Empowerment of Korean Medical Association with KMA Policy system developing

Recently, the Korean Medical Association (KMA) launched the KMA Policy system based upon the American Medical Association (AMA) Policy system. The KMA's official positions on health issues and medical ethics, as well as its constitution, bylaws, and directives, will be included in the KMA Policy system. The AMA's organizational structure and decision making process provided essential information for developing the KMA Policy system. Through the KMA Policy system, hereafter, the KMA should introduce a procedure not only to decide upon positions on various health issues but also a means to open them to the public. In addition, the KMA can expect the continuity and transparency of work, enhanced benefits to members, public credibility, and growth of its social reputation by means of KMA Policy. Furthermore, the system would be beneficial for both KMA members and the public, as they can easily access KMA Policy, and, in turn, access the healthcare systems of Korea and its medical knowledge. To achieve a successful KMA Policy system, the definite authority and responsibility should be granted to the organizational bodies of the KMA, for example, the House of Delegates and Board of Trustees, and the regional societies and other sections. These various groups must then efficiently divide up their work and cooperate systematically. Moreover, it is crucial that each individual member of the KMA pay much more attention to health issues and participate in the decision making process on KMA Policy.

Proposed Master Plan for Reform of the National Infectious Disease Prevention and Management System in Korea

A Middle East respiratory syndrome (MERS) - coronavirus (CoV) cluster that attacked Korea in May 2015 revealed several weaknesses in Korea's health care system in the face of the crisis of an emerging infectious disease and its public health implications. This experience has shown that is necessary to prepare comprehensive countermeasures through the cooperation of civil and public agencies to prevent a second or even third MERS outbreak and to control future crises of infectious disease and public health. The MERS Policy Committee of the Korean Medical Association has thus proposed a master plan for reform of the national infectious disease prevention and management system to prepare a new framework for national infectious disease prevention and control. The specific targets of the master plan are improvement of the system of usage of medical services and of the medical culture among national health insurance subscribers, improvement of the emergency room management system to prevent the spread of infectious disease, the establishment of a support system to promote effective voluntary infectious disease prevention activities among medical institutions, the building of a public health crisis communication system in collaboration with medical organizations, the establishment of an independent Ministry of Health and capacity building of the Korea Centers for Disease Control (KCDC), the securing of an advanced research and development system in the field of prevention and control of infectious disease, and the capacity building of professional epidemiologists and personnel needed to prevent and control infectious disease. The five core strategies of the master plan have been planned by medical experts in this order of priority: the reform of the healthcare delivery system, the independence of the Ministry of Health and capacity building of the KCDC, fundraising for a public infection management fund, enforcement of medical organization infection control, and improvement of the emergency room management system.

Estimating financial loss to medical clinics resulting from the Middle East respiratory syndrome coronavirus outbreak in Korea

Korea experienced an unprecedented national level disaster caused by the Middle East respiratory syndrome (MERS) in the first half of 2015. Because of the secretiveness of the government and the insufficiency of the nation's quarantine system, Korea could not effectively respond to the MERS coronavirus (CoV) outbreak. Many people suffered huge losses across most sectors, and medical clinics were no exception. Now the Korean Government and many professionals are discussing the matter of compensation. This study aimed to provide evidence for the necessity of compensation support. We conducted a questionnaire survey of the level of economic damage over the course of a month. The financial loss rate of medical clinics that experienced MERS damage has decreased by more than half over the previous year. The total financial loss of 48 medical clinics was about 1.6 billion Korean won (KRW) based on insurance benefits and 3.4 billion KRW based on sales. Due to the spreading of the MERS-CoV outbreak after May 20, 2015 in Korea, the loss rate in June was much higher than that in May or July. In July, the financial position tended to be restored to more than half of that in June but had not fully recovered to the level prior to the MERS-CoV outbreak. As most of the population, including professionals, perceive that the government is liable for damages from the MERS-CoV outbreak, the authorities concerned should prepare a compensation and redress plan. Furthermore, we expect our study to be used as good evidence for a redress plan for medical clinics damaged by the MERS-CoV outbreak.

A study on establishing a technical safety assessment system for the Korean telemedicine system

Telemedicine is a critical infrastructure that directly affects people's lives. In this vein, the government announcement of the introduction of a telemedicine service has caused controversy among the government and medical institutions over the safety of the service. Before the introduction of the telemedicine service, its technical safety and effectiveness should be validated. The telemedicine system should be supported by proper policies to ensure a secure, continuous service. To this end, we have conducted research to derive the security requirements from domestic and foreign standards and laws relating to telemedicine and information security. Based on the derived requirements, we have developed a security standard for telemedicine that facilitates the objective assessment of the security of the telemedicine service. Furthermore, we have analyzed the vulnerabilities of telemedicine devices through penetration tests. Finally, using a risk analysis method, we have created risk scenarios that might occur in the provision of telemedicine services, and have calculated risk levels and expected loss for each scenario. We expect that the results of this research will be a basis for ensuring a sufficient budget and staff for the safety of telemedicine, and for establishing relevant policies.

Current status of state telemedicine policy in the United States and policy implications for Korea

The main objective of this study to propose an implementation about telemedicine policy in Korea through analyzing current status of state telemedicine policy in the United States. To achieve the result, three types of data sets were used to draw conclusions; 1) status of insured service of telemedicine in each state, 2) physician practice standards related to telemedicine, and 3) licensure. Analyzed results indicated differentiation in insured status of telemedicine service among private insurance parity law, medicaid coverage parity law, and state employee health plan parity in each states. Only two states provide insured service of telemedicine without any limits or certain conditions. Other states have a strict regulation or coverage condition about providing insurance. Each states also apply rigorous standards to telemedicine providers about physician practice standards and licensure. Some states restrict telemedicine itself or provide strict regulation process of telemedicine in Physician-patient encounter. Also, the most strict type 'full state license' and 'consulting exemptions (applied in certain condition)' are applied in most of states. On the basis of study result, environmental and conditional requirement implementation in application of telemedicine policy in Korea is provided in conclusion.

A study on the clinical characteristics of emergency peripartum hysterectomy / 대한주산의학회잡지

OBJECTIVE: To investigate the clinical characteristics and associated risk factors for emergency peripartum hysterectomy classified by the amounts of blood loss. MATERIAL AND METHODS: We reviewed the medical records of 159 cases of peripartum hysterectomy among 46,666 deliveries, from Jan. 1995 to Dec. 2005 at the Dept. of Ob. & Gy. of Graduate School of Medicine, Gachon University of Medicine and Science. We divided the 159 cases into three groups based on the amounts of blood loss, which were group A as less than 2,000 mL of blood loss, group B as 2,000 to 4,000 mL of blood loss, and group C as more than 4,000 mL. The incidence, the type of delivery, the amounts of transfusion, the operative indication and the complications of peripartum hysterectomy were evaluated. RESULTS: The incidence of peripartum hysterectomy was 0.34% (159/46,666) and 0.47% in cases of cesarean section and 0.19% in vaginal delivery, respectively. There was no meaningful correlation between maternal age, parity, gestational age, hospital stay and amount of blood loss. The increments of blood loss correlated to the frequency of peripartum hysterectomy after cesarean section (p<0.05). The most common operative indication in group A was uterine atony (47.19%), and those in group B and C were adherent placentation (48.08%, 50.00%). Intraoperative and postoperative complications according to excessive bleeding were increased, and DIC, pulmonary infection, urethral and bladder injury were observed more frequently in group C than in group A. CONCLUSION: The emergency peripartum hysterectomy was related to adherent placentation and was accompanied with increased blood loss.

A case of eosinophilic gastroenteritis with eosinophilic ascites / 대한내과학회지

Eosinophilic gastroenteritis is an uncommon disease of unknown cause characterized by eosinophilic infiltration in various areas of the gastrointestinal tract with gastrointestinal symptoms. It is generally classified according to the layer of the gastrointestinal tract involved. Eosinophilic infiltration of the serosa is the rarest form of presentation and may manifest eosinophilic ascites. We report a case of a 29-year-old woman who experienced rapidly progressing abdominal distension and pain. A diffuse erythematous change of the gastric mucosa was observed on gastroscopy. An abdominal computed tomography and colonoscopy showed diffuse wall thickening of the small bowel and colon with a large amount of ascites. Eosinophilic infiltration was confirmed by multiple biopsies of the gastrointestinal tract and peritoneal fluid analysis. The patient was treated with corticosteroid and responded dramatically.