Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine
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Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implemen-tation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on ‘medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,’ ‘herb combination information’ and ‘search engine by efficacy of prescription.’ The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, ‘medicine information’ and ‘prescription analysis information through basic constitution analyses.’ The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.
Abstract
Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implemen-tation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on ‘medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,’ ‘herb combination information’ and ‘search engine by efficacy of prescription.’ The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, ‘medicine information’ and ‘prescription analysis information through basic constitution analyses.’ The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.
참고문헌 (26)
- Wang S, "Access Application of Traditional Chinese Medicines as Personalized Therapy in Human Cancers", The American Journal of Chinese Medicine, 46(5), pp.953~970 (2018)
- Elf M, "The case of value-based healthcare for people living with complex long-term conditions", BMC Health Serv Res, 17(1), pp.24~ (2017)
- 이충호, "Medical big data: promise and challenges", Kidney Research and Clinical Practice, 36(1), pp.3~11 (2017), 대한신장학회
- Morris AH, "Developing and Implementing Computerized Protocols for Standardization of Clinical Decisions", Ann Intern Med, 132(5), pp.373~383 (2000)
- Linder JA, "Electronic health record use and the quality of ambulatory care in United States", Archives of internal medicine, 167(13), pp.1400~1405 (2007)
- Zhou L, "The relationship between electronic health record sse and quality of care over time", 16, pp.457~464 (2009)
- Kawamoto K, "Improving clinical practice using clinical decision support systems : a systematic review of trials to identify features critical to success", BMJ, 330, pp.765~ (2005)
- Lee DH, "Trends of clinical decision support system", Electronics and telecommunications trends, 31(4), pp.77~85 (2016)
- 최승훈, "인터넷 기반 한의진단전문가 시스템(KHU-PIPE) 개발", 동의생리병리학회지, 16(3), pp.18~531 (2002), 한의병리학회
- 박경모, "한의학의 증상표현을 위한 방법론", 동의생리병리학회지, 16(5), pp.3~850 (2002), 한의병리학회
- 박종현, "한의진단 Ontology 구축과 평가", 동의생리병리학회지, 20(1), pp.202~208 (2006), 한의병리학회
- Anastasi JK, "Understanding diagnostic reasoning in TCM practice : tongue diagnosis", ALTERNATIVE THERAPIES, 15(3), pp.18~28 (2009)
- 김상균, "한의 진단 추론과 진단 학습 방법", 동의생리병리학회지, 23(5), pp.942~949 (2009), 한의병리학회
- Oh YT, "A Study on Diagnosis Support using Knowledge of Diseases from Literature", Journal of Haehwa Medicine, 23(1), pp.13~20 (2014)
- 김철, "효율적인 한의 처방조제지원시스템 개발", 한국한의학연구원논문집, 16(3), pp.127~133 (2010), 한국한의학연구원
- 박장경, "동국대학교 일산한방병원 여성의학과에서의 歸脾湯 임상 적용 사례 분석 연구", 대한한방부인과학회지, 24(2), pp.79~96 (2011), 대한한방부인과학회
- 박진희, "병원 의사결정지원시스템의 서비스 품질이 경영성과에 미치는 영향：K대병원 사례 중심으로", Journal of Information Technology Applications & Management, 21(2), pp.81~98 (2014), 한국데이터전략학회
- Park CS, "A Study on the Data Warehousing System of General Hospital", Conference of The Korea Society of Information Technology Applications, 1(1), pp.304~318 (2002)
- Krähenbühl-Melcher A., "Drug-related problems in hospitals: a review of the recent literature", Drug Saf, 30, pp.379~407 (2007)
- Song MY, "Introduction to Korean Medicine Informatics", pp.14~17 (2012), Jipmoondang
- World Health Organization, "WHO guidelines on safety monitoring of herbal medicines in pharmacovigilance systems", World Health Organization, ~ (2004)
- ISO, "Traditional Chinese medicine Coding system for Chinese medicines. Part 1 : Coding rules for Chinese medicines", ISO, ~ (2016)
- ISO, "Traditional Chinese medicine Coding system for Chinese medicines. Part 2: Codes for decoction pieces", ISO, ~ (2016)
- "Traditional Chinese medicine Coding system for Chinese medicines. Part 3: Codes for Chinese material medica", ISO, ~ (2016)
- "Traditional Chinese medicine Coding system for Chinese medicines. Part 4: Codes for granule forms of individual medicinals for prescriptions" (2016), ISO
- Bright TJ, "Effect of Clinical Decision-Support Systems : A Systematic Review", Ann Intern Med, 157(1), pp.29~43 (2012)