As the ARRA enacted recently in the United States, the interest in EHR systems have been increased in the field of medical industry. The passage of the ARRA presents a program that provides incentives to office-based physicians and hospitals adapting the EHR systems to guarantee interoperability with various medical standards. Thanks to the incentive program, a great number of EHR systems have been developed and lots of office-based physicians and hospitals have adapted the EHR systems certified by CCHIT. Keeping pace with the rapid changes in the market of healthcare, some enterprises try to push in to the United States healthcare market based on the experience acquired by developing EHR systems for hospitals in Korea. However, the developed system must be customized because of the different medical environment between Korea and the United States. In this paper, therefore, we design and develop an integrated EHR platform to guarantee the interoperability between different medical information systems based on medical standard technologies. In the developed platform, an integrated system has been composed by integrating various basic techniques such as data transmission standards and its methods, medical standard terminologies and its usage, and knowledge management for medical decision-making support. Moreover, medical data can be processed electronically by adapting an HL7 interface engine and the terminologies for exchanging medical information and the standardization of medical information. We develop SeniCare, an EHR system for supporting ambulatory care of the office-based physicians, based on the platform, and we verify the usability of the platform by confirming whether SeniCare satisfies the criteria of "meaningful use" issued by CMS or not.Key Words : electronic health record system, medical information standard, meaningful use, interoperability
This study examined the intention to use a nursing process application on a smart phone by nursing students who undertake clinical practices, and evaluated the application effect of this program. As research subjects, the study assessed juniors in the college of nursing in Daegu, who had undertaken field training in adult nursing in surgical wards from September 2012 to September 2013. The results showed that the intention to use nursing process application has a significant relationship with effort expectancy, social influence, and self-efficacy. In addition, the nursing process application applied to the research subjects has the largest list of diagnoses, interventions and outcomes regarding acute pain. In addition, the satisfaction with the use of the program was 4.35 points. Through this study, the application of the nursing process presents more opportunities for its use and training in the clinical practice field, and measures that can be applied easily regarding its utilization should be provided.
As changed the clinical environment, the interest on u-Healthcare service and systems has been increased. The ubiquitous healthcare(u-Healthcare) systems are constructed at the integrated environment that consists of various devices and systems basically such as personal health devices(PHDs) measuring body signals, information aggregators gathering the data transmitted from PHDs through wireless technology, and health information systems storing and managing personal health information transmitted from the information aggregators. International standards such as IEEE 11073 and HL7 have been specified for the interoperability of PHDs and health information systems, but the research on u-Healthcare systems that were developed and applied in the real clinical environment by adopting the standards was rarely conducted. Therefore, we developed an u-Healthcare system which can manage personal health information, such as blood glucose, blood pressure, and body composition, based on health information exchange standards. Moreover, we verified the stability of the developed system through clinical trial in patients with endocrine disease at the Kyungpook National University Hospital, and listed problems occurred during clinical trial and found their solutions.
XML-based standards such as CCD(Continuity of Care Document) and CCR(Continuity of Care Record) have been developed for representation, integration, and exchange of personal health record(PHR), and various of researches on PHR based on the standards have been conducted. These researches have developed and used CCD/CCR parsers each with their own different ways, but it can be hard to develop and update the parsers because of the structural complexity of the standards. Moreover, inter-exchange between CCD and CCR documents in the PHR-related medical information systems should be possible for the interoperability of the systems. Therefore, we proposed a designing method to develop the tools treating XML-based CCD/CCR documents. And we implemented CCD/CCR parser based on the proposed method and developed a converter from CCD to CCR using the parsers. To confirm the usefulness of the developed tool, we performed an experiment of creating CCD documents using the personal health data gathered from chronically ill patients in Kyungpook National University Hospital and of converting from the CCD documents to CCR documents.
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