An Improved Auto-Generation System to Obtain Reference Intervals for Laboratory Medicine / 대한의료정보학회지

OBJECTIVES: Reference values are highly required parameters for all tests in the clinical laboratory, and the supplementary provision of reliable reference intervals is an important task for both clinical laboratories and diagnostic test manufacturers. Despite the progress that has been made in the conceptual aspects of reference intervals, in practice their use is still not completely satisfactory. Most of the laboratories have used various methods to calculate statistic-based reference intervals, and they have mainly focused on extracted data, yet its use is considerably limited. We had to deal with the inconvenience of using a number of programs (SPSS or SAS, MS Excel) in order to calculate the results of reference intervals. METHODS: In order to obtain standardized reference intervals, we developed an integrated program that can calculate, by a nonparametric method, reference intervals with using the Clinical and Laboratory Standards Institute (CLSI) processes as its guideline. We also developed a grouping interface that enables users to customize classification of each group (age, gender, blood group, race, etc) when calculating reference intervals. RESULTS: To verify the developed program, we compared the reference intervals of the current data on 281 persons for 8 total areas, and the reference intervals were was already calculated beforehand with by using this new program. As a result, both results perfectly matched. CONCLUSIONS: This integrated program will be convenience for calculating reasonable values through continual datainspection at an inspection lab for calculating reference intervals. The newly developed program will improve the consistency and reliability of the statistics on reference intervals.

Fall Risk Nursing Assessment according to the International Classification of Functioning, Disability, and Health / 대한의료정보학회지

OBJECTIVE: The International Classification of Function, Disability and Health (ICF) was designed to provide a common language by describing the function and disability of clients for health care professionals. The purpose of this paper is to introduce the International Classification of Function, Disability and Health (ICF) in nursing and investigate its applicability in fall risk assessment. METHODS: The Fall risk assessment system using the International Classification of Function, Disability and Health (ICF) is based on the Downton fall risk assessment tool which is most commonly used to assess the risk of falls across populations in any health care setting. To develop system, we used NetBeans 5.0 within JAVA SE Development Kit 1.4.2 (JDK 1.4.2) and Microsoft Access 2003 database was used for the information storage. RESULT: The International Classification of Function, Disability and Health (ICF) items can cover all items of the Downton fall risk assessment tool except for medication because there is no medication related items in the International Classification of Function, Disability and Health (ICF). We mapped patient's sensory deficit, mental state, and gait state in the Downton fall risk assessment with sensory function & pain, mental function, and mobility in the International Classification of Function, Disability and Health (ICF) respectively. We also adapted the qualifier to measure the degree of impairment of patients in terms of performance and capacity. CONCLUSION: Using the International Classification of Function, Disability and Health (ICF), nurses can assess functional and environmental factors of fall risk in more detail. This study proved the applicability of the International Classification of the Function, Disability and Health (ICF) in the nursing practice. Using the system we developed, nurses can better communicate with other healthcare specialists in the area of fall risk. We suggest further studies that are applying the International Classification of Function, Disability and Health (ICF) in other areas of the nursing practice to more clearly describe the status of patients.

A Development of Prototype Personal Health Record System based on Continuity of Care Document / 대한의료정보학회지

OBJECTIVE: We have developed a prototype Personal Health Record (PHR) system that can replace traditional paper-based personal health diary with structured clinical details for healthcare. Because numerous disparate electronic versions of medical record systems are found unable to share medical information among hospitals, pharmacies and clinicians, the proposed PHR system can be used to facilitate patient care. METHODS: The PHR system has been implemented on a flash memory (USB drive) that is found to be compact, light weight, cost-effective and sufficient enough to handle a large amount of clinical data. International communication standard HL7 has recommended Continuity of Care Document (CCD) that can provide complete and accurate summary of an individual health and medical history. Care documents stored in USB can also support alerts, reminders, self-management, and stakeholder communication in a standardized manner. RESULTS: The proposed PHR system consists of modules that help collect distributed patient information from multiple sources to generate individual care document (CCD) as personal health record. The preliminary experiment has demonstrated an acceptable performance. That is, the PHR is found to integrate and share various clinical data such as medications, procedures, patient demographics from admission system, test results from LIS, DICOM images from PACS, bio.signals from patient monitors. Especially, the PHR system was tested by connecting to standardized monitoring device (Mediana device) to collect ECG data. The PHR system had received 3410 HL7 messages for 1 hour, then generate CCD document.