Implementation of Medical Information Exchange System Based on EHR Standard / 대한의료정보학회지

OBJECTIVES: To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. METHODS: To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. RESULTS: The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. CONCLUSIONS: This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

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

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 (p6,000,000 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.