Journal of Health Information Management
Year:2011 | Volume:8 | Issue:2 (18)|Papers Count:21

Introduction: Private health care providers (PPs) considered a major gateway to the health services for TB (Tuberculosis) patients. However, TB management practices by PPs is inadequate. National TB Program need to collaborate with private health care providers. This paper is aimed to provide a comprehensive management program for public private mix (PPM) in TB DOTS (Directly Observed Treatment Short course) for effective case management of TB patients and reporting through a proper referral and information system in Tabriz.Methods: Mixed quantitative and qualitative methods in 5 stages have been used including: 1) Cross sectional study of current TB situation in Tabriz and a comparative study of various PPM TB DOTS programs worldwide. 2, 3) Stakeholder analysis and SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis using Qualitative Directed Content Analysis method 4) Adaptation of WHO’s recommended tools for PPM TB DOTS to local situation 5) Development of action plan using eight steps in leading change method.Results: 3.4% of new TB cases have been detected by public health network system and 96.6% by other health care providers. New smear positive case finding in Tabriz and East Azerbaijan province was 25% and 28.5% respectively. Treatment success rate in Tabriz and East Azerbaijan province was 94.8% and 87% respectively. All PPM DOTS findings showed that this program can significantly accelerate case finding while maintaining high cure rates.Conclusion: Cure rate in TB patients whom have been found in Tabriz is favorable, but case detection rate is less than expected. It is necessary to involve PPs with more sensitivity in case detection and more alliance with National TB Program in treatment and patient follow up.Regarding improving case detection rate, promoting patient satisfaction, providing more accessibility and affordability the mentioned program would be an effective approach in management of TB control program.

Introduction: To promote the processes of providing medical services, patient's rights and establishing uniformity in treatment policy, the Evaluation Quality Indexes were communicated to all general hospitals in 2002. This study evaluates the implementation of managed care guideline before their communication as Evaluation Quality Indexes of hospitals and their relationship with communication and quality degree of conducted services.Methods: This study was an analytical study based on information in the records of patients, before and after the communication of managed care guideline. The statistical population including the records of patients who underwent surgery or had delivered in the pilot hospitals affiliated to Golestan University of Medical Sciences in 2002 and 2007. The sample included 792 cases which were selected by stratified method. Data collected using three types of checklists and a standard information form communicated by the Ministry of Health. Obtained data analyzed by SPSS16 software and X2 test.Results: The preoperative assessment guideline was performed in 5.1% and 32.1% of evaluated documents in 2002 and 2007, respectively (P<0.001). The prophylactic antibiotic guideline was performed in 31.6% and 44.9% of documents in 2002 and 2007, respectively (P<0.001). The pain relief guideline was fully performed in 77.8% and 85.1% of documents in 2002 and 2007, respectively (P=0.001). Cesarean section ratio to total deliveries in investigated hospitals were 49% in 2002 and decreased significantly to 42% in 2007 (P<0.001). Most cesarean indication belongs to repeated cesarean section indication. Generally, in all investigated indexes there were positive and significant relation between establishing of Evaluation Quality Indexes and services quality.Conclusion: Implementation of managed care guideline led to improvement of quality in medical services. Establishing of guarantees and continuous rechecking regarding the quality assessment communications, could improve the quality of services in the future.

Introduction: Efficient use of information systems in provision of health services is very important for achieving efficiency, effectiveness and service quality. In this study the various aspects of clinical information systems implementation and estimate of one of main users' knowledge about these systems in hospitals was investigated.Methods: This study was conducted in two-stages: in the first step using available information resources during 1997-2008, different aspects of clinical information systems implementation have been studied. In the second step, the knowledge of medical record department's administrators of Tehran University of Medical Sciences affiliated hospitals has been determined.Validity of questionnaire was confirmed by expert panel and a reliability of 78% with test-retest coefficient was confirmed. Obtained data was analyzed with Excel 2007 software.Results: Clinical information system with improve quality and quantity of health care provided mission, is including components such as clinical documentation systems, medication management, pathology and etc. Studies indicated that there are some obstacles such as financial, behavioral and technical problems in implementation of these systems. The results of second part showed that the mean of knowledge of medical record department administrators from various aspects of clinical information systems was 53 percent.Conclusion: For effective clinical information system, review of effective factors and risk factors in the clinical information system implementation are important for prevention of repeated mistakes and neglect in cases that threat successful implementation of the project.Emphasize on education can be a key factor to promote awareness of the main users of clinical information systems about various aspects of these systems.

Introduction: For cultural development and growth of a community, the participation of all individuals, including physically disabled people are required. In this study, the compliance rate of public and academic libraries and information centers’ building and equipment in Zanjan was determined according to the international standards for the physically handicapped, from the perspective of architectural experts, library officials and disabled people.Methods: In this descriptive survey study, 142 disabled people in Zanjan and the buildings and equipment of 14 public and academic libraries of the city was studied in 2006. Data collected using a questionnaire which validity and reliability was calculated via coefficient Cronbach's Alpha (0.84). Obtained data analyzed using descriptive statistics such as percentage and frequency.Results: From disabled’s point of view, parking space, ramp and private space of libraries have the most physical obstacles and public and inner spaces has the least obstacles for them. 46.2% of libraries didn’t have ramp and 63% of libraries being studied didn’t have private study space for disabled.Conclusion: The buildings and equipment of these places are not adjusted to suitable condition to 100 percent and all spaces should be evaluated and optimized based on existing standards.

Introduction: Academic library websites have an important role in relevance and offering services for users. The aim of present study was the assessment of library websites of Iranian Medical Universities and general criteria evaluation and recognition their strength and weakness.Methods: In this survey – analytical study, first academic library websites of Iranian Medical Universities were identified through internet and then compared from a general criteria evaluation standpoint (main content criteria, search and research and evaluation of user facilities) by using three check lists with 29 questions which validity were confirmed by experts and conducted research. During a three month period, 41 academic library websites affiliated to the Ministry of Health were evaluated. Data analyzed by Excel software.Results: Totally, in studied academic library websites an average 36% of the content item index, 67% of search and research items and 46% of the users facilities assessment items have observed in designing web pages. Among the studied universities, 18 universities (45%) had considered more than 50% of check lists information items in terms of designing their website.Conclusion: In general, the content of library website of Iranian Medical Science Universities was at low level, their search and investigate was at good level and user facilities were at medium level. Totally 46% of the library's website triples general evaluation criteria were considered by studied libraries. Medical Universities of Mashhad, Zanjan, Iran, Isfahan, Tabriz and Shahed had been considered the evaluation criteria in terms of libraries websites design more than other Medical Sciences Universities.

Introduction: Web citations (URLs) are at risk of decay and can be easily fade because of the variable and unstable nature of the internet. So, the purpose of this research was to assess web citation accessibility and decay of articles published in Journal of the Medical Library Association (JMLA).Methods: In this applied-descriptive study, JMLA articles (231) in a seven year period (from 2002 to 2008) downloaded from magazines archives and the articles that have web citation (175), determined. Then, all of URLs were tested to specify their accessibility and decay. When we failed to directly access the URLs, we used Internet Explorer, Internet Archive and Google search engine to access missing URLs. Obtained data analyzed using Excel software to determine the half-life of web citations and the reasons for the URL failure Then gathered the result of these tests and analyzed them using Microsoft Excel to distinguish cause of these failure and to count web citations half-life.Results: 76 percent of articles had web citation and the average of web citation per article was 5 URL. From 1049 cited URL, 31 percent was inaccessible, but by searching these URLs, the decay decreased to 13 percent. The majority of errors were the 404 (Not found) and the average of web citations half-life was approximately 7 years.Conclusion: The decay of URLs is a big problem that cannot be ignored because URLs are increasingly used and lost in scientific articles, the decay of URLs will continue until better preservation policies (such as internet archive) are adopted.

With increasing technology in providing health care services and specialization, health care organization requires application of costing methods for calculating income and expenses to improve the health care services and compensate the costs.For this purpose, most hospitals in the developed countries, estimated system costs based on affiliated diagnostic related groups. According to this new method, hospitals were calculated costs and cost of services in return for services performed for the patient. In this review article, the data has been collected using print and electronic documents related to the topic.Considering that the diagnostic related groups known as disease classification system to facilitate medical reimbursement, so, hospitals must calculate their costs based on this method. In this article, we try to select the most appropriate method to make the necessary actions in the country with the matching process performed in this field and use the pre-eminent world experiences.

Introduction: European Foundation for Quality Management has designed the EFQM Model to determine the rate of organization development and excellence and construct ways to achieve organizational excellence. This Model is used to compare the current situation of each organization with an ideal organization. The aim of this study was to determine the performance self-assessment scores in selected hospitals in Ahvaz based on EFQM model Methods: In this cross-sectional and descriptive-analytic study 50 managers of Ahwaz Imam Khomeini and Oil Industry hospitals including vice managers, matrons and head of departments and units were enrolled. Data was collected by self-assessment standard and valid questionnaire of EFGM, including 50 questions on 9 criteria. Reliability of questionnaire was estimated %80 by appropriate test. Data analyzed using correlation and chi and descriptive statistical tests by SPSS 11.5 software.Results: In this study, 76% of studied population was female and 24% male. Most of them aged 36-40 years old.90% of persons have BS and higher degree.48 % have had 16-20 years work experience.The scores Imam Khomeini hospital for the 9 studied criteria were as follows; Leadership 66.8, Policy & Strategy 66, People 65.5, Partnership & Resources 70.4, Processes 63.9, Customer Results 62.3, People Results 60.6, Society Results 63.6, Key Performance Results 68.6 and in Oil Industry hospital were: Leadership 72.24, Policy & Strategy 67.4, People 66.4, Partnership & Resources 63.4, Processes 65.07, Customer Results 62.84, People Results 56.4, Society Results 59.45 and Key Performance Results 45.94. The total score of Imam Khomeini hospital from self-assessment questionnaire (651.79) was higher than Oil Industry hospital (615.14).Conclusion: Although the EFQM scores rated by hospital managers seems unrealistic to some extent, but considering the results can improved the hospital managers view, confirm that the costumer results, People Results, Society Results criteria need pay more attention to improved.

Introduction: The main goal of anatomical pathology is to provide information that is used for diagnostic, prognostic, and therapeutic purposes in pursuit of patient care. Effective information management and optimize information systems are crucial to the successful practice of pathology with respect to this mission. Design or improvement of Anatomic Pathology Laboratory Information Systems (APLIS) cannot be done without knowing about their situations; therefore researcher carried out a study of the current situation of APLIS’s in educational hospitals affiliated to Shahid Beheshti University of Medical Sciences.Methods: In this descriptive study, 13 APLIS’s of Shahid Beheshti University hospitals were studied.The sample size was according to the population size. Data collected through observation and by means of check list and questionnaire Validity and reliability of checklist and questionnaire was assessed by content validity and test re-test, respectively. The analysis of data was conducted based on descriptive statistics.Results: 8/77% of APLIS’s were semi-computerized. In 88/9% of APLIS’s, statistical classification of data was done by ICD-O and in 11/1% of them by ICD-10. Other types of statistical classification of data including Systemized Nomenclature of Medicine (SNOMED), determination of false negative proportion in cytopathology and digital analysis of tissue specimens was not performed in any of hospitals.Conclusion: Using of electronic information systems facilitate, promote and advance the practice of pathology. Digital analysis of tissue specimens could have many advantages for teleconsultation, preparation of virtual slides and teaching.

Introduction: The goal of Training activities is to grow potential abilities and intelligence in human.Evaluation of Training Service has main role in achieving qualified educational activities and increasing students’ skills. Therefore, this study evaluated the performance of training educators from points of view of medical record students in Kashan University of Medical Sciences in 2005-6.Methods: In this descriptive study, medical record students from all levels of associate and bachelor degree including 21 associate and 20 undergraduate students of bachelor degree in the second semester of 2005-2006, were enrolled. A questionnaire consisting of ten questions with very good to weak responses, with confirmed validity and reliability, was used. Totally 328 questionnaires were distributed to evaluate all training instructors (8 cases), from which 205 questionnaires were returned.Results: Most of the students (71.2%) considered the controlling of students’ absent and present as very good score. Respecting to Islamic and moral rules (69.7%), coming on time (67.8%), answering to students’ questions (60.5%), dominating to practical skills (60%), expressing theorical explanations for practical skills (57.1%), explain trainer's tasks (57.1%), being careful in doing trainers’ tasks (55.6%), following trainers’ problems (52.7%), supervising on learning (51.2%), were in next stages.Conclusion: Totally, students evaluated training educators ’performance in very good level. It seems that attention to the factors like following trainers’ problems, being careful in doing trainers ’tasks and supervising on his/her learning can improve learning quality more and more.

Introduction: In order to cope with the crisis of serials cost and problems associated with the shortage of budget in libraries and facilitating the access to scientific journals, the principle of Open Access to scientific publications and usually in the form of electronic journals has evolved during the last 15 years. This research aimed to clarifying the amount of citations of ISI Web of Science’s articles to DOAJ’s journals in the two fields of Health & Medical Sciences and Basic Sciences during 2003-2008 and investigating the meaningfulness of difference in the citations received by DOAJ’s journals between the above-mentioned two fields.Methods: In this study bibliometrics method and citation analysis technique was used and 1337 English-language journals from DOAJ and without sampling were investigated. Data collected by Cited Reference Search in ISI Web of Science and analyzed by SPSS 16 software.Results: The findings indicated that Basic Sciences, with 657 journals, received 10116 citations (62.91%).In this field Biology & Life Sciences received the most citations (6009 citations, equal to 59.4%) and Mathematics & Statistics received the least citations (91 citations, equal to 0.9%).On the other hand, Health & Medical Sciences, with 680 journals, received 5965 citations. In this field Medicine (General) received the most citations (3236 citations, equal to 54.25%) and Dentistry received the least citations (1 citation, equal to 0.01%). The findings of Chi-Square test showed no significant difference in the number of journals between the two fields of Health & Medical Sciences and Basic Sciences, but there was significant difference in the number of citations between them.Conclusion: Although the number of cited journals in comparison with non-cited journals in the two fields of Health & Medical Sciences and Basic Sciences in DOAJ were relatively low, but given the increasing rate of open access journals in the database, and also considering the need to identify highly cited and valid journals in areas such as Health Sciences and Medicine and Basic Science, which is the urgent need of researchers for reliable and updated information,.doing such researches has great effect in this field and will help them to access free reliable journals.

Introduction: In health care, emphasis on basic human rights is especially important. Patient’s privacy protection becomes important when the human is exposed to shortcomings of social and health systems. This study was performed to compare the patient’s rights in developed countries and suggest a proper Model for Iran.Methods: This research was a comparative and descriptive case study. Research population included the USA (New York, Florida, Missouri, Minnesota and Texas), England, Canada and Iran. Data collected by internet and e-mail based on a library search method. Furthermore, in Iran, we used a questionnaire that its validity and reliability were tested. Finally, the suggested model of patient's rights for Iran was tested by some specialist in this field with Delphi method.Results: Findings of research showed that patients’ rights of accessibility to treatment and health care, privacy, consent for treatment and protection (The right of claim) were included in “Patient’s rights” of all studied countries, except Iran. The right of confidentiality is considered in all studied countries. The rights of having translator and pain relief just were seen in some states of the USA.Conclusion: Considering that patient rights have many shortcomings in Iran, generally, main reviews in this field should be performed according to comparative surveys. So, a accordingly the appropriate model for developing “Patient’s bill of rights” in Iran was proposed.

One of the most important quantitative methods and research domains in library and information sciences is scientometrics and informatics, which has markedly developed over the last four decades.The Study in each one of the categories of this domain, need to more research and literatures review. Scientometrics applied in description, explanation and prediction of scientific situation of researchers, education and research groups, universities, organizations and countries in various national and international fields. Against the great success which has gained in this field, a lot of challenging obstacles and difficulties has been facing for researchers in mentioned fields.These challenges could be evaluated with different approaches. In this paper the positive and negative aspects of scientometrics studies have been analyzed using libraries method by a comprehensive and critical approach.The major obstacles have presented in four categories as follows:1. Limitation in Philosophical, epistemological and theoretical foundations;2. Methodological obstacles and specific difficulties of citations and citation analysis;3. Terminological chaos;4. Limitation of Scientometrics tools including the ISI in careful assessment of science.

Introduction: Anti-Counterfeiting Trade Agreement (ACTA) is a plurilateral agreement among industrialized countries including USA. Top industrialized countries and in particular USA always tried to have complete control over World Trade Organization (WTO). Although they had many success for their purpose, they are not convinced about the WTO functions and they can not tolerate critiques of their opponents in WTO, so they were looking for a way to bypass the WTO. In 2006 Japan and USA prepared an initial proposal and tried confidentially to attract other industrialized counties into their agreement. Under the cover of fighting good counterfeit, this agreement aimed to legally enforce the intellectual property rights and total control over Internet communications.They aimed for new standards and system of laws independent of existing international organizations and countries to establish a new governing body outside of the body of existing countries. All these efforts were to forcibly implement the intellectual property right and copyright law by implementing total control on the Internet as the main media for copyright infringement.This article has been written to shed some light on the issue and disclosing the hidden parts of this agreement.

Introduction: Management development assessment helps managers to systematically assess the current management capabilities of their organization and take critical steps to strengthen the management skills and sustainability of their organizations. This study aimed to identify and compare the health system management development assessment models in selected international organizations and countries.Methods: In this cross – sectional comparative study, management development assessment models developed and implemented by Management Sciences for Health (MSH), International Development Research Center (IDRC), United States, England and Iran were studied using library resources, websites and E-mail communication with experts from Iran and other countries during 2005-2006. After systematic review of the models, seven major characteristics of them selected for comparative study. Data collected using comparative tables derived from systematic review. The tables were validated by management experts from Tehran universities. Then, the characteristics of the models were compared and analyzed.Results: Studied models had common main objectives but there were differences between them in terms of structure, management areas being assessed, management indicators and use of results. All of these models emphasized employee’s involvement in management development assessment process in order to be effective in improving the management capabilities of the organization.Conclusion: In all these models management development assessment is considered as the first step in change process and improvement the management systems.Considering that the efficiency and effectiveness of health care system directly influenced by quality management of health care managers, to develop the health system management in Iran recommendations based on our last experiences of international organizations especially the World Health Organization is presented.

Introduction: Considering the health and Medicare issue plays a distinct role in public policy discourse of the government in developed societies and most often determine the socio-economic status of the country. Nowadays, developed countries expect much more from public health sector, for creating jobs, revenues and healthy social opportunities in addition to basic health necessities. The aim of the present study is to show regional disparities in Iran through measurement the level of development of different Provinces with respect to their accessibility to the health and Medicare facilities.Methods: In order to accomplish the above mentioned purpose, data regarding 18 health and Medicare indexes during the years 2006-2008, have been collected from yearly statistics published by Central Bureau of Statistics, Management and Programming Organization and Health Network Offices of Iran. The selection of indexes was done on the basis of past related studies and human development indices. For analysis of data, researcher has used quantified methods such as Numerical Taxonomy, Coefficient of Deprivation, Standardized Method and factor analysis to classify the provinces in Iran according to health care indicators and related facilities.Results: The unbalanced distribution of five main factors i.e. Specialists, Urban Health Centers, Rural Health Centers, Urban waste water Drainage Units and Sub Rural Health, could describe nearly about 76 percent of differences responsible for regional disparities in Iran. Ranking analysis show that according to the available data, provinces like Yazd, Semnan and Isfahan had the highest developing degree and provinces like Sistan Baluchistan, Kohgiloye Boyer Ahmad and Lorestan had the lowest level of development with respect to the rate of accessibility to health and Medicare facilities in Iran.Conclusion: In an efficient socio-economic system, considering the basic principles, basic needs and improve community health education infrastructure are the basic tasks that should be regarded by system administrators. In this regard providing suggested programs in the field of poverty eradication and elimination of socio-economic inequalities and regional differences within the country seems to be necessary.