Development of Optimum Information System for Health Management in Patients with Crohn s Disease

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1 , pp Development of Optimum Information System for Health Management in Patients with Crohn s Disease Seong-Ran Lee ¹Department of Medical Information, Kongju National University, 56 Gongjudaehak-ro, Kongju, Chungnam, , South Korea, lsr2626@naver.com Abstract. This paper is to develop optimum information system for health management in patients with Crohn s disease. The subjects of this paper were 124 patients who had been visited a general hospital which located in Chungnam area. As a result of this study, significantly positive changes of behaviors such as taking vegetables, drinking green tea, and practicing the healthy lifestyles of exercising diminished the progression rate of Crohn s disease. There was a significantly significant difference in hypertension control after information intervention(t=1.38, p=.032). This paper found that the health promoting behaviors in patients with Crohn s disease were increased by % compared with previous status and the patients positively perceived on information system. Therefore, the information system for the prevention of Crohn s disease can be applied to any hospital which has health promotion center. Keywords: Development, Optimum information system model, Preventive effects, Crohn s disease 1 Introduction Crohn s disease is a form of inflammatory bowel disease[1],[2]. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset. Inflammatory bowel disease is often confused with irritable bowel syndrome. Crohn s disease shares much in common with ulcerative colitis, another form of inflammatory bowel disease, but Crohn s disease can affect the whole gastrointestinal tract while ulcerative colitis only attacks the large intestine, and while ulcerative colitis can be cured by performing a total colectomy, surgery for Crohn s disease involves removing the damaged parts of the intestine and reconnecting the healthy parts, which does not cure Crohn s as it can recur after surgery, mostly at the site of the intestinal anastomosis or in other areas. Crohn s disease has an incidence of 1 to 20 cases per 100,000 individuals per year, and a prevalence of 8 to 246 per 100,000 individuals. The disease is more prevalent in northern countries of the world, as well as in northern of individual countries or other regions[3],[4]. Crohn s disease is sometimes associated with autoimmune pancreatitis. Infiltration of immunoglobulin G4 (IgG4)- positive plasma cells is sometimes detected in the colonic mucosa in patients with Crohn s disease. Changes in the expression profiles of specific proteins leads to ISSN: ASTL Copyright 2014 SERSC

2 serious colon diseases, including colitis. Sulfasalazine for treating Crohn s disease has a clinical limitation due to its adverse effects[5],[6]. As internet technology rapidly improves, clinical services are increasingly computerized in most hospitals. In order to effectively support patient care and clinical researches, information technologies are widely utilized to integrate clinical databases and disseminate information. However, most hospital information systems in Korea are still independently implemented and not fully integrated due to lack of standardization and security measure. In order to meet increasing demand for better patient care and upgrading clinical research, there is a need for a development and sharing of integrated clinical information system with a common database including clinical data collected from various hospitals. This paper attempted a new approach to develop an information system. Therefore, the purpose of this study is to develop optimum information system for health management in patients with Crohn s disease. 2 Materials and Methods 2.1 Study Materials This program was developed through review of existing literature, assessment of patients information needs, available updates on information, web site analysis and solicitation of expert advice throughout the development process[fig. 1]. Study participants were patients who were diagnosed with Crohn s disease at least 6 months ago by general surgery departments of two general hospitals in Chungnam area. The data were collected by interview and self-administered questionnaire from December 16, 2013 through April 18, This program was totally consisted 124 persons, it has been divided into two parts. 2.2 Study Methods The Chi-square test was performed to compare the general characteristics between two groups. In addition, it was measured by percentage and number. The pairwise t- test was done to compare the before and after intervention effect of health practice rate of patients with Crohn s disease. Information system planning - A method of analyzing, defining and designing the information. - A method dealing with interconnected data, processes, strategies, aims and efficient systems Setting goals - To understand key issues and opportunities with current applications - To provide executives with direction and a decisionmaking framework for the prevention of ulcerative colitis Information system usability -To develop technology for treating patients with ulcerative colitis. - To provide information systems with a developmental model. Fig. 1. Optimum Information System Structure for the Prevention of Crohn s Disease Copyright 2014 SERSC 225

3 3 Results 3.1 Basic Information of Study Subjects Table 1 presents basic information of study subjects. Male with 46.8% of the experimental group showed more than male with 38.7% of the control group according to gender. Married respondents with 56.5% of the control group were lower than survey respondents with 67.7 of the experimental group in marital status. Table 1. Basic Information of Study Subjects 3.2 Comparison of Degree of Self-Care Behavior of Before and After Information Intervention Table 2 represents comparison of degree of self-care behavior in patients with Crohn s disease before and after information intervention. Comparing the mean scores in the stress status, respondents score(52.07±0.82) after intervention significantly decreased than respondents(76.25±1.49) before intervention(t=1.94, p=.026). 226 Copyright 2014 SERSC

4 Table 2(A) Comparison of Health Practice of Before and After Information Intervention Items Before After /intervention Mean±S.D Mean±S.D t P Body weight control 59.28± ± Cholesterol 64.75± ± Stress status 76.25± ± Other disease 68.51± ± Hypertension control 57.83± ± Exercise 32.95± ± Table 2(B) Comparison of Health Practice of Before and After Information Intervention Items Before After /intervention Mean±S.D Mean±S.D t P Body weight control 59.28± ± Cholesterol 64.75± ± Stress status 76.25± ± Other disease 68.51± ± Hypertension control 57.83± ± Exercise 32.95± ± Having vegetable 48.16± ± Anxiety 62.59± ± Counseling 38.14± ± Smoking 49.72± ± Diabetes mellitus 61.48± ± Depression 72.39± ± Green tea drinking 47.91± ± Dandelion tea 15.76± ± drinking Chonggakkimchi ± ± intake Water drinking 41.60± ± Kiwi intake 29.14± ± Change of Health Behavior Practice Between Two Groups After Intervention Fig. 2 compares the change of health behavior practice between two groups The follow-up survey was estimated to be higher in the experimental group, regardless of the time elapsed of 40 days after the information intervention. However, the intervention effect was estimated to decrease more rapidly with time elapsed of 80 days after intervention in the experimental group as compared to the control group. Copyright 2014 SERSC 227

5 Fig. 2. Change of Health Behavior Practice Between Two Groups After Intervention 4 Discussion This paper is to develop of optimum information system model for preventive effects of Crohn s disease. The design and implementation of an information system brought better health related quality of life in patients with Crohn s disease than control group. As a result of this study, statistically significantly positive changes of behaviors such as taking vegetables and chongak kimchi, and drinking green tea diminished the progression rate of Crohn s disease. The findings were similar with the previous studies on the chronic disease[7],[8]. This study suggests that individuals with Crohn s disease should be targeted for specific health behavioral intervention to prevent the progression of Crohn s disease. Based on the results obtained by the study, it is anticipated that this paper may be used as basic data for developing and interventing health promotion behavior for the colorectal patients. However, the result shows that in order to maintain desirable food behaviors, it need periodic education programs related patients with Crohn s disease. Until the present, the limitation of patients with Crohn s disease lies in that there in nothing put into action despite the increase of knowledge. The result of this study would be the enhancement of practice behavior for the prevention of Crohn s disease. Thus, this paper indicated that the implemented systematic intervention showed significant positive effects on the life of subjects and health behavior. The quality of life in the experimental group has been enhanced as time passes by compared to control group, showed that it is an effective program for the prevention of Crohn s disease. Therefore, the management program for patients with Crohn s disease implemented by intervention research is quite meaningful in that it is evidence-based program development which will contribute in replicating the intention under field conditions for patients with Crohn s disease. 228 Copyright 2014 SERSC

6 The patients with Crohn s disease who had moderate exercise level and who were under diet care had better quality of life. Current practice of exercise in patients with Crohn s disease were obtained through intervention of information system. Therefore, adequate health practice behavior in patients with Crohn s disease will improve their quality of life in accordance with appropriate information system. The development about management system is so essential to the patients with Crohn s disease. For successful performance of this study, this paper had tried to provide various information to enhance the practice rate of health behavior in patients with Crohn s disease using a clinical management system. So, there were many changes which improve the quality of life in patients with Crohn s disease using the system. 5 Conclusion The purpose of this study is to find the effects of a new information system on prevention and management methods for patients with Crohn s disease. As a result of this study, positive changes of behaviors diminished the progression rate of osteoarthritis. This paper found that the health promoting behaviors in patients with Crohn s disease was increased by % compared with the previous status and the patients positively perceived on a clinical management system. Moreover, this paper showed that using the system as health practice tool was a good way to enhance the practice rate of health behavior in patients with Crohn s disease. References 1. Statistics Korea, Annual Report on the Cause of Death Statistics, (2011). 2. Miltermaier C, Dajaco. C., Waldhoer, T, Oeffer lbauer-ernst, A., Michsler, W., Beier M. et al, Impact of Depressive Mood on Relapse in Patients with Inflammatory Bowel Disease : A Prospective 18-Month Follow-up Study, Psycholmomatic Medicine 66, , (2004) 3. Kugathasan S, Werlin SL, Martinez A, Rivera MT, Heikenen JB, Binion DG, Prolonged Duration of Response to Infliximab in Early But Not Late Pediatric Crohn s Disease, Aa J, Gastroenterol, 95, , (2000) 4. Hyams T, Crandall W, Kugathasan S, Griffiths A, Olson A, Johanns J. et al, Induction and Main Tenance Infliximab Therapy for the Treatment of Moderate-to-Severe Crohn s Disease in Children, Gastroenterology, 132, (2007). 5. Peyrin-Biroulet L, Deltenre P, De Suray N, Branche, J., Sandborn WT, Colombel JF., Efficacy and Safety of Tumor Necrosis Factor Antagonists in Crohn s Disease : Meta- Analysis of Placebo-Controlled Trials. Clin Gastroenterol Hepatol, 6, (2008) 6. Ministry of Security and Public Administration, Information System Audit Standard Revision (2010) 7. National Information Society Agency, The Commentary on the Information System Audit Standards, v3 National Information Society Agency (2009) 8. Siegel CA, Marden SM, Persing SM, Persing SM, Larson RJ, Sands, BE, Risk of Lymphoma Associated with Combination, Anti-tumor Necrosis Factor and Immunomodulator Therapy for the Treatment of Crohn s Disease : A Meta-analysis, Clin Gastroenterol, Hepatol, 7, Copyright 2014 SERSC 229