different compared to the AAS patients. No significant variation was found for the day of the week in either group. Although no significant seasonal variation was observed in the frequency of AMI, the frequency of AAS was significantly higher during winter (p<0.001). The circadian and seasonal variations in the frequency of AIH were similar to those of AD. CONCLUSION: AAS shows unique circadian and seasonal variations in Korean populations. Our findings may have implications for the prevention of AAS by tailoring treatment strategies to ensure maximal benefits during the vulnerable periods.
Angioplasty ; Circadian Rhythm ; Diagnosis ; Hematoma ; Humans ; Hypertension ; Myocardial Infarction* ; Retrospective Studies ; Seasons

BACKGROUND: Since the bioavailability of itraconazole capsule is influenced by patients gastric acidity, it results in treatment failure due to its low dissolution and subsequent low absorption when administered in fasting. Itraconazole Melt-Extrusion tablet has been lately developed in order to improve its dissolution profile. It is the first clinical study to evaluate the efficacy and safety of itraconazole Melt-Extrusion tablet in Korea. OBJECTIVE: This study was conducted to evaluate the efficacy and safety of itraconazole melt-extrusion tablet 400mg daily for 1 week(pulse therapy) for hyperkeratotic type of tinea pedis and manus. METHODS: A clinical and mycological investigation was made of 812 outpatients with hyperkeratotic type of tinea pedis and/or tinea manus who had visited at 52 general hospitals under the lead of the Korean Dermatological Association from June to December, 1998. Patients confirmed by clinically and microscopically as hyperkeratotic type of tinea pedis and/or tinea manus were administered 2 tablets twice a day for one week and followed up for 8 weeks from the start of the medication. RESULTS: The results were summarized as follows; 1. Clinical symptoms of hyperkeratotic type of tinea pedis and/or tinea mauns were significantly improved at the end of study, week 8(p<0.001). 2. Clinical response rate, defined as more than 50% decrease of the sum of the clinical symptom scores, was 79.3%(512/646). 3. Mycological cure rate, dafined as both culture and KOH negative at week 8, was 78.2%(244 /312). 4. 40(5.5%) patients, of the 727 patients evaluable for drug safety evaluation, were reported to have adverse event. CONCLUSION: Itraconazole Melt-Extrusion tablet 400mg/day for 1 week (pulse therapy) is effective and safe in the treatment of hyperkeratotic type of tinea pedis and/or tinea manus.
Absorption ; Biological Availability ; Fasting ; Gastric Acid ; Hospitals, General ; Humans ; Itraconazole* ; Korea ; Outpatients ; Tablets ; Tinea Pedis* ; Tinea* ; Treatment Failure

BACKGROUND: Knowledge about the degree of risk and location of multiple primary cancers can facilitate the targeting of screening and surveillance practices on follow-up after treatment of cervical cancer. PURPOSE: The retrospective study was performed to evaluate the characteristics of multiple primary malignancies in patients treated for cervical carcinoma. METHOD: From data base file of gynecologic cancer patients between 1976 and 1995, total 20 patients were found to have cervical cancer and another primary malignancy. Their medical records and pathologic slides were reviewed. Follow-up information was obtained from medical records or by telephone. RESULT: There were 8 synchronous and 12 metachronous multiple primary cancers (MPC) among 20 patients. Their mean age was 51 years (range 23 ~ 68 years). The distribution of FIGO stage of the patients with cervical cancer was classified into stage I, 6 patients; stage II, 9 ; and stage III, 5. All patients showed squamous cell type histology of cervical cancer. Eight(40 %) of 20 patients developed second cancer in uterus : 6 malignant mixed Mllerian tumors(MMMT), one endometrial stromal sarcoma, and one endometrial adenocarcinoma. Seven of 8 synchronous type MPC patients are alive (median follow-up, 27 months). In contrast, only one out of 12 metachronous type MPC patients is alive(median follow-up, 114 months). The occurrence of eight malignancies including 6 MMMT, one bladder cancer, and one rectal cancer might be related with previous radiation therapy for cervical cancer. CONCLUSION: These results suggest that routine screening and surveillance work-up might not be necessary in most of patients with cervical cancer. However, the patients with cervical cancer undergoing radiation treatment have to be followed carefully with the consideration of possibility for developing second cancer in the field of irradiation.
Adenocarcinoma ; Follow-Up Studies ; Humans ; Mass Screening ; Medical Records ; Neoplasms, Second Primary ; Rectal Neoplasms ; Retrospective Studies ; Sarcoma, Endometrial Stromal ; Telephone ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms ; Uterus

This study was performed to demonstrate the efficacy of combination of cold-knife conization and cold-coagulation for the treatment of cervical intraepithelial neoplasia(CIN). In addition, the accuracy of the colposcopic biopsy and Pap smear compare to conization was determined. Cold-coagulation was performed simultaneously in 151 patients after cold-knife conization for diagnosis and treatment of CIN from Jan. 1995 to Dec. 1996. Medical records and pathologic slides of those patients were reviewed. Histologic comparison between the Pap smear and conization specimens showed agreement with 70 % within one grade difference ; Histologic comparison between the colpodirected punch biopsy and conization specimens showed agreement with 80 %. The margin involvement of conization was seen in 35 patients(23 %). There was a tendency of increasing rate of positive cone margin with grade of the lesion : 14 %(1/7) in CIN 1, 20 %(2/10) in CIN 2, 35 %(31/88) in CIN 3, and 33 %(1/3) in microinvasive cervical cancer. Among these 35 patients, 11 patients underwent hysterectomy and showed residual disease in 4 patients(36 %). Recurrence of CIN was found in 4 patients(16 %) with positive cone margin and 1 patient(0.9 %) with negative cone margin. Bleeding was observed in 13 patients(9 %). Two patients underwent hysterectomy because of severe bleeding. These results suggest that cold-knife conization with cold-coagulation is an effective procedure to reduce recurrence rate of the patients with CIN regardless of status of cone margin and to reduce the severity of bleeding after conization.
Biopsy ; Cervical Intraepithelial Neoplasia* ; Conization* ; Diagnosis* ; Hemorrhage ; Humans ; Hysterectomy ; Medical Records ; Recurrence ; Uterine Cervical Neoplasms