BACKGROUND: We examined the current status of specialized agencies for occupational health management (SAs) and their workforce. Furthermore, we aimed to clarify the current practice status of SA healthcare professionals and factors that influence their performance. METHODS: To examine the current SA workforce, we analyzed data from the 2014 Survey of Current Status of SA and their Workforce from the Ministry of Employment and Labor (MOEL). Furthermore, we mailed out an original questionnaire to SA professionals to determine their current health management status and factors that affect their performance. Data from the respondents (N = 384) were analyzed. RESULTS: In 2014, the workforce performing health management in SAs comprised 232 physicians, 507 nurses, and 312 occupational hygienists, with no significant regional differences in the distribution of physicians and nurses. According to the findings of the questionnaire, the average daily number of worker consultations by physicians and nurses was 22.8, while the average time taken for health management ranged from 74.3 to 104.3 min, depending on the size of the firm. Most of the respondents (41.5%) answered that they were following-up on more than 80% of individuals with illnesses. Among health management tasks, performance scores of “consultations for general diseases” and “consultations for lifestyle habits” were relatively high, whereas health promotion activities at workplaces were relatively low. There was a significant correlation between the utilization of general and special health examination results and task performance. CONCLUSION: Among health management tasks, follow-up management of individuals with illnesses and consultations for disease/lifestyle habits were relatively well performed, whereas health promotion activities at workplaces were not performed well. Among factors that positively influenced SA performance at workplaces, only the utilization of health examination results had significant effects. Therefore, to accomplish health management goals and perform effective health management at workplaces, there is a need to establish a comprehensive system of occupational health service outsourcing integrating health examinations and health management services. Furthermore, the current task system, which focuses on follow-up management, should be expanded to incorporate preventive and health promotion functions—the fundamental functions of occupational health services (OHS).
Cross-Sectional Studies* ; Delivery of Health Care ; Employment ; Follow-Up Studies ; Health Promotion ; Life Style ; Occupational Health Services ; Occupational Health* ; Outsourced Services ; Postal Service ; Referral and Consultation ; Surveys and Questionnaires ; Task Performance and Analysis ; Work Performance

With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.
Clinical Trials as Topic ; Data Collection ; methods ; Information Storage and Retrieval ; methods ; Outsourced Services ; Quality Control

OBJECTIVES: The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. METHODS: Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. RESULTS: Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. CONCLUSIONS: Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.
Cost Savings ; Hospitals, General ; Information Systems* ; Organizational Innovation ; Outsourced Services* ; Surveys and Questionnaires

The purpose of this study was to explore the laboratory biosafety status of Public Health Centers (PHCs) in Korea during Oct.7~26, 2012. We surveyed the environment of biosafety management, especially for the recognition level for biosafety of workers in the organizations. The questionnaires given out to 98 workers who are working for PHCs are to research the recognition level of workers for the knowledge of biosafety, related laws and regulations. The level was the highest in the Research Institute of the Public Health & Environment (RIPHE) followed by quarantine station, and the health center was assessed as the last. It was turned out that the biosafety educational program in the RIPHE was implemented on a regular basis (65.2%) with irregular cases (21.7%), and some outsourcing chances (8.7%). However, quarantine stations and health centers didn't practice actively biosafety training programs compared to RIPHE. In addition, there was a majority of opinions that the most important thing to improve biosafety level of PHCs is to strengthen current poor training and education system. In conclusion, it is necessary to develop more improved training system for biosafety on exposure risks including injuries, personal protective equipment, and chemical hazards.
Academies and Institutes ; Delivery of Health Care ; Hospitals, Isolation ; Humans ; Jurisprudence ; Korea ; Outsourced Services ; Public Health ; Social Control, Formal ; Surveys and Questionnaires

OBJECTIVES: To examine the current status of hospital information systems (HIS), analyze the effects of Electronic Medical Records (EMR) and Clinical Decision Support Systems (CDSS) have upon hospital performance, and examine how management issues change over time according to various growth stages. METHODS: Data taken from the 2010 survey on the HIS status and management issues for 44 tertiary hospitals and 2009 survey on hospital performance appraisal were used. A chi-square test was used to analyze the association between the EMR and CDSS characteristics. A t-test was used to analyze the effects of EMR and CDSS on hospital performance. RESULTS: Hospital size and top management support were significantly associated with the adoption of EMR. Unlike the EMR results, however, only the standardization characteristic was significantly associated with CDSS adoption. Both EMR and CDSS were associated with the improvement of hospital performance. The EMR adoption rates and outsourcing consistently increased as the growth stage increased. The CDSS, Knowledge Management System, standardization, and user training adoption rates for Stage 3 hospitals were higher than those found for Stage 2 hospitals. CONCLUSIONS: Both EMR and CDSS influenced the improvement of hospital performance. As hospitals advanced to Stage 3, i.e. have more experience with information systems, they adopted EMRs and realized the importance of each management issue.
Adoption ; Decision Support Systems, Clinical ; Electronic Health Records ; Electronics ; Electrons ; Health Facility Size ; Hospital Information Systems ; Information Management ; Information Systems ; Knowledge Management ; Korea ; Outsourced Services ; Tertiary Care Centers

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

BACKGROUND: Cost containment through continuous quality improvement of medical service is required in an age of a keen competition of the medical market. Laboratory managers should examine the matters on make-or-buy decision periodically. On this occasion, a break-even point analysis can be useful as an analyzing tool. In this study, cost accounting and break-even point (BEP) analysis were performed in case that the immunoassay items showing a recent increase in order volume were to be in-house made. METHODS: Fixed and variable costs were calculated in case that alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), prostate-specific antigen (PSA), ferritin, free thyroxine (fT4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), CA 125, CA 19-9, and hepatitis B envelope antibody (HBeAb) were to be tested with Abbott AxSYM instrument. Break-even volume was calculated as fixed cost per year divided by purchasing cost per test minus variable cost per test and BEP ratio as total purchasing costs at break-even volume divided by total purchasing costs at actual annual volume. RESULTS: The average fixed cost per year of AFP, CEA, PSA, ferritin, fT4, T3, TSH, CA 125, CA 19- 9, and HBeAb was won 8,279,187 and average variable cost per test, won 3,786. Average break-even volume was 1,599 and average BEP ratio was 852%. Average BEP ratio without including quality costs such as calibration and quality control was 74%. CONCLUSIONS: Because the quality assurance of clinical tests cannot be waived, outsourcing all of 10 items was more adequate than in-house make at the present volume in financial aspect. BEP analysis was useful as a financial tool for make-or-buy decision, the common matter which laboratory managers meet with.
alpha-Fetoproteins ; Calibration ; Carcinoembryonic Antigen ; Cost Control ; Ferritins ; Hepatitis B ; Immunoassay ; Outsourced Services ; Prostate-Specific Antigen ; Quality Control ; Quality Improvement ; Thyrotropin ; Thyroxine ; Triiodothyronine

Clinical Competence ; Humans ; Outsourced Services ; Radiology ; education ; trends ; Radiology Information Systems

Teleradiology will have a significant impact on the delivery of healthcare and the practice of medicine. In order to ensure a positive outcome, the expected benefits, limitations and potential pitfalls of teleradiology must be carefully considered. For Singapore, teleradiology can be used to facilitate a quantum leap in the standards of radiological services. This can be achieved through the development of an integrated, nationwide, high-speed radiology network which will allow patients to have access to high-quality and responsive subspecialty radiology expertise located throughout the country. If judiciously implemented, teleradiology has the potential to propel Singapore radiology to an unprecedented level of professional quality and service delivery, and will provide the framework for sustainable radiological insourcing from other countries.
Communication ; Economic Competition ; Health Services Accessibility ; Humans ; International Cooperation ; Outsourced Services ; Quality of Health Care ; Singapore ; Teleradiology ; organization & administration ; trends

OBJECTIVE: This study aims to describe the basic features of Electronic Medical Records at the Seoul National University Hospital and Seoul National University Bundang Hospital and to discuss the process we developed and adopted the system. We also aim to suggest potential risks and success factors in our processes. METHODS: Seoul National University Hospital, a tertiary teaching hospital with 100-year-old history, 1000 medical staffs, and 1700 in-patient beds has successfully adopted Electronic Medical Records system from October 2004 and runs very well for more than one year. Our system is fully integrated with Computerized Physician's Order Entry (CPOE) and Picture Archiving and Communication System (PACS). RESULTS: We identified that the key step for the successful adoption of the full system was to overcome physicians' resistance to their use of Electronic Medical Records and to help their earlier accommodation to new practice environment. We then found that five important success factors were the clinical leadership, adoption strategy, young doctors' participation, outsourcing of the department of information technology and the accumulated domain knowledge. Our experience shows it is important to expose young medical staffs to the change before the main Electronic Medical Records system opens and "patient-centered" was the most important concept to make these reform processes successful. CONCLUSION: Development and adoption of Electronic Medical Records at large teaching hospital are not easy but are very important and powerful tool for patient-centered medical practice.
Electronic Health Records* ; Hospitals, Teaching ; Humans ; Leadership ; Medical Staff ; Outsourced Services ; Seoul*