Ubiquitous-Severance Hospital Project: Implementation and Results / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements. METHODS: Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information. RESULTS: The EMR system of Yonsei University Health Systems (YUHS) consists of HP integrity superdome servers using MS SQL as a database management system and MS Windows as its operating system. CONCLUSIONS: YUHS is a high-performing medical institution with regards to efficient management and customer satisfaction; however, after 5 years of implementation of u-Severance system, several limitations with regards to expandability and security have been identified.

The Current Status of Hospital Information Systems in Yanbian, China / 대한의료정보학회지

PURPOSE: The purpose of this study was to analyze the current status of Hospital Information system in Yanbian, China. METHODS: Structured self-administered questionnaires were sent to hospitals in Yanbian to survey the issues and six hospitals answered. Data were analyzed by using Windows SPSS 12.0. RESULTS: All facilities were second-grade national hospitals with 100~500 beds, kept about 40 computers and all used internet. Four of them had information exclusive department, and the other two had the implementation plans. All of the hospitals had Patient Billing System and some features of Medication Administration System. Four hospitals had administration systems, and the other two had no plans to develop or adopt administration system in the next three years. Two hospitals used the packages composed of Electronic Data Interchange System, Amount Receivable Management System and Laboratory Information System. One hospital used the Picture Archiving and Communication System, Telemedicine System, Radioactive Examination. CONCLUSIONS: Compared with Korea, the results showed relevant explanation on the delays of implementing HIS and its current status in Yanbian. In order to develop Hospital Information System, various strategies must be developed and active international support and research was required to provide the appropriate experiences.

The effect of lipopolysaccharide on the migration of osteoclast precursors / 대한치주과학회지

No abstract available.

Construction and Functional Analysis of a Synthetic Wound-and Hormone-inducible Promoter ocs/mas / 中国生物工程杂志

The use of optimal regulatory sequences for simultaneous expression of the transgenes might play a significant role in engineering plants with increased disease and insect resistance.The plant expression vector pOMS-GUS,which contained the GUS gene under the control of a chimeric promoter based upon the mannopine synthase(mas)promoter and the octopine synthase(ocs)enhancer,was constructed.Used as control,another vector pMAS-GUS,carried the GUS gene driven by only the mas promoter.The two vectors were introduced into tobacco plants by Agrobacterium-mediated transformation.Fluorometric assays for GUS activity and reverse transcription-polymerase chain reaction(RT-PCR)analysis revealed that GUS gene expressed weakly with untreated transgenic tobacco while the level of GUS activity increased steadily after 1 h subjected to wounding.The expression of the mas and ocs/mas promoters was induced a further 1.8-fold and 5.7-fold,respectively.SA(1 mmol/L)or MJ(250 ?mol/L)treatment also caused a large induction of the ocs/mas chimeric promoter;And the application of SA in combination with MJ(1 mmol/LSA & 250 ?mol/L MJ)produced an additive effect that exceeded the wounding response.The results showed that the ocs/mas chimeric promoter is a strong inducible promoter that can be activated by various stresses.The chimeric promoter should have utility in development of disease and insect resistant transgenic crops.

O enfermeiro e as drogas: percepções a partir de um sujeito coletivo / The nurse and the drugs: perceptions from a collective subject

Este estudo tem como objeto o uso e abuso de drogas psicoativas por trabalhadores de enfermagem, e sua relação com a saúde deste trabalhador. A abordagem foi exploratória, qualitativa e baseou-se na metodologia do Discurso do Sujeito Coletivo (DSC). O objetivo geral foi o de identificar, por meio da construção de discursos coletivos, as percepções de 10 trabalhadores de enfermagem de um hospital público, alocados nos setores de clínica médico-cirúrgica e emergência. A coleta de dados foi realizada por meio de entrevista semi-estruturada, e a organização dos dados seguiu os passos de categorização do DSC; a discussão dos achados foi realizada tomando como base as normativas técnicas da SENAD (1999), e os referenciais teórico-metodológicos de LEFÉVRE (2003), MURAD(1982), GUERINO PIN (1999), SPRIClGO (2004) e CARILLO (2003). Os resultados forma organizados em três categorias principais, i) a droga como fenômeno social: ii) o uso de drogas pelo trabalhador de enfermagem e iii) a droga e a saúde do trabalhador de enfermagem. Em relação à primeira categoria, foram discutidas as subcategorias: o fenômeno drogas na atualidade, e sua relação com a criminalidade; as drogas como elemento negativo para a saúde e droga ilícita , segurança pública e medidas repressivas. Na discussão sobre o uso de drogas pela enfermagem, as questões abordadas foram: a facilidade de acesso e uso pelo profissional e a falta de regulação deste acesso; o uso de drogas pela enfermagem está em crescimento; alguns enfermeiros desconhecem os efeitos negativos das drogas. Na relação com a saúde deste trabalhador, discutiu-se o uso de drogas como elemento que facilita o enfrentamento das jornadas de trabalho, sobretudo noturnas; o uso abusivo de drogas causa problemas à saúde do enfermeiro e interfere no seu trabalho...

This study investigated psychoactive drugs use and abuse by nursing workers, and it's relationship with their health. An exploratory, qualitative study was carried on, using the methodology of Collective Subject's Discourse (OSC). The main objective was to identify the perceptions of 10 nursing workers of surgical clinic and emergency room of a public hospital. Data collection was accomplished through semi-structured interviews, and the organization followed the steps of DSC categorization. Theoretical-methodological discussion was based on SENAD (1999), LEFÉVRE (2003), MURAD(l982), GUERINO PIN (1999), SPR1CIGO (2004) and CARlLLO (2003). The results were organized in three main categories, i) the drug as a social phenomenon: ii) drug use by nursing and iii) drug use and nursing worker's health. From the first category, followed sub-categories as: drug phenomenon at present time, and it's relationship with criminality; the drugs as negative element for health; illicit drugs, public safety and repressive measures. In the discussion on the drug use by nursing workers, the issues that emerged were: the easiness of access and use by health professional and the lack of regulation of this access: the increasing drug use by nursing workers; some nurses ignorance about the negative effects of drugs. In the category that related drug use with the worker's health, drug use was discussed as an element that facilitates workers to cope with the difficulties in their work. mainly in night shifts; drug abuse as a cause of problems to nurse's health and work...

Clinical Use of Emergency Medical Information by Using a Computerized Network and the Internet

PURPOSE: To provide effective emergency care, the emergency physician should get medical information as rapidly as possible. They could get medical data within a few minutes if all the data were saved as digitalized data. We compared the time spent to get medical information and the time to make a transportation report between a computerized system and a non-computerized system. METHOD: The cases of 2,131 emergency patients who had been treated previously at Asan Medical Center (AMC) and who revisited the center were analyzed to compare the time spent getting previous medical information, and 241 cases of patients who were transported to another hospital after emergency care were analyzed to estimate the time spent making transportation reports and copying X-ray images. The data for the patients were estimated in two ways, using a computerized system and using a non-computerized one. The computerized group used the OCS (order communication system), the PACS (picture archiving communication system), the EMR (electronic medical record), and the webbased medical information system (http://cyber-AMC.net). RESULTS: The time spent to get previous medical information was 33.7+/-5.1 seconds in the computerized group compared with 1313.2+/-271.5 seconds in the noncomputerized group. To get the X-ray images, 17.3+/-9.8 seconds was spent in the computerized group, where as longer time of 1432.8+/-317.6 seconds was need in the non-computerized group (p value < 0.01). The time spent to make a transportation report was 172.8+/-32.1 seconds in the computerized group compared with 473.8 +/- 117.1 seconds in the non-computerized group. The time spent to copy the X-ray image was 67.2 +/-7.5 seconds in the computerized group, and 613.4+/-300.7 seconds in the other group (p value < 0.01). CONCLUSION: By use of a computerized medical information system, the emergency physician can get medical information and previous X-ray images rapidly and effectively, and can make the transportation reports and slides of X-ray images quickly.

IT-based Management Model for TCM Pharmacy / 中国药房

OBJECTIVE:To upgrade the information management of the traditional Chinese medicine(TCM)pharmacy in our hospital.METHODS:The benefits and problems in implementing information management in our hospital's TCM pharmacy were discussed,and solutions for improvement were proposed.RESULT & CONCLUSION:The application of the information management system can help regulate the management of the TCM pharmacy,and establish a closer connection between traditional medicine and modern technology.

Factors Affecting Users' Satisfaction with Order Communicating System / 예방의학회지

OBJECTIVES: To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. METHODS: A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was performed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience , OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. RESULTS: There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. CONCLUSIONS: There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

The Programming of Chemotherapy Order System in Gynecology Oncology / 대한부인종양콜포스코피학회잡지

As a part of plan to construct a multifunctional hospital information system, we planned to develop a chemotherapy order system. First, a software developing team was established which is composed of gynecologic oneology staffs, special pharmacists and programmer who are responsible for OCS(Order Communication System). We set up and outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.

The Impact of Order Communication System on Changes of User's Work Patterns, Adaptation and Satisfaction / 대한의료정보학회지

Order communication system(OCS) could change involved users' work pattern profoundly. Also adaptation to OCS and satisfaction with it influence the efficiency of management in hospital. This study applied self-administered questionnaire and individual interview to evaluate changes of users' work pattern, adaptation and satisfaction after the introduction of OCS. The survey measured the experience of computer use, user's evaluation on OCS education, degree of usage, change of work patterns, relation with co-workers or other departments, user's adaptation and satisfaction of physicians, nurses and pharmacists who worked in two university hospitals in Seoul that had introduced OCS. The major findings of this study were as follows; 1. Changes of users' work patterns were different between two hospitals. In a hospital major business time to issue and confirm order was decreased but in another hospital increased . 2. Relations of doctors with nurses were also different between two hospital. Frequency of contacts in a hospital was increased and doctor-nurse relationship grew worse, while in another hospital decreased and grew better. These situations were observed on the relationship with other departments, such as pharmacy and admission/discharge service. 3. There were no significant variables that explained user's adaptation, but again there was a difference between hospitals. 4. User's satisfaction was significantly affected by hospital and job catergories classified. Level of satisfaction of a hospital was higher than that of another, and highest in pharmacists, and the next was nurses and doctors in order. 5. There was o difference in satisfaction level by the type of hardwares, operations and accuracy between hospitals, but was difference by the contents of information, convenience of use and timeliness between hospital. The hospital factor consistently influenced users' work pattern, adaptation, and satisfaction. It implied that, if OCS was designed familiarly and conveniently for users, users' resistance will not trouble the implementation of OCS.

Status of the Use and Assessment of Order-Communicating System(OCS) in Emergency Care Center / 영남의대학술지

Hospital information system has been widely used and increased recently for a variety of many aspects. And Order-Communication System(OCS), as like as hospital information system, has been used in many medical care facilities, which is simple and easily accessible, useful system. Also then the use of OCS in emergency care center in YUMC has been introduced sine 1996. 10, above 70% of availability is notice at present and increasing in the use rate, is considered that is very simple and accurate, time-saving, widely applicable system. So authors say that, after the use of OCS in emergency care center, interhospital exchange of the patient's information and also accomplishment of EMSS can be possible.

A Study on Model for Decreasing an Outpatient Waiting Time / 대한의료정보학회지

This study is tried to suggest the new model to shorten the patient's waiting time from counting department to receiving drugs from pharmacy after doctor's diagnosis. The method of this study is designed to simulate from counting time to finishing time of dispensing drugs for internal medicine outpatients. The results are as follows : First, the increasing the numbers of server at pharmacy and counting department in present model don't effect on shortening outpatient's waiting time. Second, in the case of application of OCS, the outpatient's waiting time for receiving dispensed drugs from pharmacy is rather delayed because of no waiting time for counting. Third, in the case of application OCS and ATC simultaneously, the outpatient's waiting time for receiving dispensed drugs is shortened, and in this case, the increasing the numbers of server at pharmacy effect more greatly on the changes of patient's waiting time for receiving dispensed drugs from pharmacy. From the results of this study, it is noted that the best optimal for shortening outpatient's waiting time in general hospital is to introduce the OCS and ATC simultaneously in the process between the counting department and pharmacy, and increasing the numbers of server at pharmacy.