Journal of Health Information Management
Year:2016 | Volume:13 | Issue:2 (48)|Papers Count:19

Introduction: To successfully implement new information systems in health care, especially electronic medical records, it is important to understand the factors that influence the adoption of these systems in the opinions of users, particularly managers. Therefore, the purpose of this study was to determine the factors affecting the adoption of electronic medical records using the technology acceptance model (TAM).Methods: This descriptive-analytical survey was conducted in 2015. The study population consisted of 235 top and middle managers of teaching hospitals in Shiraz, Iran. The subjects were selected through census method without the use of sampling.Data were collected using the standard TAM questionnaire and analyzed in SPSS and LISREL software using regression analysis, independent t-test, and ANOVA.Results: The findings of this study showed a positive direct relationship between perceived ease of use and attitude of the users (r=0.46) (P<0.05). There was also a positive, direct relationship between perceived usefulness and attitude toward use (r=0.42) (P<0.05). In addition, there was a positive, direct relationship between attitude toward use and actual use (r=0.36) (P<0.03).Conclusion: In evaluations and plans, through the consideration of factors of perceived usefulness and perceived ease of use, which affect the attitude toward use, the adoption of the electronic medical records system among top and middle managers in hospitals can be improved.

Introduction: Numerous studies have evaluated health information systems in Iran, but most studies have not followed a standard format for reporting their findings. The objective of this study was to evaluate the compliance of health information systems’ evaluations published in Persian journals with the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI).Methods: This was a review study in which papers reporting on evaluation of health information systems were assessed in terms of 51 principles of the STARE-HI using a checklist. These papers were retrieved from the Persian databases of Magiran, IranMedex, and SID using appropriate keywords. Data were classified and reported based on 13 main sections of the STARE-HI.Results: From the 727 retrieved papers, 36 were relevant to the study objectives. All paper had an introduction section, but none of the paper had the authors’ contribution and conflict of interests sections. The mean compliance of articles with the STARE-HI was 71.4%, with the lowest being 52.94% and the highest being 82.35%.Conclusion: The writing style and structure of studies evaluating health information systems require improvements . The quality of study reports can be improved through reporting essential information in articles and using corresponding guidelines in the design of authors’ instruction sections of journals. Improving the reporting format of papers can result in better and higher rate of application of study results and increased citation of articles.

Introduction: Although many studies have been conducted on thalassemia from different aspects, none of them have yet identified the preferences of parents of patients with thalassemia major in receiving health information. Parents of these patients need appropriate and timely information to manage and resolve the problems of their children and family. This study aimed to identify the preferences of these parents in obtaining information to manage their children’s health.Methods: This was an applied, descriptive, and cross-sectional research. The study was conducted through interviews with the parents of patients with thalassemia major who were admitted to the pediatric ward of a hospital affiliated to Semnan University of Medical Sciences, Iran, in 2014. The data collection tool was a valid and reliable researcher-made questionnaire (Cronbach’s alpha = 0.87). The data were analyzed using descriptive statistics and the Friedman test.Results: According to the results, 39.6% of the parents reported obtaining information about mental health problems as their first priority, while 56.6% of the parents reported obtaining information about the side effects of Desferal as their first priority. In addition, 56.6% of the parents preferred that the information be given to the patients’ father.Conclusion: The results indicated the type of information parents prefer to obtain first. Informational support can help the parents better manage their children’s illness. Transference of valuable knowledge through several information sources to the parents can lead to improvement of health in the society and parents feeling that they are socially supported.

Introduction: Despite the great importance of comprehensive evaluation of mobile health services, as a part of novel health services, most researches have only focused on the evaluation of the technical aspects and have neglected other aspects of these services. The main objective of this study was the identification and prioritization of the indicators and dimensions of mobile health systems’ quality by considering all critical aspects including technical, information, and interactive dimensions.Methods: This applied and descriptive study was conducted through survey method. A questionnaire was used to collect data the validity of which was confirmed by academic experts. The statistical population of the study included experts of health services quality evaluation with emphasis on mobile health with more than 3 years of experience in this field. Using judgmental sampling (non- probability purposive sampling), 28 subjects were selected and questionnaires were distributed among them. The content validity of the scale was confirmed by experts and its reliability was approved through calculation of inconsistency rate for all pairwise comparison matrixes (less than 0.1). The collected data were analyzed using the analytic hierarchy process in Expert Choice Software.Results: The interaction quality dimension was the most important among the dimensions of quality assessment of mobile health services. In addition, the indicators of privacy, effectiveness, safety, real-time performance, accountability, after-sales service, and patient-centered services were respectively, the most important quality indicators.Conclusion: It is necessary to study mobile health services in the context of other health services and not just simply as software. The success of a mobile health system is based, first, on the quality of general health service indicators such as accountability, patient-centered services, and privacy, and then, on the quality of software system indicators. Therefore, it is necessary for all stakeholders to be involved in the process of designing a mobile health service in order to improve the chances of success.

Introduction: Scientific collaboration is a process in which two or more scientists collaborate in a project or write an article. The purpose of this study was the mapping of scientific collaboration among Iranian researchers in the field of radiology in the Science Citation Index until the end of 2014.Methods: This applied research was conducted using scientometric and network analysis methods. The study population consisted of all scientific publications in the field of radiology in the Science Citation Index until the end of 2014. A total of 1938 documents were retrieved. Data were analyzed using HistCite, VOSviewer, UCINet, PAJEK, and Excel software packages.Results: The scientific production growth rate was 11.3. The Tehran University of Medical Sciences (661 documents) was the most prolific university in this field. The collaboration network showed high density (63%).Conclusion: The collaboration network analysis showed that Saghari, Beiki, Eftekhari, Javadi, Assadi, and Fallahi were the most important authors and the majority of scientific collaboration took place among them. The clustering coefficient of the collaboration network was 0.52.

Introduction: Librarians in academic libraries should have suitable information literacy skills in order to access the information they need and meet the needs of their clients. Hence, the present study aimed to evaluate and determine the status of the three levels of information literacy skills and their related factors among librarians of Mashhad University of Medical Sciences and Ferdowsi University of Mashhad, Iran.Methods: This applied research was conducted through survey method. The study population consisted of all librarians with a bachelor’s degree or master's degree in librarianship or non-librarianship fields working in the abovementioned university libraries (n=120). Through non-proportional stratified random sampling method, 80 individuals were selected as the final sample. The assessment tool was a researcher-made questionnaire the validity and reliability (Cronbach's alpha=0.86) of which were confirmed. Data were analyzed through descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (one-sample t- test, independent t-test, ANOVA, and Duncan's post hoc test) in SPSS software.Results: The librarians’ information literacy status was less than desirable; neither of the elementary, basic, and advanced levels of information literacy had desirable scores among the librarians. The mean scores of information literacy of librarians with degrees in librarianship and medical librarianship were significantly higher than that of librarians with other degrees. Moreover, the mean information literacy score of librarians with a master’s degree was higher than that of librarians with a bachelor’s degree. There was no significant difference between the mean information literacy scores of librarians based on their work experience.Conclusion: The results of this study showed the undesirable status of information literacy and its three levels among librarians. Moreover, it indicated the effective factors for improving information literacy among librarians for the planners and administrators of the libraries of these two universities.

Introduction: Hospital websites can be appropriate and effective tools for attracting medical tourism. However, many structural and content criteria should be considered in designing hospital websites. The aim of this study was the evaluation of websites of hospitals affiliated to medical universities in Tehran, Iran, based on information necessary for attracting medical tourists.Methods: This study was carried out using applied survey method. The study population consisted of all hospitals affiliated with Tehran University of Medical Sciences, Iran University of Medical Sciences, and Shahid Beheshti University of Medical Sciences, Iran, (n=50). The data collection tool was the MDS-Hospital website questionnaire, the validity and reliability of which were approved in previous literature (a=0.90). Data were analyzed using descriptive statistics (frequency and percentage).Results: The average score of the structural dimension of hospital websites based on the questionnaire was 64.5%. However, the average score of the contextual dimension of hospital websites was less than 50%. The websites of hospitals affiliated with Tehran University of Medical Sciences and Iran University of Medical Sciences had a more favorable score in terms of structural dimension and contextual dimension, respectively.Conclusion: The websites of the studied hospitals had an acceptable status in terms of the structural dimension. However, they did not obtain favorable scores on the contextual dimension. Thus, these hospitals must redesign their websites in terms of the contextual dimension in order to be more successful in attracting medical tourism.

Introduction: Since the relationship between the user and the web is through the user interface, it is essential that health websites be user- centric. The aim of the present study was to identify the strengths and weaknesses of the user interface of health websites in Iran.Methods: This applied and descriptive research was conducted using heuristic method. Based on their Alexa rank and the rate of related pages, 13 health websites were selected. The websites were examined by 5 evaluators (3 graduates in computer sciences and 2 in medical library and information sciences) using a checklist containing 5 major criteria and 27 items. The data were analyzed using descriptive statistics in Excel software.Results: The health literacy websites had observed 63.78% of the criteria of the checklist. The criteria of flexibility (89%), technical features (81%), and aesthetics and visibility (77%) gained the highest scores, respectively. However, the lowest scores belonged to the criteria of help and documentation (36.9%) and responsiveness and interaction (35%).Conclusion: The websites’ user interfaces were in relatively desirable conditions. According to the findings, the criteria of help and documentation and responsiveness and interaction require more attention. It is suggested that these websites resolve the identified problems and minimize the gap between them and the users, so that users can visit these websites more frequently.

Introduction: Strategic thinking is the infrastructure of artistic maneuvers of managers based on creativity and true perception of business environments. It results in the creation of strategies suitable to the present changing business environment. Due to the failure of strategic plans and organizational changes in more than half of organizations, it can be concluded that there might be a common cause for these failures. The goal of the present study was to assess the relationship between readiness to change and strategic thinking in managers of social security hospitals of Isfahan, Iran, based on the Liedtka model including the five elements of systemic thinking, intensive focus, hypothesis approach, intelligent opportunism, and thinking in time.Methods: This practical, analytical, and correlative research was conducted using the Strategic Thinking Assessment Questionnaire (a=87.3) and Readiness to Dunhaim Change Assessment Questionnaire (a=84) in 2013. The participants consisted of 94 head, intermediate, and operational managers of social security hospitals in Isfahan. Our response rate was 85% (80 questionnaire). Data were analyzed using the Pearson correlation and regression analysis in SPSS software.Results: Strategic thinking (Pearson coefficient=0.25) (P<0.02) and its elements based on the Liedtka model, including systemic thinking (Pearson coefficient=0.28) (P<0.01), intensive focus (Pearson coefficient=0.24) (P<0.03), and intelligent opportunism (Pearson coefficient=0.22) (P<0.04), had a meaningful relationship with readiness to change. However, the findings revealed no significant relationship between hypothesis approach (Pearson coefficient=0.18) (P<0.01) and thinking in time (Pearson coefficient=0.10) (P<0.2), and readiness to change.Conclusion: Since there was an overall relationship between most elements of strategic thinking and readiness to change among the managers in this study, education and development of strategic thinking may enhance readiness to change among managers of institutions.

Introduction: Due to the unfavorable condition of sport infrastructure in Iran, including locations, equipment, facilities, and accessories, athletes and coaches are at an increased risk of accidents and injuries. One of the main tools for protecting athletes in case of accidents is insurance. The objective of this study was to determine the status of sports insurance from the perspective of injured athletes and sports administrators in Chaharmahal Va Bakhtiyari Province, Iran.Methods: This applied and descriptive study was conducted through field surveys in 2014. The study population consisted of injured sport administrators and athletes in Chaharmahal va Bakhtiari Province (64 managers and 278 athletes). From among them, 103 athletes and 42 officials were selected through convenience sampling. The data gathering tool was a researchermade questionnaire consisting of two parts; one part related to the success rate of insurance plans and the other on problems and obstacles to a successful insurance coverage. The validity of the questionnaire was confirmed by sports management professionals, sports medicine experts, and insurance management experts. Its reliability was calculated using Cronbach’s alpha which was equal to 0.84. Data analysis was carried out using descriptive and inferential statistics.Results: From the managers’ perspective, the Federation of Sports’ Medicine has not shown a significantly favorable performance in regards to mandatory sports’ insurance. Moreover, from the athletes’ perspective, the Federation of Sports’Medicine has only been significantly successful in the prevention dimension (P<0.05).Conclusion: Based on the findings of this study, the Federation of Sports’ Medicine, as the organization responsible for the development of technical and medical services in sports, must create favorable conditions for success in the treatment and prevention of sports related incidents and provision of administrative services.

Introduction: Primary health care is an effective approach to improving public health. Providing optimal care requires supplication of various resources including financial resources. Thus, fraction of revenues of health care centers is one of the main problems in the domain of financial resources management. Therefore, the present study was carried out to identify the bottlenecks on dedicated revenues fractions in health centers.Methods: This qualitative phenomenological study was carried out in East Azerbaijan Province of Iran in 2014. Purposeful sampling method was used for the selection of participants. Focus group discussion and semi-structured interviews were used for data collection. Data collection was carried out based on prepared guidelines and continued until data saturation. The validity of the guidelines was approved by qualitative experts. Data were analyzed using content analysis method.Results: Based on the experiences and perspectives of participants, two main themes were extracted including cash fractions and none-cash fractions. Cash fractions consisted of three sub- themes of discounts fractions, fractions related to deposit of cash revenues by health centers, and registration fractions. None-cash fractions included fractions related to sending documents, fractions in the insurers' reimbursement, and fractions per capita.Conclusion: Fraction of dedicated revenues of health centers occurred in all cash and none-cash revenues and also in all stages of conversion of service into revenue. Therefore, special attention and efforts are required in order to reduce these fractions.

Introduction: Medication and its cost in the country's health care system are of grave importance. Thus, the aim of this study was to investigate the increase in medication costs in comparison to the increase in medication funding per capita of the outpatients insured by the Iranian Salamat Insurance in Isfahan, Iran.Methods: This was a descriptive-analytic study. The data were collected using an information form including the variables of pharmaceutical expenditure, pharmaceutical expenditure per capita, the number of insured per city, approved cost per capita, operating cost per capita, the number of pharmacies, expensive drugs, drugs with the highest rate per capita, and drugs with the highest frequency of use. The collected data were analyzed using descriptive statistics and the Pearson correlation coefficient.Results: From 2009 to 2013, the drug costs constituted, respectively, 25, 23, 22, 22, and 31 percent of the total health care costs of the Iranian Salamat Insurance. Amount per capita in 2013 compared to years 2009, 2010, 2011, and 2012 were 58, 49, 28, and 21 percent higher, respectively. Drug operating cost and its growth rate had increased during the studied 5 years, compared to the approved costs per capita. More than half of the total drug cost in 2009-2013 was allocated to the 35 most expensive drugs. The Pearson correlation showed that with increase in operating cost, the number of visits to pharmacies decreased.Conclusion: Revision of drug reimbursement, substitution of lower-cost drugs, and modification of the prescription pattern used by physicians can be effective in the optimization of drug costs.

Introduction: The Iranian national excellence award is a quality award which is used as a management instrument for assessment of performance of organizations. The aim of this study was to evaluate the performance of hospitals of Abadan School of Medical Sciences, Iran, based on the Iranian national excellence award.Methods: This practical and cross-sectional study was conducted in the summer of 2014. The research sample included 7 hospitals affiliated to Abadan School of Medical Sciences which were investigated using census approach. Managers and experts attempted self-assessment after participation in one of three two-day workshops and familiarization with the RADAR structure and logic model through group work. The data collection tool was a 135-item standard checklist of the model containing categorized in 54 pages based on the criteria and sub-criteria of the model. Scores were analyzed using Excel and SPSS software.Results: Among the 7 evaluated hospitals, two had a score higher than 300, two had scores of 200-300, and three hospitals had a score of less than 200. The average total score (from 1000 points) and the average score of development (total: 500 points) and results sections (total: 500 points) were 222.6±71.4, 109.8±32.6, and 112.8±47.9, respectively. There was a significant correlation between development score and size of hospitals (under 64 active beds: 96.5±43.4, and over 64 active beds: 119.9±23.5) (P=0.02).Conclusion: The results indicate that the studied hospitals are among beginner and developing organizations, and thus, need to improve and develop their organizational performance.

Introduction: Medical tourism is one of the branches of the tourism industry and, due to its low cost vs. high income, many countries seek to maximize their competitive resources in order to develop this industry. Moreover, improving service quality is considered a key factor in gaining medical tourists' satisfaction. In Iran, Shiraz is one of the main destinations of medical tourists; therefore, the present study aimed to determine medical tourists' expectations and perceptions of the quality of services provided by hospitals in Shiraz, Iran.Methods: The current study is an analytical, applied, and cross-sectional study which was carried out in 2013. The study population consisted of 200 medical tourists who referred to hospitals in Shiraz (Ordibehesht, Doctor Khodadoust, Pars, Madar and Koudak, and Markazi and Dena). In order to collect information, an adaptation of the SERVQUAL questionnaire was used.The validity of this questionnaire was approved by experts and its reliability was confirmed separately for expectations and perceptions using Cronbach’s alpha (90% and 89%, respectively). Data were analyzed using paired t-test in SPSS software.Results: The findings of this study showed negative gaps in all dimensions of quality. Overall quality gap was estimated to be -0.38. The largest gap pertained to the dimension of reliability (-0.6) and the smallest was related to the dimension of access to care (-0.08).Conclusion: The present study showed that the quality of services did not correspond to medical tourists’ expectations and needed improvement. Moreover, improving the reliability aspect of the services provided by hospitals can be an effective factor in increasing the satisfaction of medical tourists.