Constructing a Real-Time Prescription Drug Monitoring System / 대한의료정보학회지

OBJECTIVES: The objective of this investigation was to demonstrate the possibility of the construction of a real-time prescription drug monitoring system (PDMOS) using data from the nationwide Drug Utilization Review (DUR) system in Korea. METHODS: The DUR system collects information on drug prescriptions issued by healthcare practitioners and on drugs dispensed by pharmacies. PDMOS was constructed using this data. The screen of PDMOS is designed to exhibit the number of drug prescriptions, the number of prescriptions dispensed by pharmacies, and the dispensed prescription drug costs on a daily and weekly basis. Data was sourced from the DUR system between June 1, 2016 and July 18, 2016. The TOGA solution developed by the EYEQMC Co. Ltd. of Seoul, Korea was used to produce the screen shots. RESULTS: Prescription numbers by medical facilities were more numerous than the number of prescriptions dispensed by pharmacies, as expected. The number of prescriptions per day was between 2 to 3 million. The prescriptions issued by primary care clinics were most numerous, at 75% of the total number of prescriptions. Daily prescription drug costs were found to be approximately US $50 million. The prescription drug costs were highest on Mondays and were reduced towards the end of the week. Prescriptions and dispensed prescriptions numbered approximately 1,200 and 1,000 million, respectively. CONCLUSIONS: The construction of a real-time PDMOS has been successful to provide daily and weekly information. There was a lag time of only one day at the national level in terms of information extraction, and scarcely any time was required to load the data. Therefore, this study highlights the potential of constructing a PDMOS to monitor the estimate the number of prescriptions and the resulting expenditures from prescriptions.

Healthcare Utilization Monitoring System in Korea / 대한의료정보학회지

OBJECTIVES: It is important to monitor the healthcare utilization of patients at the national level to make evidence-based policy decisions and manage the nation's healthcare sector. The Health Insurance Review & Assessment Service (HIRA) has run a Healthcare Utilization Monitoring System (HUMS) since 2008. The objective of this paper is to introduce HIRA's HUMS. METHODS: This study described the HUMS's system structure, capacity, functionalities, and output formats run by HIRA in the Republic of Korea. Regarding output formats, this study extracted diabetes related health insurance claims through the HUMS from August 1, 2014 to May 31, 2015. RESULTS: The HUMS has kept records of health insurance claim data for 4 years. It has a 14-terabyte hardware capacity and employs several easy-to-use programs for maintenance of the system, such as MSTR, SAS, etc. Regarding functionalities, users should input diseases codes, target periods, facility types, and types of attributes, such as the number of healthcare utilizations or healthcare costs. It also has a functionality to predict healthcare utilization and costs. When this study extracted diabetes related data, it was found that the trend of healthcare costs for the treatment of diabetes and the number of patients with diabetes were increasing. CONCLUSIONS: HIRA's HUMS works well to monitor healthcare utilization of patients at the national level. The HUMS has a high-capacity hardware infrastructure and several operational programs that allows easy access to summaries as well as details to identify contributing factors for abnormality, but it has a limitation in that there is often a time lag between the provision of healthcare to patients and the filing of health claims.

Development of a Virtual Diabetes Register using Information Technology in New Zealand / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to consider a Virtual Diabetes Registry System (VDR) and to investigate what it is and how it is used in New Zealand. New Zealand has specified diabetes mellitus (DM) as a national health priority. The Ministry of Health requires an accurate method for tracking the number of people with diagnosed with DM in the population. METHODS: We combined five national databases, all of which included a unique patient identifier: hospital admissions coded for DM, outpatient attendances for DM, DM retinal screening, prescriptions of specific anti-diabetic therapies, laboratory orders for HbA1c, as well as Primary Health Organisation (PHO) enrolments and national mortality. The algorithm was progressively modified to improve sensitivity and specificity, and it was validated against primary care registers. The algorithm was still being used in 2014. RESULTS: The prevalence of diagnosed diabetes in New Zealand at December 31, 2009 was 189,256 (4.4% of whole population). The VDR is now used to determine the official diagnosed diabetes prevalence in New Zealand; it is also used to determine the denominator of the health targets that the Ministry of Health should achieve for diabetes service indicators in New Zealand. CONCLUSIONS: This method appears to be superior to any other practicable national survey and to be both accurate and robust. The VDR has become an invaluable tool for monitoring prevalence and the policy making process, and for supporting clinical quality improvement.

Current Status and Progress of Telemedicine in Korea and Other Countries / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to review the current telemedicine of the Korea and the telemedicine of the other countries. METHODS: This study reviewed several documents on telemedicine and summarized the documents on the initiation of the telemedicine of the Korea, the recent regulations of the government, the analytical research results, and the telemedicine of foreign countries. RESULTS: One of recent demonstration trials of telemedicine began in July 2015 in the Korea. The plan was to conduct an emergency telemedical treatment trial among the cooperative medical service centers until the end of February 2016. No telemedical services were provided at the level of local primary care clinics, and there was 1.2% provision at the hospital level. The Europe Union and the United States had more active telemedical services in comparison to the Korea. CONCLUSIONS: The introduction and usage of telemedicine in the Korea was behind those of other countries. It is necessary to develop a proactive support policy for telemedicine through a government implemented trial.