Nursing Informatics

~Korea~

Group 4 Lagare, Regeil Marao, Rodelen Natividad, Nicholas Peaflor, Karen 2NU03

in

About Korea
Comprised of 8 provinces with 7 Metropolitan Cities Language: Hangul
(/,)

History of Nursing Informatics

1970- use of computer NI and Health Informatics- KOSMI (1987) 1993- Computers for Nursing Education and
Research
Hospital Finance and Administration Systems to expedite insurance and reimburses.

1994- Nursing Informatics was taught in schools

History of Nursing Informatics

IMIA Conference MEDINFO98 (Seoul)
Provided excellent opportunity for Koreans to become acquainted with NI. 200 active nurse members in KOSMI.

NI Study Group

Korean Science and Engineering Foundation 1998 Journal review and research activities

Survey studies of NI education and Computer application in nursing practice in Korean hospitals.

Use of Information Technology in Clinical Practice

Use of Information Technology in Clinical Practice

100% of teaching hospital, 96% of general hospital, and 75% of private clinics now have hospital information system in Korea according to Health Industry development Institute in 2000. All of the teaching hospital and about 40% of general hospitals in Korea are using order communication system(kwak,2000) Which enable the physician to communicate with other departments for practice related requisitions and retrieval of data.

Use of Information Technology in Clinical Practice

In addition, about 95% of teaching hospital and 20% of general hospitals are equipped with picture archiving and communication systems (PACSs)

Use of Information Technology in Clinical Practice

PACS (Picture Archiving and Communication System)

are computers, commonly servers, dedicated to the storage, retrieval, distribution and presentation of images. The medical images are stored in an independent format. this eliminates the need to manually file, retrieve or transport film jackets.

Use of Information Technology in Clinical Practice

Use of Information Technology in Clinical Practice

Seoul National University, College of Nursing

Developed Home healthcare system for community based clinical practice. Home healthcare nurses uses laptop computers to note and check medication and progress electronic patient records, and to communicate electronically with other home healthcare team members.

Health Informatics Education

According to a recent survey on health informatics and computer education programs in south Korean medical and nursing schools, about 25% of medical schools and 21% of nursing schools offer health informatics courses. The course contents vary a great deal from school to school, and the instructors are mostly self taught in these subjects. These indicates that there is a need for standardization of health informatics.

Research

Research
Journal of the KOSMI (1991)
Addresses the application of commercially available programs Discusses use of computers as a tool for nursing education Distance education using of internet .

Research
Use of artificial intelligence in nursing diagnosis

PDA (personalized digital assistants) in hospital and home healthcare settings along with standardization Web-based electronic patient records

Standardization Activities

Standardization Activities
Efforts to implement a single, integrated healthcare and nursing terminology Korean Standard Classification of diseases- healthcare sector SNOMED (Systematized Nomenclature of Medicine)-Clinician information system

Standardization Activities
NANDA Nursing Education 3N (NANDA-NICNOC) and ICNP frequently used in clinical practice for electronic nursing record systems

Government Initiatives

Government Initiatives
Provided funds or other incentives and guidelines in the ff:
Telemedicine Emergency medical systems Infectious diseases reporting systems Standardization

Government Initiatives
Has contributed to the implementation of a nationwide information highway. Two information highways available:

South Korea Advanced Research Network mainly used for research activities Nationwide commercialized network built by telecommunication companies

Government Initiatives
Individual users at their homes can use ADSL (asynchronous digital subscriber line) to connect to the internet. The Korean Ministry of Health and Welfare ~established a longterm plan for a national health and welfare network (NHWN) in 1993.

Government Initiatives
NHWN covers six areas:
Public health Hospitals and clinics Health insurance Food and drugs National pension Health and welfare administration

Government Initiatives
In 1994, Public health was selected as the toppriority project. To be carried out in three phases:
First phase (1994-1997) computerized the administrative and patient care activities of health centers. Second phase (1998-2001) developed infrastructure for the ff:
public health network, integrating network systems among health centers health subcenters primary healthcare posts

Third Phase (2001-Present) development of data warehousing at the level of major cities and provinces .

Professional Outreach

Professional Outreach
KOSMI (Korean Society of Medical Informatics), held biannual academic conferences, various seminars, workshops, and open forums, and by publishing journals. It also offered educational programs for beginners in health informatics. Organizations such as the Korean Medical Association and the Korean Nurses Association include health informatics in their continuing programs.

Professional Outreach
Health Informatics Standardization Committee, serving as the South Korean
has held open forums and published health information standards.

technical advisory group of ISO/TC215

The IMIA (International Medical Interpreters Association)

has contributed significantly to furthering the knowledge of South Korean healthcare professionals about worldwide trends in health informatics.

Technology Trends

Technology Trends
The rapid growth of mobile telephone users and the advances in wireless local area network (LAN) technology have lead to mobile computing in healthcare becoming a popular issue in South Korea. The main users of the systems currently are nurses attending patients at bedsides, but this will soon be extended to other healthcare professionals. Users favor notebook computers with wireless LAN connections because of their larger screen size and easier-to-use interface.

Technology Trends
Telemedicine
Teleconsultation ex. generalist doctor at a health center in a remote area to have a telepathology or a teleradiology consultation with the specialists of a tertiary hospital. Currently, fee is reimbursed by health insurance. Telecare at home telepractitioners maintain special schedules for their remote clients. They set aside 1-2 days per week to take care of their clients using virtual reality technology via the Internet.

Galaxy Tab, M.D.

transforms the tablet PC into a handy terminal that helps doctors stay organized and gives patients a better view of their treatment and health.

 Thanks to the new system, introduced in November 2010, patients can now instantly see graphs showing their vital signs, test results and prescriptions records displayed on the Tab's 7-inch screen. Such access to information would not be possible with only a desktop PC. It's also changing the organization of medical records and how doctors and staff communicate. Young doctors and nurses record their chiefs' instruction, take patients' pictures and put important information on the system right away with just a few touches and swipes.

Healthcare Reforms

Healthcare Reforms
1. Health Care Financing NHI consisted of over 350 health insurance societies (no consumer choice) for - industrial workers (36.0% of pop) : based on employment - self-employed (regional) (50.1%) : based on regions - public and school employees (10.4%)

Healthcare Reforms
Context of the Health Care Financing Reform a. Inequity in the economic burden Differential method of setting contribution - between industrial workers and the self-employed (income vs. income & property) - among industrial workers (difference in contribution base) Same benefit package but different contribution across ins. societies (w/o consumer choice)

Healthcare Reforms
b. Chronic fiscal instability of rural h. insurance - decreasing population, poor health, increasing proportion of the elderly c. Diseconomies of scale (too small in size) - inefficient risk pooling - administrative costs

d. Regulation and influence of the Ministry of Health and Welfare -> revolving door and little self-governance

Healthcare Reforms
2. Health Care Delivery

Characteristics of health care delivery - For-profit nature: most hospitals are profit-making and owned by physicians (KMA, KHA) - Physicians clinics have inpatient facilities and hospitals have huge outpatient clinics (competition and duplication) - Closed hospital system - No differential payments to physicians and hospitals

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