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Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.

Objective: This study analyzes the chronic disease management, which is a core business of the public health centers, and grasps the functions of the information system that users need. Methods: It is conducted by analyzing work flows in two public health centers that using two different health information systems, Posdata system and Daeryun systems. We also performed detailed interview and discussion to formulate the functionality for the information system in the future. Results: Both two health information systems currently used at public health centers emphasized hypertension, diabetes mellitus and hyperlipidemia as major target disease. They used information systems as a tool of case registration, assessment, reporting, consultation and education and patient care. But functionality of current systems supports only a part of the whole system and manual data input using excel program was still applied. The current information system is just inputting the data of manual works in computer and many of the functions are not used and still there are many duplicate and manual works. Two major problems of information systems in Korean public health centers are lack of standardization in the business process and reporting, and the current system does not support current functionalities. Conclusion: We found that management of the chronic disease is to be more important work for the public health centers in the future. The future direction of the work process of the management of chronic disease would be upgrading the current functionality as well as new functionalities. Better linkage with direct care system and interoperability with national electronic health records system are new demands (Journal of Korean Society of Medical Informatics 13-3, 279-284, 2007)

Electronic health records(EHR) hold promise in improving the quality and efficiency of health care, yet the health care system remains years behind other industries with respect to the adoption of information technology(IT). Stakeholders in the medical community, including government and tertiary hospitals, have emphasized the urgent need to adopt IT systems. This paper reviews the current research and development efforts related to EHR in Korea, which have been supported by the government since December 2005, on the basis of the following core EHR components: EHR architectures that incorporate an external, implementation-independent view of a complete EHR; EHR functionality for defining tasks that an EHR system should perform; semantic ontology for developing standard vocabularies at the national level; EHR messaging standards for exchanging data; and clinical decision support systems for improving patient safety. Recent international work on EHR systems and the underlying trends are described, and suitable directions for research and development are suggested under relevant subtopics. Advances in the relevant areas will greatly facilitate our ability to achieve interoperability and promote patient safety. However, EHR systems will perform optimally only if we improve our understanding of the political, structural, and technical foundations for EHR, and reach consensus via collaborations between all the stakeholders in the health care system.

This study aims to describe the basic features of Electronic Medical Records at the Seoul National University Hospital and Seoul National University Bundang Hospital and to discuss the process we developed and adopted the system. We also aim to suggest potential risks and success factors in our processes. Methods: Seoul National University Hospital, a tertiary teaching hospital with 100-year-old history, 1000 medical staffs, and 1700 in-patient beds has successfully adopted Electronic Medical Records system from October 2004 and runs very well for more than one year. Our system is fully integrated with Computerized Physician's Order Entry (CPOE) and Picture Archiving and Communication System (PACS). Results: We identified that the key step for the successful adoption of the full system was to overcome physicians' resistance to their use of Electronic Medical Records and to help their earlier accommodation to new practice environment. We then found that five important success factors were the clinical leadership, adoption strategy, young doctors' participation, outsourcing of the department of information technology and the accumulated domain knowledge. Our experience shows it is important to expose young medical staffs to the change before the main Electronic Medical Records system opens and "patient-centered" was the most important concept to make these reform processes successful. Conclusion: Development and adoption of Electronic Medical Records at large teaching hospital are not easy but are very important and powerful tool for patient-centered medical practice.

As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. Methods: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. Results: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. Conclusion: The results showed the high prioritized functions were decision support and health information/data management.