Prospects of Hospital Information Systems and Patient Safety in Japan / 대한의료정보학회지

Objectives@#Approximately 20 years have passed since hospital information systems (HISs) featuring full-scale electronic medical records were first implemented in Japan. Patient safety is one of the most important of the several “safety” roles that HISs are expected to fulfill. However, insufficient research has analyzed the contribution of HISs to patient safety. This paper reviews the history of HISs in connection with patient safety in Japan and discusses the future of the patient safety function of HISs in a favorable environment for digitization. @*Methods@#A review on the history of HISs with functions that contribute to patient safety was conducted, analyzing evidence from reports published by the Japanese government and papers on patient safety and HISs published in various countries. @*Results@#Patient safety has become a concern, and initiatives to promote patient safety have progressed simultaneously with the spread of HISs. To address the problem of patient safety, most large hospitals prioritize patients’ welfare when building HISs. However, no HIS-associated reduction in adverse events due to medical treatment could be confirmed. @*Conclusions@#HISs are expected to help prevent medical accidents, such as patient- and drug-related errors. It is hoped that the patient safety functions of HISs will become generalized and contribute to patient safety in the future. To achieve this, the government and academic societies should provide regulations and guidelines on HISs and patient safety to the medical community and medical-device vendors. Furthermore, departments responsible for HISs and patient safety should collaborate to gather evidence for the effectiveness of HISs.

Factors Affecting the Effect of Treatment of VCM Based on the Quantity of MRSA for Hospital-Acquired Pneumonia / 医薬品情報学

<b>Objective: </b>To determine the factors affecting the antimicrobial effect of VCM on MRSA.<br><b>Study Design: </b>Case series study.<br><b>Methods: </b>This study was conducted on pneumonia patients admitted to a university-affiliated hospital between January 2000 and December 2008 and had MRSA in their sputum culture.  From seven days prior to the starting VCM administration through the end of the administration, detailed information such as underlying diseases, VCM serum concentration and quantity of MRSA were recorded.  Logistic regression analysis was carried out on current diseases, trough concentration, surgery experience, and the detection of Gram-negative bacteria to verify the antimicrobial effect of VCM.<br><b>Results: </b>The number of subjects investigated this study was 55 subjects.  Multiple logistic regression analysis did not yield any significant factors when carried out using the factors affecting the antimicrobial effect of VCM on MRSA as independent variables.<br><b>Conclusions: </b>Multivariable analysis yielded no factors as being significant in affecting the antimicrobial effect of VCM, but did indicate in that patients aged 70 and older, the antimicrobial effect of VCM was poor for MRSA.  This suggests that when pharmacists intervene in antimicrobial treatment for improved effects, it is important to consider not only the serum concentration of VCM, but also the background of the patient.