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Objective In South Korea, the Gyeonggi Fire Services introduced a multi-tiered dispatch system for out-of-hospital cardiac arrest (OHCA) cases in July 2015. In this study, we investigated whether the multi-tiered dispatch system improved the pre-hospital return of the spontaneous circulation (ROSC) rate. Methods All non-traumatic adult OHCAs treated and transported by the 119 emergency medical system from July 2015 to December 2015 were included in the study. Demographic and pre-hospital Utstein element-data were collected from the emergency medical system OHCA database. The primary outcome was pre-hospital ROSC as measured at the scene. Results Of the included OHCAs, 1,436 (89.0%) were categorized to the single-tiered dispatch group and 162 (10.1%) to the multi-tiered dispatch group. The rate of administration of advanced airway ventilation (61.1% vs. 48.0%, P=0.002) and intravenous access (18.5% vs. 12.5%, P=0.037) was higher in the multi-tiered group compared to that in the single-tiered group. The use of epinephrine was higher in the multi-tiered group (4.9% vs. 1.5%, P=0.002). The pre-hospital ROSC rates in the multi-tiered group were higher when compared with the single-tiered group, but the difference was not significant (10.5% vs. 7.5%, P=0.218). The adjusted odds ratio for pre-hospital ROSC rates in the multi-tiered group was 1.29 (95% confidence interval, 0.69 to 2.40). Conclusion The multi-tiered dispatch system was not associated with a significant increase in the pre-hospital ROSC rate during the early phase of its implementation, even though advanced maneuvers were performed more frequently.

This study developed a nursing process database based on the object-oriented database model for the development of the nursing process computerization program. Received (September 15, 2015), Review Result(Octorber 02, 2015) Accepted(October 22, 2015), Published(December 31, 2015) 41156 Dept. of Medical Informatics, Kyungpook National Univ., 680, Gukchaebosang-ro, Jung-gu, Daegu, Korea email: phs510@naver.com 41156 Dept. of Medical Informatics, Kyungpook National Univ., 680, Gukchaebosang-ro, Jung-gu, Daegu, Korea email: medinfo@knu.ac.kr 27136 Dept. of Nursing, Semyung Univ., 65, Semyeong-ro, Jecheon-si, Chungcheongbuk-do, Korea email: ag392@naver.com (Corresponding Author) 38610 Faculty of Medical Industry Convergence, Daegu Haany Univ., 1, Hanuidae-ro, Gyeongsan-si, Gyeongsangbuk-do, Korea email: pulala@dhu.ac.kr Development and application of the nursing process database based on the object-oriented database model Copyright c 2015 HSST 168 The database coded the data of the North American Nursing Diagnosis Association (NANDA) 2015-2017, Nursing Outcomes Classification (NOC) 5th edition and Nursing Interventions Classification (NIC) 6th edition, and it produced the appropriate entities based on the class diagram to design data structure in an object-oriented perspective. The nursing process database is composed of classification systems, patient information and nursing process, user information entities, and it has the separate structure that all of the information is dependent on user and patient information entity. That is, the database developed can integrate and develop the computerized program without a separate process by resetting only the relationship between the core entities. In order to take advantage of these object-oriented database model, this study developed a part of the nursing process education program by using the Java programming language, Java Swing, JDBC Connector. The further studies are scheduled to develop the complete program which includes standard protocol transfer function for the standardization of nursing practice, the interoperability between other information systems, and the nursing process macro function.

With the shift from an industry-based society to a knowledge-based one, there has been a gradual increase in the importance of intangible assets such as technologies and information. Patents are a representative intellectual outcome of intangible assets and can be used as an objective measure of the level of technology or innovation of individuals, firms, and countries. In addition, patents can be regarded as a rich source of data for the provision of technological and commercial information. Patent data facilitate research on technological advances and innovation; hence, an analysis of this data can provide important insights into innovation activity and technology management strategies. This paper presents a method for extracting core technologies from core fuel cell vehicle (FCV) patents registered with the United States Patent and Trademark Office by using a data mining technique. Core patents are determined by analyzing patent citations, and the data mining technique identifies those firms with core FCV technologies and reveals the overall research focus of the firms by deriving patent portfolios and and technology recommendations considering the extracted core technologies.

The existing Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) toolkit includes only a clinical term search, and its output functions are not linked to a particular database, making it difficult for users to map biological data, and the use of biobanks requires much time and effort. This study developed a SNOMED-CT toolkit using an optimized search, allowing users to map clinical items for efficient utilization and standardization of biobank resources. The toolkit was developed using the Java programming language and Java Database Connectivity to connect to a previously developed research database. The user interface was implemented using Swing. The functions and interfaces of the toolkit were developed after a requirement analysis by SNOMED-CT experts. Using the toolkit, the user can search SNOMED-CT concepts. Using pre-and post-coordinated mapping of clinical items with the toolkit, it is possible to maximize the semantic interoperability of the previously developed database.

The purpose of this study was to build Ontology based database for efficient operation and interoperability of the human resource bank. The team 7,197,252 of human resources information was collected through previous studies and classifies the 1,796 clinical item through high quality work. For a clear expression of clinical terminology mapping and item of international standard terminology Received (April 15, 2015), Review Request(April 16, 2015), Review Result(May 01, 2015) Accepted(May 21, 2015), Published(June 30, 2015) 700-842 Dept. of Medical Informatics, Kyungpook National Univ., Gukchaebosang-ro, Jung-gu, Deagu, Korea email: yth2320@naver.com 712-715 Dept. of Faculty of Medical Industry Convergence, Daegu Haany Univ., Yugok-dong, Gyeongsan-si, Gyeongsangbuk-do, Korea email: daspula@daum.net (Corresponding Author) 700-842 Dept. of Medical Informatics, Kyungpook National Univ., Gukchaebosang-ro, Jung-gu, Deagu, Korea email: medinfo@knu.ac.kr Study on OWL-based database built for the efficient operation of human resources bank Copyright c 2015 HSST 56 SNOMED-CT it was found to have 826 different synonyms of the term and value types, the data type for the international standard code. In this study, we selected a preferred term of 76 to minimize the redundancy due to the synonyms. Also define the relationship between synonyms and preferred terms using the OWL for interoperability between human resources banks and were stored in XML and databases. OWL-based database built in this study has a common terminology, it can be interchangeably without complex mapping process between the human resource banks.

The previous HL7 interface should be developed as a separate package or conversion module for each version to process HL7 messages from different versions. This study designed and developed an HL7 parser compatible among different versions based on the requirements of compatibility defined in HL7 V2.5. According to the structure of the parser, the inheritance concept in object-oriented programming was adopted so that the class object of the HL7 message from the lower version could be inherited to the class object of the upper version. Therefore, every version’s HL7 messages could be processed using only the upper class’ object regardless of the version. To evaluate the compatibility of the developed parser, 700 data sets about inpatients with rheumatoid arthritis were used. The 700 cases underwent the compatibility test successfully. In the near future, further research on the Inter-compatibility HL7 parser is planned.

Hypertension is one of the major causes of death in the world as it is related with cardiovascular or cerebrovascular disease, so it is needed to provide continuos management for blood pressure. This study selected Health Level 7 Fast Health Interoperability Resources (HL7 FHIR) as a bio-signal data exchange service model that can provide constant blood pressure management in the rapidly growing mobile health care environment. The HL7 FHIR framework developed communicates with the IEEE 11073-10407 Personal Health Device (PHD) protocol through the bluetooth Health Device Profile (HDP) between the manager (smart phone) and the agent (hemomanometer) and acquires information about blood pressure. According to the test results, it performed its tasks successfully including hypertension patients’ blood pressure monitoring, management on measured records, generation of document, or transmission of measured information. Because in the actual, clinical environment, it is possible to transmit measured information through the TCP/IP protocol, it will be needed to conduct constant research on it and vitalize it in the field of mobile health care afterwards. ☞ keyword : Bluetooth Health Device Profile, HL7 FHIR, Hypertension, Personal Health Device, mobile Healthcare 1 Dept. of Medical Informatics, Kyungpook National Univ., Daegu, 700-422, Korea. 2 College of Nursing, Kyungpook National Univ., Daegu, 700-422, Korea. 3 Dept. of Medical Information Technology, Daegu Haany Univ., Kyungsan, 712-715, Korea. * Corresponding author (hshong@knu.ac.kr) [Received 27 January 2014, Reviewed 29 January 2014, Accepted 01 April 2014] ☆ 이 논문은 2009년과 2013년 정부(교육부)의 재원으로 한국연 구재단의 지원을 받아 수행된 기초연구사업임 (NRF-2009-0066546, NRF-2012R1A1A2004829) 1. 서 론 2012년 세계보건통계(World Health Statistics) 보고서에 의하면 전 세계 성인의 1/3이 뇌졸중 및 심장질환의 원인 인 고혈압이 있다고 조사되었다[1]. 또한 고혈압은 사망 에 이르게 하는 위험한 요소 중 하나이다[2]. 2000년 전 세계 성인 인구의 고혈압 발병률은 26%이었고 2025년에 60%로 증가할 것이라고 전망하였다[3]. 2008년 심장 질 환, 뇌졸중, 암, 만성 호흡기 질환 그리고 당뇨 등과 같은 만성질환으로 사망한 인구 비율은 전 세계 사망자의 58% 를 차지하였다. 동일한 기간에 심혈관계 질환으로 사망한 ISSN 1598-0170 (Print) ISSN 2287-1136 (Online) http://www.jksii.or.kr http://dx.doi.org/10.7472/jksii.2014.15.3.21 고혈압 관리를 위한 헬스레벨 7 FHIR 기반 생체정보 교환 서비스 모델 구현 22 2014. 6 인구 비율은 만성질환으로 사망한 인구의 30%이고 그 수 는 1700만 명이다[4]. 또한 2011년 국내 통계청 발표에 의 하면 고령자 사망원인 1, 2, 3위는 각 암, 뇌혈관 질환, 심 장 질환 등으로 조사되었다. 동일한 기간의 3대 질병 사 망률이 전체 사망자의 47.4%를 차지하였고 심장 질환으 로 인한 사망자 비율은 49.8%로 전 년도에 비해 2.9% 증 가하였다[5]. 고혈압 환자 수는 점차 증가하고 있고 사망 원인으로 부각되고 있으므로 고혈압 관리와 예방을 할 수 있는 기술이 절실히 필요하다. 최근 건강관리를 위한 서비스 기술은 모바일 기기와 인터넷의 의한 원격 Healthcare, 모니터링 그리고 의료영 상의 융합이 특징적이다. 특히 실시간으로 생체신호를 모 니터링 하는 유비쿼터스 센싱, mHealth 환경에서 구현을 위한 홈 안전의 지원, 생체 신호기록 및 기기 표준 그리고 소셜미디어 활용센서 등을 제시하고 있다[6]. mHealth는 eHealth의 한 형태이며, 용어는 Robert Istepanian로부터 2005년에 발간된 “새롭게 부상하는 모바 일 헬스 시스템” 서적을 통해 처음 사용되었다[7]. mHealth는 광범위하게 모바일과 무선 보건의료서비스전 달체계와 통합된 것으로 모바일 통신 또는 멀티미디어 기술들을 포함한다[7]. 2011년 GlobalData 사의 조사에 따르면 모바일 응용프 로그램과 원격 환자 모니터링 기기를 포함한 mHealth 시 장의 가치는 12억 이었고 2018년에는 118억으로 늘어날 것으로 전망하였다. 미국의 mHealth 시장은 세계시장의 50% 이상을 차지하고 연평균성장률(Compound Annual Growth Rale, CAGR)은 39% 이다. mHealth 시장 비중은 소프트웨어와 서비스 분야가 80%로 가장 크고 이다음 하 드웨어와 네트워크가 각 12%를 차지한다. 그리고 어플리 케이션 사용자는 70%가 일반 소비자용이며, 30%가 의료 전문가용으로 나타났다[8]. HIMSS 사의 모바일 기술 조 사에 의하면 임상전문가의 80%는 환자 진료의 환경을 개 선하기 위한 직접적인 영향력을 행사하는 장비를 이용하 며 93%는 모바일 기기를 매일 이용한다. 또한 65%는 임 상 검사의 결과나 환자 정보를 조회하기 위해 어플리케 이션을 이용한다[9]. Frost와 Sullivan 사는 고성능을 가진 어플리케이션의 개발이 촉진될 것이라고 전망하였다. 오 늘날 임상관련 어플리케이션 대부분은 정보 입력 또는 참조만 가능하다. 향후의 어플리케이션은 활력징후를 모 니터링 하는 시스템으로써 모바일 기기에 작은 측정기를 연결하여 생체 신호를 검사하고 진단 기능이 강화될 것 이라고 예측하였다[10]. 모바일 폰은 사용자가 서비스에 빠르고 편리하게 접근할 수 있는 장치이다. 고혈압 환자가 매일 병원을 방문하여 지속적인 치료 및 관리를 받는 것은 한계가 있다. 본 연구에서는 국제표 준인 Bluetooth Health Device Profile (HDP), IEEE 11073 PHD 그리고 HL7 FHIR(Fast Health Interoperability resources)을 이용하여 환자가 매일 병원 방문을 하지 않 고도 mHealth 환경에서 지속적인 혈압 관리가 가능한 FHIR 기반의 생체정보 교환 시스템 모델을 설계하고 구 현하였다.

본 연구는 임상실습을 하는 간호학생들의 간호과정 스마트폰 애플리케이션의 사용의도를 조사하고, 이 프로그램의 적용효과를 평가하기 위해 시도되었다. 연구대상자는 대구 지역 일개의 간호대학 3학년 학생으로, 2012년 9월부터 2013년 9월까지 외과 병동 성인간호학 실습을 나가는 60명이다. 연구결과 간호과정 스마트폰 사용의도는 학습의 용이성, 사회적 영향, 자기효능감과 유의한 관계가 있었다. 그리고 대상자에게 적용된 간호과정 앱 애플리케이션은 급성통증에 대한 진단, 중재, 결과에 대한 목록이 가장 많았고, 프로그램 사용 만족도는 4.35점이었다. 이 연구결과를 통해 간호과정 앱은 임상실습 현장에서 간호과정 앱 사용에 대한 더 많은 기회와 교육을 제공하고, 그것의 활용에 관하여 손쉽게 적용될 수 있는 방안이 마련되어야 할 것이다. 【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.】

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.

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.

The purpose of this research paper is to develop Mobile application-based Nursing Process Programs on `Nursing Diagnosis`, `Nursing Interventions` and `Nursing Outcomes Classification` targeting nurses and nurse students. To achieve it, this paper uses `standard classification-focused research data` on the basis of Nursing Diagnosis Classification established by NANDA (North American Nursing Diagnosis Association), NIC (Nursing Interventions Classification) and NOC (Nursing Outcomes Classification) mainly developed by Iowa State University. The existing research methods are difficult to be applied to patients, since such methods put a restriction on choosing, developing, and generalizing `Nursing Process Programs` in clinical spheres. But, this research thesis focuses on developing guidelines applicable to any clinical experiences, with the use of the framework in mutual links with all the nursing diagnosisoutcomes- interventions. In this regard, the Korean version programs were developed and registered in App store in March. Thus, it is expected that these programs would be wildly-available as tools for nursing education.

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.

Various standard terminologies in medical field are composed in dividually to different structure. Therefore, information on crosswalking between the termino logies is needed to combine and use the terminologies. Lots of mapping tools have been developed and used to create the information. However, since those tools deal with specific terminologies, the information is restrictly created. To overcome this problem, some tools have been developed, which perform mapping tasks by com-posing various terminologies. However, the tools also have diff iculty of composing automatically the terminologies because the terminologies have different structures. Therefore, in this paper, we propose a method for composing and using the terminologies in the developed mapping system with keeping the original structure of the terminologies. In the proposed method, additional terminologies could be added on the mapping system and used by making metadata involving in-formation on location and structure of the terminologies. And t he mapping system could cope flexibly with the changes of the structure or context of the terminologies. Moreover, var ious types of mapping informat ion could be defined and cre-ated in the system because mapping data are constructed as trip lets in ontology. Therefore, the mapping data can be transformed and distributed in different formats such as OWL, R DF, and Excel. Finally, we confirmed the usefulness of the mapping system based on the proposed method through the experiments about creating mapping data.Key Words : Standard medical terminology, Mapping system, Ontology, SNOMED-CT, ICD, NANDA, NIC, NOC

Most of the terminologies used in medical domain is not intended to be applied directly in clinical setting but is developed to integrate the terms by defining the reference terminology or concept relations between the terms. Therefore, it is needed to develop the subsets of the terminology which classify categories properly for the purpose of use and extract and organize terms with high utility based on the classified categories in order to utilize the clinical terms conveniently as well as efficiently. Moreover, it is also necessary to develop and upgrade the terminology constantly to meet user’s new demand by changing or correcting the system. This study has developed a mapping tool that allows accurate expression and interpretation of clinical terms used for medical records in electronic medical records system and can furthermore secure semantic interoperability among the terms used in the medical information model and generate common terms as well. The system is designed to execute both 1:1 and N:M mapping between the concepts of terms at a time and search for and compare various terms at a time, too. Also, in order to enhance work consistency and work reliability between the task performers, it allows work in parallel and the observation of work processes. Since it is developed with Java, it adds new terms in the form of plug-in to be used. It also reinforce database access security with Remote Method Invocation (RMI). This research still has tasks to be done such as complementing and refining and also establishing management procedures for registered data. However, it will be effectively used to reduce the time and expenses to generate terms in each of the medical institutions and improve the quality of medicine by providing consistent concepts and representative terms for the terminologies used for medical records and inducing proper selection of the terms according to their meaning.Key Words : Electronic medical records system, Semantic interoperability, Mapping tool, Remote method invocation† 교신저자, 정회원 : 경북대학교 의과대학 의료정보학과 연구교수E-mail : pulala@paran.com.*비 회 원 : 경북대학교 의료정보학과 박사후연구원** 비 회 원 : 경북대학교 간호대학 간호학과 박사과정***비 회 원 : 경북대학교 의과대학 의료정보학과 교수 접수일자 : 2010년 10월 16일 최종완료 : 2010년 12월 14일

We propose the creation of a standard data model for medication administration activities through the development of a clinical document architecture using the Health Level 7 Development Framework process based on an object-oriented analysis and the development method of Health Level 7 Version 3. Medication administration is the most common activity performed by clinical professionals in healthcare settings. A standardized information model and structured hospital information system are necessary to achieve evidence-based clinical activities. A virtual scenario is used to demonstrate the proposed method of administering medication. We used the Health Level 7 Development Framework and other tools to create the clinical document architecture, which allowed us to illustrate each step of the Health Level 7 Development Framework in the administration of medication. We generated an information model of the medication administration process as one clinical activity. It should become a fundamental conceptual model for understanding international-standard methodology by healthcare professionals and nursing practitioners with the objective of modeling healthcare information systems.

Kyungpook National University School of Medicine, Daegu, Kore a Purpose: The purpose of this study is to understand student recognition of CBT as well as its strengths and weaknesses, and to explore the improvement methodologies for the effective development and implementation of CBT. Methods: A questionnaire survey was conducted twice(before and after implementation of CBT) with a total of 17 multiple-choice and 2 essay-type questions. The multiple-choice ques-tions were analyzed by frequency analysis and the essay-type questions were coded by content analysis. Results: The results are as follows. First, the overall satisfaction with CBT was shown to be high. Second, students listed the merits of CBT as follows: simple correction of answers(before: 89.4%; after: 80.8%), presentation of realistic materials(before: 72.9%; after: 84.7%), prompt feedback on grades(before: 60.3%; after: 71.1%), shortened exam time and effective time scheduling(before: 86.5%; after: 66.4%), accurate estimation of abilities (before: 70.2%; after: 36.6%), and assistance in academic improvement(before: 70.9%; after: 22.1%). Drawbacks of CBT were: inconvenience of review(before: 70.9%; after: 22.1%), inconvenient screen organi-zations(before: 0%; after: 48.1%), possibility of cheating(before: 73.9%; after: 31.8%), and equality issue of test(before: 47.3%; after: 17.3%). Conclusion: Assessment paradigms are currently shifting from summative evaluation to forma-tive evaluation, from one-off assessment to continuous assessment, and from output assessment to process assessment. Therefore, CBT must be expanded to move from result-oriented sum-mative evaluation to formative evaluation continuously monitoring the student learning process. 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏Key Words: Computer-based test, Evaluation, Medical education

The Resource Description Framework (RDF) is widely used for sharing biomedical data, such as gene ontology or the online protein database UniProt. SPARQL is a native query language for RDF, featuring regular expressions in queries for which exact values are either irrelevant or unknown. The use of regular expression indexes in SPARQL query processing improves the performance of queries containing regular expressions by up to two orders of magnitude. In this study, we address the update operation for regular expression indexes in RDF databases. We identify major performance problems of straightforward index update algorithms and propose a new algorithm that utilises unique properties of regular expression indexes to increase performance. Our contributions can be summarised as follows: (1) we propose an efficient update algorithm for regular expression indexes in RDF databases, (2) we build a prototype system for the proposed algorithm in C++ and (3) we conduct extensive experiments demonstrating the improvement of our algorithm over the straightforward approaches by an order of magnitude.

The purpose of this study was to develop and evaluate a mobile health application (Self-Management mobile Personal Health Record: "SmPHR") to ensure the interoperability of various personal health devices (PHDs) and electronic medical record systems (EMRs) for continuous self-management of chronic disease patients. The SmPHR was developed for Android 4.0.3, and implemented according to the optimized standard protocol for each interface of healthcare services adopted by the Continua Health Alliance (CHA). That is, the Personal Area Network (PAN) interface between the application and PHD implements ISO/IEEE 11073-20,601, 10,404, 10,407, 10,415, 10,417, and Bluetooth Health Device Profile (HDP), and EMRs with a wide area network (WAN) interface implement HL7 V2.6; the Health Record Network (HRN) interface implements Continuity of Care Document (CCD) and Continuity of Care Record (CCR). Also, for SmPHR, we evaluated the transmission error rate between the interface using four PHDs and personal health record systems (PHRs) from previous research, with 611 users and elderly people after receiving institutional review board (IRB) approval. In the evaluation, the PAN interface showed 15 (2.4 %) errors, and the WAN and HRN interface showed 13 (2.1 %) errors in a total of 611 transmission attempts. Also, we received opinions regarding SmPHR from 15 healthcare professionals who took part in the clinical trial. Thus, SmPHR can be provided as an interconnected PHR mobile health service to patients, allowing `plug and play' of PHDs and EMRs through various standard protocols.

Objectives This study developed an integrated database for 15 regional biobanks that provides large quantities of high-quality bio-data to researchers to be used for the prevention of disease, for the development of personalized medicines, and in genetics studies. Methods We collected raw data, managed independently by 15 regional biobanks, for database modeling and analyzed and defined the metadata of the items. We also built a three-step (high, middle, and low) classification system for classifying the item concepts based on the metadata. To generate clear meanings of the items, clinical items were defined using the Systematized Nomenclature of Medicine Clinical Terms, and specimen items were defined using the Logical Observation Identifiers Names and Codes. To optimize database performance, we set up a multi-column index based on the classification system and the international standard code. Results As a result of subdividing 7,197,252 raw data items collected, we refined the metadata into 1,796 clinical items and 1,792 specimen items. The classification system consists of 15 high, 163 middle, and 3,588 low class items. International standard codes were linked to 69.9% of the clinical items and 71.7% of the specimen items. The database consists of 18 tables based on a table from MySQL Server 5.6. As a result of the performance evaluation, the multi-column index shortened query time by as much as nine times. Conclusions The database developed was based on an international standard terminology system, providing an infrastructure that can integrate the 7,197,252 raw data items managed by the 15 regional biobanks. In particular, it resolved the inevitable interoperability issues in the exchange of information among the biobanks, and provided a solution to the synonym problem, which arises when the same concept is expressed in a variety of ways.

The Resource Description Framework (RDF) is widely used for sharing biomedical resources, such as the online protein database UniProt or gene database GeneOntology. SPARQL is the native query language for RDF databases and it features regular expressions in queries for which the exact values are either irrelevant or unknown. A recent paper by Lee et al. presented an efficient indexing support for such queries adopting multigram indexes for regular expressions. In this paper we contribute to their work by addressing index updates. As a result, we identify a major performance problem of straightforward implementations and design a new algorithm that utilizes unique properties of multigram indexes. Our contributions can be summarized as follows: 1) we propose an efficient update algorithm for regular expression indexes in RDF databases; 2) we build a prototype system for the proposed framework in C++; 3) we conduct extensive experiments to demonstrate the properties of our algorithm. The experiments show that our algorithm outperforms the straightforward implementations by an order of magnitude.

Problems of having different vocabularies pointed at the same terminology for health care parties are today's issue. Communication problem of this kind in health information system around the globe are still without answers. By fast growing Intelligent Agent technology in the medical field, this issue becomes large enough to halt the progress. Agents for valid communication need to have same understanding over the terminology. Misunderstanding about meaning of a specific terminology by human is as same as misunderstandings of intelligent agents about meaning of a term-which concludes a fault communication-with the difference that agents are connected to each other and can exchange though at no time. The problem is where an agent can report for a valid knowledge base and correct meaning of a term. This paper is addressing this issue by presenting a Medical Vocabulary Interpreter as an Agent (We assume it to be a well known software, waiting to answer questions about original meaning of a terminology and ready to reply-first in first out service) to share a vast amount of complex information pointing to the same root.

In general, hospital information systems are operated independently of each other. We propose a next-generation hospital information system (HIS) based on the HL7 clinical document architecture (CDA) including also an electronic health record (EHR) and a clinical data repository (CDR) to enable the sharing of medical information among health and medical institutions. We designed an XML schema through which an effective clinical document was generated from the HIS after defining the item regulations and the templates for the release form and radiation interpretation form. The schema was analyzed according to the HL7 reference information model, and HL7 V2.4 was used as the transmission protocol. In addition to proposing a new HIS, we attempted to define the CDA of a release form and create a generation, saving, and control system for the release form based on that definition, the first such undertaking in Korea.

We have developed a CDA (Clinical Document Architecture) based PACS, by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. We'll make more effort to develop the application which insures the better quality of medical images. The medical image history manages the patient's image flies and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary devices and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. The system is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images. And, target model of this research limited to HIS (Hospital Information Systems) of hospital have 200 beds.

A basic assumption of Health Level Seven (HL7) protocol is 'No limitation of message length'. However, most existing commercial HL7 interface engines do limit message length because they use the string array method, which is run in the main memory for the HL7 message parsing process. Specifically, messages with image and multi-media data create a long string array and thus cause the computer system to raise critical and fatal problem. Consequently, HL7 messages cannot handle the image and multi-media data necessary in modern medical records. This study aims to solve this problem with the 'streaming algorithm' method. This new method for HL7 message parsing applies the character-stream object which process character by character between the main memory and hard disk device with the consequence that the processing load on main memory could be alleviated. The main functions of this new engine are generating, parsing, validating, browsing, sending, and receiving HL7 messages. Also, the engine can parse and generate XML-formatted HL7 messages. This new HL7 engine successfully exchanged HL7 messages with 10 megabyte size images and discharge summary information between two university hospitals.

PURPOSE: This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. METHODS: The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. RESULTS: One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. CONCLUSION: Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.

Objectives Fuzzy cognitive maps (FCMs) representing causal knowledge of relationships between medical concepts have been used as prediction tools for clinical decision making. Activation functions used for inferences of FCMs are very important factors in helping physicians make correct decision. Therefore, in order to increase the visibility of inference results, we propose a method for designing certain types of activation functions by considering the characteristics of FCMs. Methods The activation functions, such as the sinusoidal-type function and linear function, are designed by calculating the domain range of the functions to be reached during the inference process of FCMs. Moreover, the designed activation functions were applied to the decision making process with the inference of an FCM model representing the causal knowledge of pulmonary infections. Results Even though sinusoidal-type functions oscillate and linear functions monotonously increase within the entire range of the domain, the designed activation functions make the inference stable because the proposed method notices where the function is used in the inference. And, the designed functions provide more visible numeric results than do other functions. Conclusions Comparing inference results derived using activation functions designed with the proposed method and results derived using activation functions designed with the existing method, we confirmed that the proposed method could be more appropriately used for designing activation functions for the inference process of an FCM for clinical decision making.

Objectives The Health Level Seven Interface Engine (HL7 IE), developed by Kyungpook National University, has been employed in health information systems, however users without a background in programming have reported difficulties in using it. Therefore, we developed a graphical user interface (GUI) engine to make the use of the HL7 IE more convenient. Methods The GUI engine was directly connected with the HL7 IE to handle the HL7 version 2.x messages. Furthermore, the information exchange rules (called the mapping data), represented by a conceptual graph in the GUI engine, were transformed into program objects that were made available to the HL7 IE; the mapping data were stored as binary files for reuse. The usefulness of the GUI engine was examined through information exchange tests between an HL7 version 2.x message and a health information database system. Results Users could easily create HL7 version 2.x messages by creating a conceptual graph through the GUI engine without requiring assistance from programmers. In addition, time could be saved when creating new information exchange rules by reusing the stored mapping data. Conclusions The GUI engine was not able to incorporate information types (e.g., extensible markup language, XML) other than the HL7 version 2.x messages and the database, because it was designed exclusively for the HL7 IE protocol. However, in future work, by including additional parsers to manage XML-based information such as Continuity of Care Documents (CCD) and Continuity of Care Records (CCR), we plan to ensure that the GUI engine will be more widely accessible for the health field.

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.