When IT Met Medicine
When IT Met Medicine
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  • 승인 2007.10.12 10:44
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The Korea IT Times previously introduced a brief note on the increasingly ubiquitous technology of the Yonsei University Health System in an article on the IT21 conference in July. The article referenced a presentation Professor Chang Byungchul made at the IT21 Conference. After a visit with the CIO of the Division of Cardiovascular Surgery, Dr. Chang Byung-chul at Yonsei University Health System in Seoul, the Korea IT Times can finally draw a full picture of modern medical science at the top leading medical institution, Severance Hospital, Yonsei University Health System.

Yonsei University Health System (YUHS) was first established by Kwang Hye Won in 1885 by a missionary, Dr. Horace N. Allen, under a special mission, With the love of God, Free Humankind from Disease and Suffering. Not only did YUHS first introduce western medicine to Korean patients, but it also has always been an early adopter in bringing the newest medical and operation technologies to Korea. Today, YUHS consists of 2 graduate schools, 3 undergraduate schools, 3 general hospitals and one mental hospital. YUHS serves more than 2.57 million outpatients and 957,000 inpatients yearly. The main facility, Severance Hospital, serves nearly 9,000 patients per day.

The outgrowing number of Severance Hospital's daily visiting patients has indicated the need of a ubiquitous system, a solution to serve and satisfy both patients and employees. An individual centered u-Health Service System, useroriented quality of management record, and ubiquitous environment knowledge base and CDSS are all a part of YUHS' ultimate goal of customer-centered and lifelong service. Professor Chang Byung-chul added: "Ubiquitous healthcare is the most needed system for modern society. Take a close look at the society's fast change in development of technology. Aging populations in an aging society is increasing the needs for Tele-medicine. Competition between hospitals is increasing due to development of ICT and the health industry.

Paradigm change for health shifted from treatment to maintenance of health. Yet the government suppressed a budget increase for healthcare. All these factors increase the need for ubiquitous healthcare." From ubiquitous to intelligent, patient centered transition Professor Chang Byung-chul's presentation at the IT21 Conference showed the slogan, From Ubiquitous to Intelligent at the top left corner throughout the slides. But is there any difference between the two And what motivates the transition "The form of ideas and strategies are fixed and developed by our customer's demands and evaluations.

Let's say Jane Doe is suffering from a Marfan Syndrome which manifests lens dislocation, tall stature, and aortic dilation with gene defect. What would she want of a hospital to help her to live in less fear of aortic rupture" Professor Chang continued: "She would want to have adequate management at any time from a proper doctor, and would want to discuss her problem with her private nurse at any time. That would be the case of home healthcare the hospital sought to provide in the future. She would want to visit the hospital on her own schedule and be able to travel abroad regardless of her illness.

This would be the case of ubiquitous healthcare the hospital sought to develop for the patients. Now, the hospital will seek to find a way to meet Jane Doe's desire to prevent the passing on of such a hereditary disease to her children as well as progression of the aortic disease. We categorize that as intelligent healthcare."

The root is the patients. An anytime anywhere accessible hospital incorporates intelligent services to provide the security and convenience to patients for which they endlessly longed.

Intelligent medical service and the future

The u-Severance application configuration is designed with .NET architecture based on a 3-Tier structure. The first tier is the Present Tier which would be on a users PC. It is modularized with the separation of screen forms and a logical UI. The second is the Business Logic Tier on the application server which is designed to enable business module reuse with separation of business. Then the Data Access Tier on the database server makes it easy to maintain separation of data access from a query.

YUHS is applying intelligent medical services to provide the best service by performing adequate diagnosis and management with minimal medical errors. One of the services is YUHS's Electronic Health Records (EHR). According to Professor Chang, the EHR system has five advantages. First, it reduces medical errors via a safe medication decision support system. If a physician clicks on a prescription irrelevant to a patient's diagnosis, the system shows a red mark. Most general prescriptions are saved in sets or pairs for common symptoms of illness as well. The system saves the physician time for diagnosis while reducing the chance of inaccuracy.

Second, EHR provides life-time service with improved quality via integration of resources and better communication.

Patients are no longer required to jot down as much as they remember of their past medical experiences when they sit before a physician. This will specifically benefit the elderly of society.

The third advantage is that EHR will allow a physician and a patient to access their health records anywhere at any time. YUHS secures the records from anyone else but the patient and the doctor.

Fourth, EHR allows evidence based clinical research via clinical data repository. Going through paper files of a patient's twenty year medical history is an old story. The clinical data repository system has a backup system in Severance Hospital.

That guarantees the preservation of a patient's life-time health records.

Last of all, EHR enhances efficiency of service by saving time and securing data.

"With the development of information technology in medicine, patients and employees are asking for services to be advanced as well as authentication, reliability, and efficient administration. One of the suitable solutions we found was EHR. EHR is an easy way to input and view OCS, EMR, and PACS. Local network EHR can be used worldwide so that a patient can travel overseas with less concern," Professor Chang concluded.

The mobile System of YUHS improves the quality of EHR. Physicians of YUHS are provided with mobile phones to be able to access a patient's electronic health records any time and anywhere. "When a physician is called regarding a patient while he is away from the hospital, he can log onto the website and check the patient's electronic health records to give emergency instructions to the residing staff at the hospital,"

Professor Chang showed a black, wide screen mobile phone. The U-SMART website is groupware for employees of Severance Hospital. Here they log in with such mobile phones to find out if there is anything to sign for the day. It also shows the physicians' operation schedule and provides a mailing service. The most interesting and efficient feature is its customized sets of medical orders. For example, it provides automated calculation of children's TPN dosage from pre-entered information at the front desk.

It alerts for a reduced history of medication when the medicine is repeatedly prescribed.

Diagnosis at Severance Hospital with smart cards

"In order to help you to draw a full picture, I will show you a video clip of one of our visitors," Professor Chang continued. "If you drive to the hospital, you can park using the hospital smart card, which shows a patient's identification and electronic signature with built-in electronic tags. Once you access the parking lot by placing the card on the card reader, you may park and put your card on the card reader once again to save the location. The card readers are located at the front of most columns. As soon as you enter the building, the computer assistant will read your card to let you know which appointment is made and where the clinic is located.

A character in the screen shows the way to get to the clinic by walking on the map of the building for you to visualize the path. Once you reach the clinic, you put your card on the card reader on a registration desk to register to meet your professor, or a doctor. By doing so, you can view your registration process and the waiting list on the PDP screen while you are sitting to wait. When your name appears at the top of the list, you may enter the room to meet your physician. All prescriptions and medical information are entered into the system for management.

After the examination, an automatic payment machine outside the examination room receives your payment with credit card or cash, and prints out the receipt. Then the prescription is printed out at the automatic prescription issue kiosk while the prescription list is automatically sent to the pharmacy of your choice. By the time you get to the pharmacy of your choice, the medicine will be ready to be picked up."

Long waits in line for examinations and prescriptions are now ancient history. Severance is taking full advantage of Information Technology to provide efficient services for customers. "Customer here could refer not only to the patient, but our employees as well," Professor Chang Byung-chul said. Yonsei University Health System is constructing another new building on the severance hospital campus and taking the next step forward to be a global medical hub.


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