Global Trends of Regional Health Information Systems and Suggested Strategic Utilization of their Medical Information / 대한의료정보학회지

Objectives@#Along with the exponentially-growing data produced and accumulated every day through mobile platforms, social networking services, the Internet, and other media, information is becoming increasingly important as a strategic resource. This report presents specific and clear directions and suggests empirical project plans regarding innovations in regional health information systems to promote the utilization of medical information. @*Methods@#We reviewed and examined documents about global trends and examples of regional health information systems. The problems and solutions of health information utilization and regional health information systems in Korea were analyzed. @*Results@#This study presented examples of the establishment of health information systems, problems in the use of local healthcare information, and an empirical project for improvement. @*Conclusions@#The results of this study imply the need for long-term and systematic approaches for the use of medical information and the establishment of a local healthcare information system, along with implementation plans. As a first step, it is imperative to clarify the goal of building a medical information system, the information that must be provided to build the system, and the data that should be collected to provide such information, while moving away from the mentality of focusing on technology-oriented medical information services. In addition, it is necessary to consider information governance, data-based service development, and the medical innovation framework, which are ways to efficiently manage, utilize, and systemize the data to be collected.

Global Trends of Regional Health Information Systems and Suggested Strategic Utilization of their Medical Information / 대한의료정보학회지

Objectives@#Along with the exponentially-growing data produced and accumulated every day through mobile platforms, social networking services, the Internet, and other media, information is becoming increasingly important as a strategic resource. This report presents specific and clear directions and suggests empirical project plans regarding innovations in regional health information systems to promote the utilization of medical information. @*Methods@#We reviewed and examined documents about global trends and examples of regional health information systems. The problems and solutions of health information utilization and regional health information systems in Korea were analyzed. @*Results@#This study presented examples of the establishment of health information systems, problems in the use of local healthcare information, and an empirical project for improvement. @*Conclusions@#The results of this study imply the need for long-term and systematic approaches for the use of medical information and the establishment of a local healthcare information system, along with implementation plans. As a first step, it is imperative to clarify the goal of building a medical information system, the information that must be provided to build the system, and the data that should be collected to provide such information, while moving away from the mentality of focusing on technology-oriented medical information services. In addition, it is necessary to consider information governance, data-based service development, and the medical innovation framework, which are ways to efficiently manage, utilize, and systemize the data to be collected.

Population Pharmacokinetic and Pharmacodynamic Models of Propofol in Healthy Volunteers using NONMEM and Machine Learning Methods / 대한의료정보학회지

OBJECTIVES: The primary objective of this study is to compare model performance of machine learning methods with that of a previous study in which a nonlinear mixed effects model was created using NONMEM(R) for the pharmacokinetic and pharmacodynamic data for propofol. The secondary objective was to evaluate if a pharmacodynamic model describing the relationship between the dose of propofol and bispectral index (BIS) outperform that describing the relationship between a pharmacokinetic model derived-predicted concentrations of propofol and BIS. METHODS: Data were collected during a study involving the infusion of propofol into healthy volunteers. Pharmacokinetic and pharmacodynamic models were constructed using artificial neural networks (ANNs), support vector machines (SVMs), and multi-method ensembles and were compared with the nonlinear mixed effects method as implemented by NONMEM(R). Model performance was assessed by goodness-of-fit statistics, paired t-tests between predicted and observed values for each model and scatterplots. RESULTS: In pharmacokinetic analysis, ensemble I, the mean of ANN and NONMEM(R) predictions, achieved minimal error and the highest correlation coefficient. SVM produced the highest error and the lowest correlation coefficient. In pharmacodynamic analysis, ANN exhibited the best performance. An ANNModel describing the relationship between the dose of propofol and BIS was not inferior to an ANN model describing the relationship between predicted concentrations of propofol derived from an ANN pharmacokinetic model and BIS. CONCLUSIONS: In pharmacokinetic analysis, ensemble combined with ANN achieved slightly better performance than NONMEM(R). The relationship between the dose of propofol and BIS can be predicted without considering pharmacokinetics of propofol.

A Study on the Development of Curriculum for Health Information Manager / 대한의료정보학회지

As the business environment of medical recorder changes from a paper-based environment to a computer-based environment, the medical recorder has to change Health Information Manager. The most important thing of the role change for HIM is the development of college curriculum. For the development of curriculum, I invested on the situation of HIM. To invest on the situation of HIM, I invested as follows; The first content of invest is job analysis of medical recorder. The second content of invest is curriculum contents in Korea, America. The third content of invest is survey on the medical recorder. I analyzed curriculum contents of 9 colleges in America. Also 22 colleges in Korea were analyzed for this study. Also I analyzed survey contents of 263 medical recorders. I have adapted AHIMA define of HIM as follows; Health information professionals collect, integrate, and analyze primary and secondary healthcare data; disseminate information; and manage information resources related to research, planning, provision, and evaluation of healthcare services. As the base of invests, I proposed curriculum on the base of invested contents. As the proposed curriculum is not official curriculum, we have to continuously study the content of curriculum.

A Study on Effects of Critical Pathway Practices by Using BSC and Datamining Method / 대한의료정보학회지

Emphasis on healthcare during the 1990s has been to provide both optimal wellness and function with quality in a cost-effective manner. Critical Pathway was developed to meet the need to guide clients along the continuum of care and to achieve continuity of care. The purpose of this study was to develop on evaluating model of Critical Pathway practices. The topics which developed into Critical Pathway were normal delivery, repairment of cataract, cesarean section delivery, pediatric tonsillectomy and hemorrhoidectomy. The main goals set by teams were educations, improvement of process and quality of care, customer satisfaction and financial achievements. To evaluate the performace of Critical Pathway in clinical process, 13 kinds of perspective key performance indicators were selected by using Balanced Scorecard(BSC) method. The analysis method was Data Mining. Cesarean section discharge abstract data were reviewed for guidelines of model development and classification of control groups. Five kinds of Critical Pathway were developed by multidisciplinary participation by personnels of related departments, and pilot-test was performed. All the Critical Pathway was applied as standard protocols in patient s care since November, 1999. Length of stay was significantly shortened and increased patient s satisfaction in 4 case groups except pediatric tonsillectomy group. Hospital and medication cost of each patient remarkably decreased in all 5 case groups. And the improvement of process and quality of care was appeared during the Critical Pathway implementation period. These results show that new evaluation model of Critical Pathway in medical practice was an effective.

Development of Health Insurance Rate-Setting System Utilizing Data Mining Technique / 대한의료정보학회지

The objective of this study is to present a new approach to the development of national health insurance rate-setting system using data mining technique. In particular, this paper examines the feasibility of applying the rate-setting system for the regional insurance program to the insureds of the workman' s insurance program, so that the unified rate-setting system can be developed. The subjects of the study were the beneficiaries(sample size = 234,224) of the workman' s insurance program(excluding government officials and teachers) residing in Goyang City. 1998 data from Korean Medical Insurance Corporation were analyzed through various data mining techniques such as Decision Tree, Regression, Assessment and SCORE. Major results and conclusions are as follows: 1) On average, the insured' s property element of insurance fee, automobile element of insurance fee, property score of income assessment, and automobile score of income assessment together accounted for only 16% of the actual income, which implies that we need more precise data in order to develop an equitable rate-setting system. 2) To do so, it is necessary to gather all the income-related data(property income, financial income, earnings, ...) in a timely manner. Since current computer and information system would not allow efficient maintenance and utilization of such data, it would also be necessary to establish data warehouse for this purpose. 3) In developing the rate-setting system on the basis of data warehouse, various data mining techniques should be employed to ensure the equity of insurance rates among different classes of insureds.

The Efficient Ways of Health Promotion Program on Public Health Center Using Data Mining / 대한의료정보학회지

This study provides an application of data mining approach to Health Promotion Program on Public Health Center. We analyed the survey data in health practice. The main results of this study is as follows; 1) the smoking rate of overweight man was higher than normalweight man. 2) the lower group of 39 age in alchol offerer was very high possibility of alcholism. We found that the technology of data mining was very efficient tool to find the group of Health Promotion Program on Public Health Center. In the base of results, we offered the efficient ways of Health Promotion Program using Data Mining. The contents of efficient ways as follows; 1) The target group of Health Promotion Program is necessary to find using Data Mining Technology 2) The ways of Health Promotion Program is necessary to find using Data Mining Technology.

An Application of Data Mining Approach to CQI Using the Discharge Summary / 대한의료정보학회지

This study provides an application of datamining approach to CQJ using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data -mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were identified through the information gain summary.Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the degree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption and postoperative wound infection.This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas for CQI using other hospital databases.

Hospital Database Marketing Using Discharge Summary DB: An Application of Data Mining Technique / 대한의료정보학회지

The environment of hospital management is becoming more turbulent as the government continuously puts pressure on hospitals to reduce medical expenditures while the public increasingly demands improved services. To survive in this turbulent environment, hospitals need to develop and apply various management techniques. Database marketing is considered as one of the useful tools. This paper applies the concept of database marketing by way of using discharge summary DB, and attempts to segment the customers (patients) to develop a differentiated marketing strategy for the target market. In particular, discharge summary DB for 1996-1999 of a university hostital located in Pusan, Korea, was utilized. The data were restructured for our study purpose and analyzed through the use of data mining technique. Major results are as follows: 1) Applying 'Decision Tree Model' suggests that the most important variable in determining the readmission(re-use of the hospital) was 'disease group. 2) Analyzing disease structure of readmitted patients reveals that the readmission rate was highest for the neoplasma patients; therefore, for this hospital, neoplasma patients can be considered as the target market. 3) Conducting cluster analysis on this target market shows that the neoplasma patients are classified into 4 groups: (1) 'Group I' can be named as 'sustaining customer(patient) group' in that they have visited the hospital until the most recent period. (2) 'Group II' is 'loyal customer(patient) group' in that frequency of admission and length of hospitalization are highest among the four groups. (3) 'Group III' can be named as 'departing customer(patient) group' in that the period between the discharge and the last visit of the hospital is shortest, which implies that they probably have changed the hospital or used other types of health care services after discharge. (4) 'Group lV' is 'average customer(patient) group' in that they show average loyalty in terms of frequency of admission, length of hospitalization, and the period between discharge and last visit.

The Strategic Planning of Hospital Management using Information Technology / 대한의료정보학회지

In the health-care market, the shift from a fee-for-service to a DRG environment has dramatically altered the landscape. To survive in this situation, hospital have to change. Information technology is one of change means. In this study, the means on information technology are presented Data warehouse, Data Mart, OLAP, Forecasting Tool, Statistic Package, Data mining.

Economic Analysis of Electronic Patient Record / 대한의료정보학회지

This study was carried out to analyse the economic feasibility of EPR. A hospital with 500 beds under the construction was selected for this study. The economic effect was performed with cost-benefit analysis for 5 years from the year 1998 to 2002. The results of this study were as follows; The economic effect of EPR was classified into direct benefit, value acceleration, and value linking. Each factor was applied and analyzed step by step. In the analysis including only direct benefit, the net present value and the ratio of benefit to cost were minus 82,920,000 won and 0.8. With this traditional cost-benefit analysis alone, the EPR in hospital can be regarded as very unprofitable. However, when value acceleration was added, the net present value and the ratio of benefit to cost rose to 748,637,000 won and 2.7 respectively. Moreover, when value linking was added, the net present value and the ratio of benefit to cost were 1,473,162,000 won and 4.3, respectively. In the results of this study, as EPR has only direct benefit, EPR can be regarded as unprofitable project. However, when value acceleration and value linking were added, EPR can be profitable project.

Standardization of Code of Hospital Information / 대한의료정보학회지

The rapid change of hospital environment emphasizes the importance of hospital information system. To be effective, the definitions and codes of data which will be required by the health professionals workstation should be standardized. In Korea, many hospitals are implementing order communication system in order to expedite the patient management process, to enhance the service, and for effective management of medical information. Various codes those are in use in hospitals should be standardized for effective interdepartmental and interhospital communication. This paper shows the current status of implementing order communication system in hospitals which have more than 400 beds in Korea, application status of operation an procedure classification systems, e.g., International Classification of Procedures in Medicine, and International Classification of Diseases-9th-Clinical Modification. 22 hospitals (29.0%) are implementing inpatient OCS and 29 hospitals(38.2%) for outpatient OCS. 46 hospitals(60.5%0 are applying ICPM and among them 23 hospitals(50.0%) showed dissatisfaction for that classification system. 30 hospitals(39.5%) are applying ICD-9-CM and none of them revealed dissatisfaction for that classification system. 64 hospitals(84.2%) want new classification system for operation and procedures and 58 hospitals(76.3%) revealed the necessarily of standardization of code of physicans, clinical departments and administrative departments.

A development of Entity-Relationship Model on Computer Based Patient Record / 대한의료정보학회지

The purpose of this study presents the model of Entity-Relationship Diagram on CPR. The specific purpose of this study as follows; The first goal is to identify the content and logical structure of the CPR. The second goal is to define the relationship of data coming from diverse systems(for example, clinical laboratory information systems, order entry systems) and the data stored in the CPR. The 22 kinds forms on Medical Record were collected from 10 hospitals. The Clinical heart of the CPR is the core of entities: patient, provider, problem, encounter order, service, history, etc.