Development of an Integrated Biospecimen Database among the Regional Biobanks in Korea / 대한의료정보학회지

OBJECTIVES: This study developed an integrated database for 15 regional biobanks that provides large quantities of high-quality bio-data to researchers to be used for the prevention of disease, for the development of personalized medicines, and in genetics studies. METHODS: We collected raw data, managed independently by 15 regional biobanks, for database modeling and analyzed and defined the metadata of the items. We also built a three-step (high, middle, and low) classification system for classifying the item concepts based on the metadata. To generate clear meanings of the items, clinical items were defined using the Systematized Nomenclature of Medicine Clinical Terms, and specimen items were defined using the Logical Observation Identifiers Names and Codes. To optimize database performance, we set up a multi-column index based on the classification system and the international standard code. RESULTS: As a result of subdividing 7,197,252 raw data items collected, we refined the metadata into 1,796 clinical items and 1,792 specimen items. The classification system consists of 15 high, 163 middle, and 3,588 low class items. International standard codes were linked to 69.9% of the clinical items and 71.7% of the specimen items. The database consists of 18 tables based on a table from MySQL Server 5.6. As a result of the performance evaluation, the multi-column index shortened query time by as much as nine times. CONCLUSIONS: The database developed was based on an international standard terminology system, providing an infrastructure that can integrate the 7,197,252 raw data items managed by the 15 regional biobanks. In particular, it resolved the inevitable interoperability issues in the exchange of information among the biobanks, and provided a solution to the synonym problem, which arises when the same concept is expressed in a variety of ways.

Development of an Integrated Biospecimen Database among the Regional Biobanks in Korea / 대한의료정보학회지

OBJECTIVES: This study developed an integrated database for 15 regional biobanks that provides large quantities of high-quality bio-data to researchers to be used for the prevention of disease, for the development of personalized medicines, and in genetics studies. METHODS: We collected raw data, managed independently by 15 regional biobanks, for database modeling and analyzed and defined the metadata of the items. We also built a three-step (high, middle, and low) classification system for classifying the item concepts based on the metadata. To generate clear meanings of the items, clinical items were defined using the Systematized Nomenclature of Medicine Clinical Terms, and specimen items were defined using the Logical Observation Identifiers Names and Codes. To optimize database performance, we set up a multi-column index based on the classification system and the international standard code. RESULTS: As a result of subdividing 7,197,252 raw data items collected, we refined the metadata into 1,796 clinical items and 1,792 specimen items. The classification system consists of 15 high, 163 middle, and 3,588 low class items. International standard codes were linked to 69.9% of the clinical items and 71.7% of the specimen items. The database consists of 18 tables based on a table from MySQL Server 5.6. As a result of the performance evaluation, the multi-column index shortened query time by as much as nine times. CONCLUSIONS: The database developed was based on an international standard terminology system, providing an infrastructure that can integrate the 7,197,252 raw data items managed by the 15 regional biobanks. In particular, it resolved the inevitable interoperability issues in the exchange of information among the biobanks, and provided a solution to the synonym problem, which arises when the same concept is expressed in a variety of ways.

Development of Cell Phone Application for Blood Glucose Self-Monitoring Based on ISO/IEEE 11073 and HL7 CCD / 대한의료정보학회지

OBJECTIVES: The objectives of this research were to develop and evaluate a cell phone application based on the standard protocol for personal health devices and the standard information model for personal health records to support effective blood glucose management and standardized service for patients with diabetes. METHODS: An application was developed for Android 4.0.3. In addition, an IEEE 11073 Manager, Medical Device Encoding Rule, and Bluetooth Health Device Profile Connector were developed for standardized health communication with a glucometer, and a Continuity of Care Document (CCD) Composer and CCD Parser were developed for CCD document exchange. The developed application was evaluated by five healthcare professionals and 87 users through a questionnaire comprising the following variables: usage intention, effort expectancy, social influence, facilitating condition, perceived risk, and voluntariness. RESULTS: As a result of the evaluation of usability, it was confirmed that the developed application is useful for blood glucose self-monitoring by diabetic patients. In particular, the healthcare professionals stated their own views that the application is useful to observe the trends in blood glucose change through the automatic function which records a blood glucose level measured using Bluetooth function, and the function which checks accumulated records of blood glucose levels. Also, a result of the evaluation of usage intention was 3.52 +/- 0.42 out of 5 points. CONCLUSIONS: The application developed by our research team was confirmed by the verification of healthcare professionals that accurate feedback can be provided to healthcare professionals during the management of diabetic patients or education for glucose management.

Implementation of Ontology-based Clinical Decision Support System for Management of Interactions Between Antihypertensive Drugs and Diet

PURPOSE: The influence of dietary composition on blood pressure is an important subject in healthcare. Interactions between antihypertensive drugs and diet (IBADD) is the most important factor in the management of hypertension. It is therefore essential to support healthcare providers' decision making role in active and continuous interaction control in hypertension management. The aim of this study was to implement an ontology-based clinical decision support system (CDSS) for IBADD management (IBADDM). We considered the concepts of antihypertensive drugs and foods, and focused on the interchangeability between the database and the CDSS when providing tailored information. METHODS: An ontology-based CDSS for IBADDM was implemented in eight phases: (1) determining the domain and scope of ontology, (2) reviewing existing ontology, (3) extracting and defining the concepts, (4) assigning relationships between concepts, (5) creating a conceptual map with CmapTools, (6) selecting upper ontology, (7) formally representing the ontology with Protege (ver.4.3), (8) implementing an ontology-based CDSS as a JAVA prototype application. RESULTS: We extracted 5,926 concepts, 15 properties, and formally represented them using Protege. An ontology-based CDSS for IBADDM was implemented and the evaluation score was 4.60 out of 5. CONCLUSION: We endeavored to map functions of a CDSS and implement an ontology-based CDSS for IBADDM.

Construction of the Nursing Diagnosis Ontology in Obstetric and Gynecologic Nursing Unit using Nursing Process and SNOMED CT

PURPOSE: This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. METHODS: The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. RESULTS: One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. CONCLUSION: Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.

Design of Activation Functions for Inference of Fuzzy Cognitive Maps: Application to Clinical Decision Making in Diagnosis of Pulmonary Infection / 대한의료정보학회지

OBJECTIVES: Fuzzy cognitive maps (FCMs) representing causal knowledge of relationships between medical concepts have been used as prediction tools for clinical decision making. Activation functions used for inferences of FCMs are very important factors in helping physicians make correct decision. Therefore, in order to increase the visibility of inference results, we propose a method for designing certain types of activation functions by considering the characteristics of FCMs. METHODS: The activation functions, such as the sinusoidal-type function and linear function, are designed by calculating the domain range of the functions to be reached during the inference process of FCMs. Moreover, the designed activation functions were applied to the decision making process with the inference of an FCM model representing the causal knowledge of pulmonary infections. RESULTS: Even though sinusoidal-type functions oscillate and linear functions monotonously increase within the entire range of the domain, the designed activation functions make the inference stable because the proposed method notices where the function is used in the inference. And, the designed functions provide more visible numeric results than do other functions. CONCLUSIONS: Comparing inference results derived using activation functions designed with the proposed method and results derived using activation functions designed with the existing method, we confirmed that the proposed method could be more appropriately used for designing activation functions for the inference process of an FCM for clinical decision making.

Design of Activation Functions for Inference of Fuzzy Cognitive Maps: Application to Clinical Decision Making in Diagnosis of Pulmonary Infection / 대한의료정보학회지

OBJECTIVES: Fuzzy cognitive maps (FCMs) representing causal knowledge of relationships between medical concepts have been used as prediction tools for clinical decision making. Activation functions used for inferences of FCMs are very important factors in helping physicians make correct decision. Therefore, in order to increase the visibility of inference results, we propose a method for designing certain types of activation functions by considering the characteristics of FCMs. METHODS: The activation functions, such as the sinusoidal-type function and linear function, are designed by calculating the domain range of the functions to be reached during the inference process of FCMs. Moreover, the designed activation functions were applied to the decision making process with the inference of an FCM model representing the causal knowledge of pulmonary infections. RESULTS: Even though sinusoidal-type functions oscillate and linear functions monotonously increase within the entire range of the domain, the designed activation functions make the inference stable because the proposed method notices where the function is used in the inference. And, the designed functions provide more visible numeric results than do other functions. CONCLUSIONS: Comparing inference results derived using activation functions designed with the proposed method and results derived using activation functions designed with the existing method, we confirmed that the proposed method could be more appropriately used for designing activation functions for the inference process of an FCM for clinical decision making.

Comparison of Knowledge Levels Required for SNOMED CT Coding of Diagnosis and Operation Names in Clinical Records / 대한의료정보학회지

OBJECTIVES: Coding Systematized Nomenclature of Medicine, Clinical Terms (SNOMED CT) with complex and polysemy clinical terms may ask coder to have a high level of knowledge of clinical domains, but with simpler clinical terms, coding may require only simpler knowledge. However, there are few studies quantitatively showing the relation between domain knowledge and coding ability. So, we tried to show the relationship between those two areas. METHODS: We extracted diagnosis and operation names from electronic medical records of a university hospital for 500 ophthalmology and 500 neurosurgery patients. The coding process involved one ophthalmologist, one neurosurgeon, and one medical record technician who had no experience of SNOMED coding, without limitation to accessing of data for coding. The coding results and domain knowledge were compared. RESULTS: 705 and 576 diagnoses, and 500 and 629 operation names from ophthalmology and neurosurgery, were enrolled, respectively. The physicians showed higher performance in coding than in MRT for all domains; all specialist physicians showed the highest performance in domains of their own departments. All three coders showed statistically better coding rates in diagnosis than in operation names (p < 0.001). CONCLUSIONS: Performance of SNOMED coding with clinical terms is strongly related to the knowledge level of the domain and the complexity of the clinical terms. Physicians who generate clinical data can be the best potential candidates as excellent coders from the aspect of coding performance.

Development of an Electronic Claim System Based on an Integrated Electronic Health Record Platform to Guarantee Interoperability / 대한의료정보학회지

OBJECTIVES: We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. METHODS: The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. RESULTS: The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. CONCLUSIONS: The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.

Analysis of Nursing Interventions Performed by Gynecological Nursing Unit Nurses Using the Nursing Interventions Classification / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify nursing intervention performed by nurses on gynecological nursing units. METHODS: The instrument in this study is based on the fifth edition of Nursing Interventions Classification (NIC) (2008). Data was collected by Electronic Medical record from August, 2010 to October, 2010 at one hospital and analyzed by using frequencies in the Microsoft Excel 2010 program. RESULTS: Of a total of 82 NIC, domains of the nursing interventions showed higher percentages for physiological: basic (36.3%) and physiological: complex (34.5%). The classes of nursing interventions showed higher percentage for health system mediation (12.1%), perioperative care (10.0%), and drug management (8.6%). The most frequently used top interventions were Discharge Planning. The thirty least used interventions was environmental management. Top thirty most frequently used interventions belonged to the domain of physiological: basic (37.9%), physiological: complex (31.1%), and behavioral (5.4%). CONCLUSION: These findings will help in the establishment of a standardized language for gynecological nursing units and enhance the quality of nursing care.

The Development of a Graphical User Interface Engine for the Convenient Use of the HL7 Version 2.x Interface Engine / 대한의료정보학회지

OBJECTIVES: The Health Level Seven Interface Engine (HL7 IE), developed by Kyungpook National University, has been employed in health information systems, however users without a background in programming have reported difficulties in using it. Therefore, we developed a graphical user interface (GUI) engine to make the use of the HL7 IE more convenient. METHODS: The GUI engine was directly connected with the HL7 IE to handle the HL7 version 2.x messages. Furthermore, the information exchange rules (called the mapping data), represented by a conceptual graph in the GUI engine, were transformed into program objects that were made available to the HL7 IE; the mapping data were stored as binary files for reuse. The usefulness of the GUI engine was examined through information exchange tests between an HL7 version 2.x message and a health information database system. RESULTS: Users could easily create HL7 version 2.x messages by creating a conceptual graph through the GUI engine without requiring assistance from programmers. In addition, time could be saved when creating new information exchange rules by reusing the stored mapping data. CONCLUSIONS: The GUI engine was not able to incorporate information types (e.g., extensible markup language, XML) other than the HL7 version 2.x messages and the database, because it was designed exclusively for the HL7 IE protocol. However, in future work, by including additional parsers to manage XML-based information such as Continuity of Care Documents (CCD) and Continuity of Care Records (CCR), we plan to ensure that the GUI engine will be more widely accessible for the health field.

Development and Effects of a Comprehensive Web-Based Nursing Process for Nursing Students / 기본간호학회지

PURPOSE: This study was conducted to develop a comprehensive web-based nursing process program to assist nursing students and to evaluate the effects of the program. METHODS: The system provides nursing students with guidelines based on NNN (NANDA, NOC, NIC) when the nursing students conduct a series of nursing procedures on diagnosis-outcome-intervention for a specific symptom. It also maintains and manages nursing processes actually conducted by students for clinical practices, and provides an environment where the patient information and nursing process can be converted into a formatted document for printing. This web-based program was used to surgical patients from April to June 2011. RESULTS: The overall satisfaction rate was 3.64. The item with the highest score was, 'Do you think a web-based nursing process program is necessary?' (3.87), followed by 'Do you want to use this program when you become a nurse and implement the nursing process?' (3.33). CONCLUSION: These results indicate that implementation of web-based programs needs to be continued as an effective tool, but more research is needed on the best way to implement web-based programs in various clinical setting.

An Improved Auto-Generation System to Obtain Reference Intervals for Laboratory Medicine / 대한의료정보학회지

OBJECTIVES: Reference values are highly required parameters for all tests in the clinical laboratory, and the supplementary provision of reliable reference intervals is an important task for both clinical laboratories and diagnostic test manufacturers. Despite the progress that has been made in the conceptual aspects of reference intervals, in practice their use is still not completely satisfactory. Most of the laboratories have used various methods to calculate statistic-based reference intervals, and they have mainly focused on extracted data, yet its use is considerably limited. We had to deal with the inconvenience of using a number of programs (SPSS or SAS, MS Excel) in order to calculate the results of reference intervals. METHODS: In order to obtain standardized reference intervals, we developed an integrated program that can calculate, by a nonparametric method, reference intervals with using the Clinical and Laboratory Standards Institute (CLSI) processes as its guideline. We also developed a grouping interface that enables users to customize classification of each group (age, gender, blood group, race, etc) when calculating reference intervals. RESULTS: To verify the developed program, we compared the reference intervals of the current data on 281 persons for 8 total areas, and the reference intervals were was already calculated beforehand with by using this new program. As a result, both results perfectly matched. CONCLUSIONS: This integrated program will be convenience for calculating reasonable values through continual datainspection at an inspection lab for calculating reference intervals. The newly developed program will improve the consistency and reliability of the statistics on reference intervals.

Developing a Smart Phone Application for the OMAHA System Guidelines

PURPOSE: The remarkable progress in information and communication technology has had a great effect on the healthcare delivery system. The development of smart phone applications is a new field. The aim of our research was to provide assistance in developing smart phone applications for community health nursing. METHODS: Based on an informative approach, this study developed persona and site maps, followed by a storyboard as a way of analyzing users' requirements and designing responses in the context of smart phone application development methodology. RESULTS: We developed persona, user interface and database design successfully, and then seven nurses selected four nursing problems (income, residence, pain, and digestion hydration). The search time in seconds for the 2005 English OMAHA guidelines to find three nursing interventions for these problems was used to evaluate the effectiveness of the smart phone application. The results showed that smart phone applications' search was 21 times faster on the average than book guidelines. CONCLUSION: An English version of the OMAHA system application was developed for the Android smart phone market. It is hoped that smart phone applications such as this will be used internationally for nursing education.

Proposed Algorithm with Standard Terminologies (SNOMED and CPT) for Automated Generation of Medical Bills for Laboratory Tests / 대한의료정보학회지

OBJECTIVES: In this study, we proposed an algorithm for mapping standard terminologies for the automated generation of medical bills. As the Korean and American structures of health insurance claim codes for laboratory tests are similar, we used Current Procedural Terminology (CPT) instead of the Korean health insurance code set due to the advantages of mapping in the English language. METHODS: 1,149 CPT codes for laboratory tests were chosen for study. Each CPT code was divided into two parts, a Logical Observation Identifi ers Names and Codes (LOINC) matched part (matching part) and an unmatched part (unmatched part). The matching parts were assigned to LOINC axes. An ontology set was designed to express the unmatched parts, and a mapping strategy with Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) was also proposed. Through the proceeding analysis, an algorithm for mapping CPT with SNOMED CT arranged by LOINC was developed. RESULTS: 75% of the 1,149 CPT codes could be assigned to LOINC codes. Two hundred and twenty-five CPT codes had only one component part of LOINC, whereas others had more than two parts of LOINC. The system of LOINC axes was found in 309 CPT codes, scale 555, property 9, method 42, and time aspect 4. From the unmatched parts, three classes, 'types', 'objects', and 'subjects', were determined. By determining the relationship between the classes with several properties, all unmatched parts could be described. Since the 'subject to' class was strongly connected to the six axes of LOINC, links between the matching parts and unmatched parts were made. CONCLUSIONS: The proposed method may be useful for translating CPT into concept-oriented terminology, facilitating the automated generation of medical bills, and could be adapted for the Korean health insurance claim code set.

A Development of Prototype Personal Health Record System based on Continuity of Care Document / 대한의료정보학회지

OBJECTIVE: We have developed a prototype Personal Health Record (PHR) system that can replace traditional paper-based personal health diary with structured clinical details for healthcare. Because numerous disparate electronic versions of medical record systems are found unable to share medical information among hospitals, pharmacies and clinicians, the proposed PHR system can be used to facilitate patient care. METHODS: The PHR system has been implemented on a flash memory (USB drive) that is found to be compact, light weight, cost-effective and sufficient enough to handle a large amount of clinical data. International communication standard HL7 has recommended Continuity of Care Document (CCD) that can provide complete and accurate summary of an individual health and medical history. Care documents stored in USB can also support alerts, reminders, self-management, and stakeholder communication in a standardized manner. RESULTS: The proposed PHR system consists of modules that help collect distributed patient information from multiple sources to generate individual care document (CCD) as personal health record. The preliminary experiment has demonstrated an acceptable performance. That is, the PHR is found to integrate and share various clinical data such as medications, procedures, patient demographics from admission system, test results from LIS, DICOM images from PACS, bio.signals from patient monitors. Especially, the PHR system was tested by connecting to standardized monitoring device (Mediana device) to collect ECG data. The PHR system had received 3410 HL7 messages for 1 hour, then generate CCD document.

Fall Risk Nursing Assessment according to the International Classification of Functioning, Disability, and Health / 대한의료정보학회지

OBJECTIVE: The International Classification of Function, Disability and Health (ICF) was designed to provide a common language by describing the function and disability of clients for health care professionals. The purpose of this paper is to introduce the International Classification of Function, Disability and Health (ICF) in nursing and investigate its applicability in fall risk assessment. METHODS: The Fall risk assessment system using the International Classification of Function, Disability and Health (ICF) is based on the Downton fall risk assessment tool which is most commonly used to assess the risk of falls across populations in any health care setting. To develop system, we used NetBeans 5.0 within JAVA SE Development Kit 1.4.2 (JDK 1.4.2) and Microsoft Access 2003 database was used for the information storage. RESULT: The International Classification of Function, Disability and Health (ICF) items can cover all items of the Downton fall risk assessment tool except for medication because there is no medication related items in the International Classification of Function, Disability and Health (ICF). We mapped patient's sensory deficit, mental state, and gait state in the Downton fall risk assessment with sensory function & pain, mental function, and mobility in the International Classification of Function, Disability and Health (ICF) respectively. We also adapted the qualifier to measure the degree of impairment of patients in terms of performance and capacity. CONCLUSION: Using the International Classification of Function, Disability and Health (ICF), nurses can assess functional and environmental factors of fall risk in more detail. This study proved the applicability of the International Classification of the Function, Disability and Health (ICF) in the nursing practice. Using the system we developed, nurses can better communicate with other healthcare specialists in the area of fall risk. We suggest further studies that are applying the International Classification of Function, Disability and Health (ICF) in other areas of the nursing practice to more clearly describe the status of patients.

Development of Home Hospice Information SystemUsing Personal Digital Assistants: In Association with the Goryeong Health Center / 대한의료정보학회지

OBJECTIVE: This study focuses on the development of a systematic and efficient information system for effective management of patient data in home hospice care. It is easily implemented in the hospice environment and is based on wired and wireless communications along with mobile computing technology. METHODS: The design of this portable home hospice information system was based on an analysis of the services provided by visiting nurses and on the opinions of users, in accordance with the Ministry of Health and Welfare's Guidelines for Cancer Patient Management Program 2005. The system has eight main menus, each of which performs a different function. The system includes the home hospice information system (HHIS), a compact .NET framework, and the health center information system (HCIS). RESULTS: A trial was conducted with three experienced visiting nurses, who each used a personal digital assistant (PDA) loaded with the new system to add patient information. The functions include registering a new patient, performing appropriate nursing service according to established guidelines, based on the patient's condition, and searching data records. The system resulted in a saving of 8.5 minutes in nursing data recording time. CONCLUSION: The findings of this study are expected to help field workers in community nursing to decrease the nursing data recording time by using PDAs.

Development and Adoption of a LOINC Mapping Algorithm / 대한의료정보학회지

OBJECTIVES: LOINC(R)(Logical Observations Identifiers, Names, Codes) is being used as the global standard for sharing laboratory test information and standardization. However, difficulties have been encountered in transferring local code to LOINC. Use in existing laboratory information systems(LIS) is possible with maximized local codes and LOINC mapping. Since the existing mapping tool has parts that do not match domestic medical environments, it is difficult to use without modification or supplementation. To this end, we have developed algorithms for LOINC mapping and have evaluated their usefulness. METHODS: We used 2,376 M-codes transformed from Pusan National University Hospital's 1,150 local codes, and codes from various laboratory test domains(Diagnostic Hematology, Clinical Chemistry, Seroimmunology, Molecular and Cytogenetics, Microbiology, Transfusion Medicine). In materializing the automatic mapping algorithms, spread sheet programs(Excel, Microsoft) and existing mapping tools(RELMA, Regenstrief) were used. The accuracy of the mapped codes was verified by a specialist of the Laboratory Medicine Department. RESULTS: Of the 2,376 M-codes, mapping on LOINC was found to be possible for 78.7%(1,871) while LOINC corresponding with the local codes could not be found for 21.3%(505). Of the mapped codes, 90.8%(1,699) were mapped accurately automatically, while the rest were mapped manually. CONCLUSIONS: The LOINC mapping algorithm that was developed in this study was useful for mapping various forms of local code with LOINC.

Development of WHO impairment grading system for Managing Leprosy Patients / 대한의료정보학회지

OBJECTIVES: We have developed a computerized WHO impairment grading for the clinical management of leprosy patients. The primary aim of this research is to redefine from the legacy disability grading to impairment grading recommended by ICF of WHO. METHODS: The degree of impairment can be determined at the moment of clinical examination and directly entered by a physician. The computation of impairment sum scores, cumulative reports and analysis can be automated. RESULTS: Annual report of health statistics is submitted with high degree of accuracy. CONCLUSIONS: WHO impairment grading and ICF terminology is found to be essential for the clinical management of leprosy patients, and can be a valuable basis for the development of information system in rehabilitation facilities.