Journal of Health Information Management
Year:2012 | Volume:8 | Issue:6 (22)|Papers Count:24

Introduction: Organizational memory (OM) is a tool for implementation of knowledge management. The objective of this study was designing an OM for medical records (MR) departments.Methods: This descriptive study was carried out in 2007. The study population consisted of all employees in five teaching hospitals in Tabriz. Process and required knowledge identification was performed through questionnaires and structured interviews with 65 employees. OM models were derived from the available literature and the Internet. Our model was provided according to the assessment and review of models. Then, experts in health information management gave their opinion on the model by Delphi technique.Results: The studied employees believed that their performance could have been better if the required knowledge had been provided (85%). They considered OM as necessary (98%) and indicated mistakes, work slowness, dissatisfaction and confusion of clients as some subsequences of employees transfer. Most models provided for OM (86%) were process-based. Our model was considered as a system in which inputs, processes and outputs were determined.Conclusion: An OM system which relates organizational knowledge to the business processes is a necessity for an MR department. This system can lead to organizational learning and productivity. In this study, a set of items and entities required for a process-based OM system were provided.

Introduction: Today, many organizations attempt to fully develop in gradual evolution of their processes. PCMM is one of the models which focus on improving organizational human capabilities. This model is applied to continually increase people's ability to attract, develop, motivate, organize and retain the skills. In this study, PCMM was used to investigate organizational maturity needs in medical record departments of Isfahan public hospitals and to determine strengths, weaknesses, skills and capabilities of their staff members.Methods: This was an applied, cross-sectional study in which data was collected by questionnaires. The questionnaires were given to the staff of Isfahan public hospitals to investigate PCMM model needs at levels 1 and 2. The questionnaire has been extracted from the PCMM model and its validity and reliability have been approved by Cronbach's alpha (a=0.96).The collected data was analyzed by SPSS using descriptive statistics.Results: Our findings showed that the mean score of skills and capabilities of medical record staff in governmental hospitals was 35 (out of 56). Medical record staff of hospital number 10 had the maximum maturity in level 2 of PCMM model (mean score=55). Hospitals number 1 and 4 had minimum maturity in level 2 of PCMM model (mean score=24). There was no significant relation between organizational maturity and the characteristics of medical record staff.Conclusion: PCMM model application would lead the staff and managers to pay increased attention to identifying the weaknesses of current activities and practices to improve and develop the onging processes.

Introduction: The articles indexed in accredited citation databases essentially indicate how scientists share knowledge and promote sustainable development in each country. Therefore, according to citations to the papers of individuals, it could be possible to assess the rate of their acceptability in the scientific community. The main objective of this study was to review Lotka' s law of scientific productivity and Bradford's law of scatter in scientific productions among researchers at Isfahan University of Medical Sciences (IUMS) whose articles have been cited in Web of Science (WOS) database during 1992-2008.Methods: This was an applied study using scientometric indicators. Data was collected, sorted and analyzed in two phases and with two tools. In the first stage, data was extracted from the WOS in the form of plain text and stored on a personal computer. In the second stage, using ISI.exe, data was identified, analyzed and entered into spreadsheets in Microsoft Excel. In this research, Bradford's law of scatter, collaboration rates formula and Lotka's law of scientific production were used.Results: The results showed that the distribution of articles by authors at IUMS followed Lotka' s law, i.e., a few writers released a large portion of the scientific products. In addition, the distribution frequency of journals published by IUMS followed Bradford's law, i.e., a small number of journals published the highest number of scientific papers. Moreover, the researchers at IUMS collaborated most with authors from the United States, Canada and England.Conclusion: The results of the present study indicated that the researchers of IUMS highly collaborate in writing their papers. Generally, collaboration rate in this university was equal to 0.967 which was relatively high.

Introduction: The manual and paper-based process of production and storage of medical records in Iran have led to difficulties in filing and retrieval of the medical records. One of the usual solutions is using computerized medical records via electronic storage of paper-based medical records. The aim of this study was to recognize using computerized medical records in nine selected hospitals.Methods: In an observational, descriptive study, 9 hospitals in Ahvaz, Isfahan and Shiraz that used electronic storage method to store their medical records were evaluated. Data was collected by a checklist and a questionnaire whose validity and reliability have been previously confirmed.Direct observation and semi-structured interviews were conducted for data collection. Data was analyzed using descriptive statistics.Results: Using computerized medical records have advantages such as accelerating storage and retrieval of medical records, costs reduction of medical records maintenance, and improving the security of patients' information in the studied hospitals. The most important challenges observed in using computerized medical records were lack of proper infrastructure, using inappropriate hardware equipments, existence of different software systems and lack of data integration.Conclusion: Overall, the results of this study showed that the use of computerized medical records in hospitals can enhance the retrieval and access to medical records and help solve the problem of space shortage in medical record departments.

Introduction: The rate of access to health care is known as the main index of community health. Teleconsultation is defined as using comminuting equipments to connect physicians and patients. This study aimed to survey the readiness of specialized hospitals to implement teleconsultation, focusing on manpower readiness, as well as communicational equipments and procedures.Methods: The present descriptive cross-sectional study was carried out in 2010. Research population consisted of hospital management unit, information technology (IT) unit, matron, supervisors, etc. The research sample included 106 top and middle managers of the studied hospitals. Data was collected by a self-developed questionnaire that researcher. The validity and reliability of the questionnaire was determined by the researcher. Data was analyzed by SPSS.Results: Among the 8 studied hospitals, 4 cases scored more than average (29). Hasheminezhad Hospital was in the best condition than the other hospitals in the study. In addition, Hasheminezhad and Shahid Fahmide Hospitals scored higher than average on awareness of managers and required standards.Conclusion: Implementation of teleconsultation could facilitate community accessibility to health services. It would also lead to a considerable reduction in health expenditures. Therefore, hospitals are suggested to do the necessary interventions for establishing teleconsultation network.

Introduction: The most important variable in success of every organization is attention to ethics.Since library and information sciences naturally involve service provision to users, commitment to professional ethics is necessary. The purpose of this research was to determine the attention rate of librarians in Isfahan University of Medical Sciences and Isfahan University to professional ethics based on Ethical Codes of Iranian University Librarians.Methods: In this survey, data of 128 librarians was collected by a questionnaire whose validity has been confirmed by specialists. The reliability of the questionnaire was determined by Cronbach's alpha (a=0.93). Data was analyzed by SPSS13.Results: While most professional ethics-related attention was paid to positive relations with colleagues (mean=4.52), development of scholarly view and evaluation of activities received the least amount of attention (mean=2.71). Attention rate to professional ethics principles in various dimensions showed that responsibilities towards colleagues had the highest average (mean=4.22) and responsibilities towards profession had the lowest average (mean=3.27). There were no significant correlations between attention rate to professional ethics principles and gender, education field, employment status, salary rate, and work type. However, a significant correlation was observed between educational level and attention rate to professional ethics principles.Conclusion: Librarians in Isfahan University of Medical Sciences and Isfahan University pay the most amount of attention to positive relations with colleagues, suitable and respectable behavior with users, and understanding social and professional responsibilities. Although, in the most cases, attention rate to professional ethics principles were above average, the mentioned library managers should attend to the others that have middle and lower than middle average. So, managers should try to promote other aspects of professional ethics.

Introduction: The critical dependence of healthcare services systems on information along with the indigenous restriction of paper documents in satisfying this need has caused a trend toward computer information systems. The main goal of such systems is to achieve electronic health records (EHR). However, implementation of EHR in healthcare organizations is difficult and complicated. This research aimed to assess the barriers of EHR implementation.Methods: This descriptive, cross-sectional study was conducted in 2010. It included 120 employees (such as physicians, nurses, laboratory and radiology and medical records departments staff) from teaching hospitals affiliated to Urmia University of Medical Sciences. Data was collected by a self-developed questionnaire whose reliability and validity had been measured by specialists and internal consistency method (r=0.86), respectively. The collected data was analyzed using descriptive statistics and analytical statistics (t-test and chi-square test) in SPSS.Results: Based on our results, attitudinal-behavioral (93.4%) and organizational change barriers (88.4%) scored the highest among the barriers of HER implementation. In addition, minimum scores were related to financial barriers (72.8%). Correlation analysis showed a significant correlation between job and organizational change barriers (p=0.003), and also between the history and attitudinal-behavioral barriers (p=0.006).Conclusion: Since the most important barriers of EHR implementation were attitudinalbehavioral barriers and organizational change barriers, educational interventions seem necessary to create an appropriate attitude among health care providers. Increasing knowledge of system users about the features, objectives, benefits and positive effects of the system while ensuring the confidentiality and security of HER would decrease change resistance and increase the acceptance and participation in EHR implementation.

Introduction: A career development consists of jobs that a person passes in order to reach a professional goal. Career development management results in job satisfaction, professional commitment and higher effectiveness. The purpose of this study was to determine different dimensions of career development among the staff of Shiraz University of Medical Sciences.Methods: This study was a cross- sectional study on the staff of Shiraz University of Medical Sciences in 2009. Data was collected by ratio random sampling from university vice-chancellors and simple random sampling was used within all vice-chancellors. The sample consisted of 236 employees who completed the 43-item Schein's Career Anchor Inventory. Analyses were performed using ANOVA, Spearman correlation and t-test in SPSS 11.5.Results: Most of the participants were male (49.6%), held a BSc (52.1%), contractual (30.5%), were working in vice-chancellor for Development and Resource Management Affairs (49.6%).The highest mean score of career anchors was gained in service port (3.28±0.43) and the lowest mean was achieved in identity port (2.47±0.5). There were significant inverse relationships between innovation port and age and years of services. There were also significant relationships between sex and service port and security port.Conclusion: The staff of Shiraz University of Medical Sciences likes to provide service to the society and people. It seems that in their point of view, it is not important to be identified with their organization. Hiring well-educated managers in job development and approving educational courses for managers and staff can solve the related problems.

Introduction: One of the common methods for scientific activity assessment is scientometrics. It has been made possible with citation databases like Web of Science (WOS) and Scopus. In this paper, we studied the scientific production rate of Hamadan University of Medical Sciences during 11 years via scientometrics methods.Methods: In a descriptive, cross-sectional study, data was collected by searching WOS and Scopus databases for articles published during 1998-2008. The research population included 472 records in WOS and Scopus databases. Descriptive statistics was used in ISI and Scopuse.exe analyzers.Results: Most of the records related to Hamadan University of Medical Sciences were published in 2008 (61 records in WOS and 79 records in Scopus). The most active author was Mehrdad Hajilooyi (17 articles in both WOS and Scopus) while the most cooperative university was Tehran University of Medical Sciences (with 23 records in WOS and 51 records in Scopus). Saudi Medical Journal (with 9 records in WOS) and Iranian Biomedical Journal (with 13 records in Scopus) had the highest number of published scientific products of Hamadan University of Medical Sciences. Finally, neuroscience (26 records in WOS) and general medicine (196 records in Scopus) were the most attractive subjects of scientific products published by Hamadan University of Medical Sciences.Conclusion: Although the number of scientific products of authors at Hamadan University of Medical Sciences had a dramatic increase in recent years, it is still low in comparison with other universities of medical sciences. Therefore, research policy-makers should consider different aspects such as research budget increase, scientific writing workshops, collaboration with internal and overseas scientists and etc. to promote research.

Introduction: Information technology might have some potential effects, such as influencing treatment process, rate and easiness of information retrieval, and information availability for making clinical decisions based on conditions and management, educational and research activities on health service systems. Recognizing these effects can be concerned as a foundation to strategic planning in order to improve the approaches of health system and finally to improve general health among the society.Methods: This descriptive cross-sectional study was conducted in the first half of 2009. It survived the viewpoints of 301 individuals selected by classified sampling method from the staff members of Beheshti Hospital in Kashan toward the influence of information technology on health system. A researcher-developed questionnaire including items about the effects of information technology on treatment, training, research and administrative process. Then the data was analyzed by using descriptive and analytical statistical indices in SPSS 15.Results: The study population included 34.9% females and 65.1% males in all clinical and administrative groups. Based on the average score of 365.5, the subjects viewed information technology to have positive effects on the improvement of health level. In addition, the participants evaluated the influence of information technology on increasing the efficiency, decreasing costs and increasing the rate of detection and treatment procedures with average desired scores of 464.1, 311.3 and 434.2, respectively.Conclusion: The positive opinions of our population obviously show the appropriate base and background to execute and develop information technology in that hospital. Thus, some initial steps must be taken to develop the health information system and to achieve electronic files of patients. To do this, problems and barriers of the application of these technologies must be recognized and some actions should be taken for a correct budgeting and to develop a standard protocol in order to facilitate health information service network.

Introduction: Scientometric indicators are used for measuring and evaluating the quality and quantity of scientific productions in the scale of individuals as well as institutions. The database of Web of Science (WOS) is one of the most prestigious international databases for analyzing scientific publications. This study aimed to determine the relationship between qualitative and quantitative indicators of scientific productions originated by Iranian universities of medical sciences indexed in WOS during 1999-2008.Methods: Using an analytical method, the quality and quantity indicators of publications originated by Iranian universities of medical science were analyzed. Data collection tools were the checklists that we designed in Microsoft Excel. The validity of the checklists was verified by experts.All dissimilar forms of university names were retrieved via Hist-Cite software. The search strategy was conducted based on the obtained various universities names in the WOS database. A total number of 15856 documents were retrieved. SPSS16 was used to analyze the data. Kruskal-Wallis and Spearman tests were used to calculate the chi-square values.Results: Analysis of data indicated a significant difference among three types of universities of medical sciences in the term of quantitative and qualitative indicators. Moreover, the Spearman tests showed a positive and significant correlation between quantitative and qualitative indicators.Conclusion: The study indicated that the universities which produced a greater number of scientific productions also had more favorable conditions in the term of quality attributes such as citations and H-index. This may suggest that the universities have taken into consideration not only the quantitative but also the qualitative aspects of publications.

Introduction: Health care classifications are essential tools for collecting and processing healthrelated information. They also provide a unified language for interdisciplinary communications.Nursing data is important for extension of knowledge, evaluating the quality and effectiveness of nursing care, and supporting human resource planning. Therefore, an integrated system for collecting, storing and retrieving nursing data is essential. The aim of this research was to compare nursing classification systems.Methods: This was a descriptive-comparative study conducted in 2009. We studied all available classification systems in the world. The systems were found through searching the Internet, books and journals. Results were presented in statistical tables.Results: All systems were American systems developed by persons, associations or universities for specific care facilities. Another classification system has been designed by the International Council of Nursing (ICN) for international use by all nursing care facilities. There were no systems for nursing classification in Iran.Conclusion: Nursing data needs to be uniquely coded for being used in computer systems and Iranian Electronic Health Records. Thus, application or development of a nursing classification system in Iran with the purpose of nursing information management seems necessary.

Introduction: Some scholars have visualized and drawn the structure of science using different instruments and methods. One of these instruments is the HistCite™ software which is exploited to draw scientific mapping according to time order. The purpose of the present research was to survey and draw the scientific structure of Tehran University of Medical Sciences' publications in Web of Science (WOS) database during 1989 -2008 using HistCite™ software.Methods: The present scientometric study was conducted using histography method (during 1989-2008). The data was retrieved from WOS on March 2009. To draw the science history of the University, the HistCite™ software was utilized. For data analysis, descriptive statistics, frequency and percentage and some of scientometric rules were applied.Results: The findings of the study showed that a high growth in Tehran Medical University' s publications in WOS. In fact a growth rate of 34.16% ranked the university as the second place among all Iranian universities and institutions. However, regarding the universities related to the Ministry of Health and Medical Education, it took the first place. Among the authors, Mr Alireza Dehpour was the first.Conclusion: The results showed that the researchers at Tehran University of Medical Sciences had a high collaboration coefficient. The distributions of the articles followed the Lotka's law. The results also showed the scientific structure of this university to be composed of 7 clusters.

Introduction: Oral diseases are the most prevalent diseases probable at any age. They are chronic in nature and expensive to care. Accurate, comprehensive, well-structured, well-managed data is required to control and prevent oral diseases, clinical audit, quality of patient care, and administrative, financial, research and legal goals fulfillment we need. In dentistry, data collection would provide all necessary information for the dentist to make an accurate diagnosis of the patient's condition. Clinical data is fundamental to the process of dental care, contributes to diagnosis, planning and correct sequencing of treatment. This research was performed to evaluate data elements used in dental care setting in America, Britain and India and present a pattern for Iran.Methods: In an applied, descriptive study, first a situational analysis of data elements in 22 dental care settings affiliated to Shahid Beheshti, Tehran and Iran Universities was performed in 2007. Based on the needs of the country, a dental data element model was suggested for Iran. The model was then confirmed through Delphi technique by 30 authorities.Results: Situational analysis showed data collection and dental data elements to face numerous limitations. There was no accurate and appropriate data element model for dental data collection.Therefore, a model for dental data collection was designed for Iran based on the models in America, England and India. After applying Delphi technique, the model was approved with a 73-100% agreement.Conclusion: Designing and implementing dental data elements for data collection in Iran is advised to promote quality of patient care, and to control and prevent oral diseases.

Introduction: The reference section is one of the most important parts in every library. Moreover, reference services represent all the attempts performed in a library. Since libraries primarily aim to satisfy users' information needs, knowing that the effects of information technologies (IT) on their services seems essential. Therefore, this study manly tried to assess the effects of IT on reference services provided by university libraries.Methods: This survey covered all librarians of central libraries associated with Ministry of Science, Research and Technology (n=66) in 2008. A researcher-developed questionnaire containing 60 questions whose validity was confirmed by library and information sciences experts. The reliability of the questionnaire was calculated by internal consistency (Cranach's alpha=0.96). This study evaluated different technologies including online public access catalogs (OPACs), databases, email, and web. It also included reference services such as individual instruction, group instruction, readers' advisory services, bibliotherapy, term-paper counseling, selective dissemination of information, ready-reference question, bibliographic verification, interlibrary loan, referral services, and research questions.Results: Based on the findings of this study, reference librarians of university libraries did not believe OPAC, databases, email, and web to fully satisfy users' needs. This research also showed significant differences between the effects of OPAC and databases, OPAC and web, databases and web, and email and web. However, there were not significant differences between the effects of OPAC and email or databases and email. In addition, among the studied technologies, the effect of web on reference services was highest and the effect of OPAC was the lowest.Conclusion: Due to insufficient computer-related knowledge, librarians still see reference services as necessary.

Introduction: The goal of every healthcare risk management program is to reduce the possibility of undesired events for patients. Such programs include identifying undesired events, analyzing their causes, estimating the possibility of outbreak and their results and taking proper actions to prevent their recurrence. The goal of this study was to compare healthcare risk management programs in selected countries and to propose a model for Iran.Methods: This descriptive-comparative study included England, the USA and Australia. National Health Services (NHS), Joint Commission on Accreditation of Health care Organization (JCAHO) and Medical Defenses Association of Victoria (MDAV) were selected as samples (because of functionality scope). Available information through the Internet, email and library references were used to collect data. Data was analyzed by comparative tables and descriptive statistical methods. The final model was prepared based on the performed analyses and after obtaining the viewpoints of related specialists.Results: There were numerous common points between the risk management process and documentation principles while few were observed in informed consent gathering principles. On the other hand, many differences were found among data elements in incident report forms. JCAHO gave more roles to medical record managers.Conclusion: Despite common points in risk management principles, each sample had mainly focused on needs and infrastructures of care delivery in their country.

Introduction: Health care is considered as one of the basic needs of human societies. Health insurance is the most appropriate option for all individuals to enjoy equal health care. However, today, different types of health insurance are facing with various problems which need to be solved through new laws. Therefore, Health Insurance Portability and Accountability Act (HIPAA) was approved to solve problems in the US health insurance system. We decided to study HIPAA and the possibility of its implementation in Iran in order to solve the problems of Iranian health insurance system.Methods: In this descriptive exploratory research, data was collected by reviewing reliable sources and referring to health insurance organizations and universities of medical sciences in Tehran, Iran during 2009. Using a questionnaire, 24 academic and health insurance management experts were asked about the possibility of applying HIPAA in Iran. The validity and reliability of the questionnaire were determined by content validity and test-retest method (r=0.84).Results: Based on our results, increased health care costs, lack of continuous health insurance coverage and too much bureaucracy were the most important problems of the American health insurance system. In addition, 66.66% of the studied health insurance experts identified increased costs as the first factor in the reform in the Iranian health care system. A total of 83.33% of the experts agreed with the health insurance system reform in Iran.Conclusion: HIPAA includes important approaches to solve the problems in the American health insurance. Considering the similarity of the problems in American and Iranian health insurance systems, experts agreed with the need for electronic data interchange, creating a national identification in the health care industry, and implementation of a comprehensive information system to coordinate the insurance system.