Journal of Health Information Management
Year:2013 | Volume:10 | Issue:4|Papers Count:14

Introduction: Primary health care is the major infrastructure of health care systems. It is clear that making and improving primary health care information systems would not be possible without awareness of their condition. Therefore, this comparative study was conducted in order to determine the situation of primary health care information systems in health centers of Tehran, Iran.Methods: This descriptive cross-sectional study was performed on primary health care information systems of 60 health centers in rural and urban areas of the province of Tehran during 2010. Data was collected through observations and interviews based on a checklist. The validity and reliability of the checklist were assessed by content validity and test-retest approach, respectively. SPSS was used for data analysis.Results: None of the studied health centers used computerized health care information systems, i.e.they all utilized manual systems. In addition, demographic data, the population of the covered area, and health status were included in 71.3%, 88.7%, and 82.9% of the systems. However, data related to efficiency, availability of services and socioeconomic status was not found in any of the evaluated information systems. Related processes such as different kinds of statistical computations, and monthly and yearly reports were performed in 74.3%, 46.4%, and 23.5% of centers, respectively. Electronic transfer of primary health care information systems and international standards did not exist in any of the centers.Conclusion: Computerized organizational approaches are required to be used for distribution, storage, and analysis of data to provide efficient and accessible care. Moreover, considering the importance of employing computerized and internet-based technologies in primary health care, experts need to be asked for necessary consultations.

Introduction: Citations are fundamental basis of all scientific papers including theses. Inaccurate and improper citations would lead to high expenses for the researchers and libraries to access these citations. This research tried to review the accuracy of references in Persian defended medical specialized theses in 2007 in Tabriz University of Medical Sciences, Tabriz, Iran. It also aimed to determine the correspondence rate of selected citations with Vancouver style.Methods: Citation analysis was used as the study approach. Systematic sampling and Morgan table were employed to select 347 articles from 1390 cited articles. The six studied factors included author (s), title of the article, title of the journal, year of publication, volume [and issue], and number of pages. Citation errors were divided into two main groups of minor and major errors. Data was collected by direct observations. Data was then entered into a checklist based on Taylor division. SPSS11 was used for data analysis.Results: Out of all 347 reviewed cited articles, 98.3% citation errors were observed. Only 164 (46.27%) articles were completely error-free. None of citations corresponded with Vancouver style.Conclusion: The main reasons for dissatisfying results of citation errors and rate of correspondence with Vancouver style were students’ unawareness of the importance of citations in scientific papers and the need for consistency, not paying attention to experts and specialized librarians’ advice, the unfamiliarity of students with reference management software, and the inconsistency of universities writing guidelines with standard styles. To improve citations in theses, some solutions are suggested. For instance, a part of thesis grade needs to be allocated to accuracy of references. Holding reference management software workshops might also be beneficial.

Introduction: The information on nutritional status as a part of patients’ medical information should be documented on patient records by dietitians. Despite the importance of this information in the process of decision making and medical care and even legal aspects, no proper attention has so far been paid to documenting such information on patient records. This study aimed to design a prototype patient nutrition record (PNR) and implement it in teaching hospitals to determine its validity, efficacy and acceptability.Methods: This applied study was conducted in 2010-2011 in two steps. First, 6 forms of PNR including nutritional history sheet (in 2 pages), food frequency questionnaire (FFQ), daily nutritional status evaluation report, diet order sheet, parental/tube feeding order sheet, were designed. The forms were then implemented for 121 patients in endocrinology and internal medicine, pediatric, and orthopedic wards of two academic hospitals in Iran (Golestan Hospital in Ahwaz and Namazi Hospital in Shiraz) for a period 4 months. The opinions of 118 medical staff members on the implementation were collected by a questionnaire. The validity of the questionnaire was verified by academic experts and its reliability was confirmed by Cronbach’s alpha. The obtained data was analyzed by descriptive statistics, analysis of variance (ANOVA) and independent t-test.Results: Mean scores of questions about the content and importance of nutritional information of the PNR and the implementation of the PNR were 4.14 and 4.1, respectively. No statistically significant differences between responses to questions and the hospitals, the type of career (medical specialist, nutritionist, and nurse), and the wards could be confirmed.Conclusion: Medical care practitioners that participated in this study accepted the prototype PNR. They confirmed that the high importance of integrating a PNR in patient records.

Introduction: Given the ever-increasing importance and value of information, providing management with a reliable information system, which can facilitate decision making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate information needs at statistics and medical records departments of Iranian medical universities.The findings of this study can be utilized in designing and selecting a comprehensive information management system.Methods: This descriptive applied cross-sectional research was carried out in 2008. The managers of statistics and medical records departments at 39 medical universities in Iran were included. Data was collected by a questionnaire. Since different methods can be used in designing information systems, the principles of BSP (business system planning) and CSF method (critical success factors) methods were considered. The collected data was analyzed by SPSS16.Results: A total number of 137 needs were determined from which 63% were considered as basic by the managers. In addition, 12% of information needs were categorized as the critical success factors of managers. On the other hand, 17% of the identified information needs were not priorities and were thus excluded. Finally, 18% of information needs were obtained through forms, 9% through the database, 33% through both forms and database, and 3% through the website. However, 37% of the needs lacked a definite source.Conclusion: Since 37% of information needs of the managers did not have a particular source, developing an information system in such offices is necessary. Despite the important role of users in designing information systems (identifying 63% of information needs), other scientific methods are also needed to be utilized in designing information systems.

Introduction: Communication is described as the most important feature for workers of all types. Librarianship, in particular, requires complete communication skills. Perhaps, the critical lesson the students must learn about users’ expectations is how to play an appropriate role in interactions with the society. Such interactions would result in job satisfaction and desirable servicing to users. Therefore, the present research aimed to evaluate the methods and rates of communication skills used by librarians at Isfahan public universities, Iran.Methods: This descriptive survey included all students and librarians of Isfahan public universities during 2009-2010 academic year. The calculated sample size was 780 students and 136 librarians that were selected by stratified random sampling. Data was collected by a checklist for the observations of the researchers and a researcher-made closed-end questionnaire to assess students’ views. That the reliability and validity of the questionnaire were confirmed. In order to analyze inferential findings obtained from the collection tools, univariate t-test was used.Results: According to our findings, the application rate of non-verbal and verbal communication skills were 3.15 and 3.31, respectively. On the other hand, students assessed the application of verbal and non-verbal skills by the librarians as 3.21 and 3.32, respectively. These results indicate a moderate level of communication skills among the librarians which needs enhancement.Conclusion: The findings of this study showed an undesirable level of communication skills application by the librarians at Isfahan public universities. Leaving this problem unresolved would lead to reduced use of libraries. Therefore, responsible organizations are recommended to promote the knowledge of librarians about communication skills through training courses, conferences, concise brochures. Librarians are also suggested to expand their studies in this field.

Introduction: Accurate and timely information and communication are vital to adequately prepare individual health organizations for emergency events. The current article investigated health-related communication and information systems for emergency management in Iran.Methods: The present study was conducted in 2009 with a mixed qualitative and quantitative approach. Simple random purposeful sampling was used to select 214 health service managers. The subjects were surveyed using a valid and reliable questionnaire. Moreover, 65 semi-structured interviews were also conducted with public health and therapeutic affairs managers who were responsible for emergency management. Data was analyzed using SPSS and framework analysis. The maximum mean score was 5.Results: The mean score of sharing incident information, registering internal and external hazards, creating emergency management databases, and introducing a formal system for logging and recording information were 3.06, 2.66, 2.61, and 2.87, respectively. A range of problems were identified including fragmentation of information, lack of local databases, lack of clear information strategy and lack of a formal system for logging disaster-related information at regional or local level.Conclusion: Creating disaster-related information databases, creating protocols and standards, setting an information strategy, training staff and hosting a center for information system in the Ministry of Health to centrally manage and share the data could improve the current information systems.

Introduction: Hospitals employing telesurgery need to be evaluated to determine whether they satisfy the international standards. The main goal of this research was to assess the software, hardware, telecommunication equipments, privacy and security methods, and staffing requirements for supporting and executing telesurgery in hospitals affiliated to Tehran universities of medical sciences, Tehran, Iran.Methods: This descriptive study included 23 hospitals affiliated to Tehran universities of medical sciences. Hospitals were selected by stratified sampling followed by simple random sampling. Data was collected by observation and interviews using a checklist. Descriptive statistics was applied for data analyses.Results: According to our findings, 10 studied hospitals employed telesurgery among which 90% used telementoring, 30% used teleproctoring accompanied by telementoring, and 10% used telerobotic surgery. None of the hospitals used telepresence surgery. Most common equipments were video camera (80%) and microphone (100%). TCP/IP was the most common telecommunication standard with which most hospitals were more familiar. Moreover, 80% of hospitals used informed consents in order to assure the security and privacy of telesurgical information.Conclusion: Overall, we consider the hospitals which employ telesurgery in weak conditions in terms of satisfying the related standards. Accessing and distributing appropriate infrastructures, equipments and transferring methods and standards are main prerequisites for successful implementation of telesurgical applications.

Introduction: The quantitative analysis of scientific output, scientific policy making, scientific relationships of researchers, and drawing historiographic outlines are all parts of scientometric discipline. This paper was designed for scientometric analysis of 20 top journals in the field of genetics and heredity in 2000-2008 and to map the scientific structure of their papers.Methods: This research utilized scientometric methods and procedures to analyze the data from 28813 papers published in 20 journals in the field of genetics and heredity with a minimum impact factor of 5 during the past 5 years. The Web of Science database was used to collect the data and HistCite™ was used to draw the historiographic outline.Results: All papers, except for 2, have been published in English. The United States, with 56.7% of all published papers, came first while Britain, Germany, France, and Japan stood the second to the fifth, respectively with a large gap. Harvard University was the most active organization in this field by publishing 1121 papers. Of the first 30 organizations, 25 were American. Moreover, 63.5% of the citations were from papers with at least one American author. Although the papers used in this study have been cited 1124511 times internationally, only 7.27% of the citations belonged to the 20 journals evaluated in this study. Cooperation had a rising trend amongst authors and the average number of co-authors increased from 6.03 in 2000 to 8.05 in 2008.The scientific outline drawn based on the top 144 papers within this discipline showed that 4 clusters had been formed during 2000-2008 of which 2 clusters covered human genetics diversity and its various sub disciplines. The other two clusters covered bioinformatics or software and database applications and utilizing advanced statistical methods in analyzing data in this field.Conclusion: The cooperation amongst researchers in publishing papers was high and increasing.The scientists in the field of genetics covered a vast number of papers in their literature review which relied extensively on old and historical publications. Bioinformatics and statistical methods were also found to be of great importance in this field.

Introduction: The integrated educational system and service provision have involved the managers of Iranian universities of medical sciences in different tasks and limited their access to adequate information for decision making. Hence, it seems to be vital to adopt plans in order to provide necessary information for decision making. The current study was carried out to define the role of research and development units in management information system of selected universities of some countries in order to apply these experiences to Iranian universities of medical sciences.Methods: This comparative, cross-sectional study was conducted in 2010. First, the theoretical foundations, the available records and related literature were studied. The status of research and development system was then investigated in 8 international universities. Data was collected by observing websites and performing supplementary interviews with the aforementioned institutions. The main research variables included the tasks, objectives and key processes of the unit. Finally, data was analyzed and compared using comparative tables.Results: The most significant roles of research and development units included providing and analyzing accurate information by conducting necessary studies at the appropriate time, supporting the decision and the policy making processes, improving the quality of activities, upgrading universities, providing an appropriate image of the university by giving relevant statistics and information, and facilitating cooperation with counterpart units in other universities.Conclusion: With regard to the key role of research and development units in university management information systems, Iranian universities of medical sciences are proposed to take corrective actions if they lack a fully efficient research and development unit.

Introduction: The prevalence of new diseases and increased number of patient referring to health care centers cause more medical malpractice. This study aimed to identify the frequency and reasons of medical errors in cases referred to Isfahan Legal Medicine Commission during 2005-2009. It also tried to provide ways to reduce such errors.Methods: In a descriptive, cross-sectional study, 380 cases of medical errors referred to Isfahan Legal Medicine Commission from 2005-2009 were evaluated. Due to inaccessibility and incompleteness of information, and also uselessness of some cases, 352 cases were finally investigated. The data was collected by a checklist whose validity was obtained by the opinions of experts in several stages. Data collection methods were resource review and observation. Data was analyzed by SPSS11.Results: The 352 studied records included claims from individuals. Among physicians and surgeons, general practitioners were claimed more than others (15.3%). Anesthesiologists, obstetrics and gynecologists, general surgeons and orthopedic specialists were claimed in 9.3%, 8.3%, 7.6%, and 7.4% of cases, respectively. Among other health care professionals, nurses had the highest frequency of claims (9.8%). They were in the second rank of total sentences. In addition, 36.9% of sentences led to conviction among which general practitioners were in the first place (15.3%). The average age of staff was 43 years. The highest frequency of claims (23.2%) was observed in the age group of 35-40 years. Males constituted 68.2% of the medical staff. Among the 23 cases of administrative staff errors, 91.3% cases led to conviction. In 35.2% of cases, negligence was the main reason of medical malpractice. In 46.4% of the issued convictions, a blood money of 1-10% was determined.Conclusion: Our results showed that patients’ claims of medical staff were increased during the past 5 years. In fact, while 62 cases belonged to 2006, 108 cases were reported in 2010. Although medical errors are inconsiderable when the delivered health care services are concerned, identifying their reasons and a proper health care management would lead to higher quality of provided services.

Introduction: The high prevalence of breast cancer, especially in Iranian young women, led us to survey the published Iranian articles related to breast cancer. The purpose of the current study was to analyze and visualize the trend of scientific output in the field of breast cancer research in Iran as well as Middle East countries.Methods: In a bibliometric study, all Iranian publication in the field of breast cancer indexed in Medline were extracted and compared with the publications of other Middle East countries during 1965-2008. Medline was searched based on the medical subject headings (MeSH) keywords. In order to make the search more comprehensive, the keywords suggested by the specialists were also included. Data was analyzed using descriptive statistics and Microsoft Word and Excel.Results: Data analysis showed that the number of publications in the field of breast cancer originated from Iran had considerably increased. In fact, from one paper in 1990, the number reached 24 papers in 2008 (105 articles during 2001-2008 vs.9 articles before 2000). Additionally, Iran ranked the 5th among Middle East countries in terms of number of breast cancer-related publications. Shiraz University of Medical Sciences, Tehran University of Medical Sciences, and Center for Breast Cancer at Jihad of Tehran University were the most active centers in the field of breast cancer. The Asian Pacific Journal of Cancer Prevention (APJCP) published the highest number of Iranian articles in the field of breast cancer research.Conclusion: This study indicated an increasing trend in the number of Iranian breast cancerrelated publications in Medline during 1965-2008. The numbers especially had an exponentially increasing trend after 2001.

Background: Health records serve several purposes and must be retained to meet those purposes.These varied purposes influence how long health records must be kept, or their retention period.The present study aimed to recognize laws and procedures related to retention of health records in selected countries and provide a proposed guideline for Iran.Methods: This was an applied, descriptive-comparative research on laws and procedures related to retention of medical records in the USA, United Kingdom, Australia and Iran in 2011. The data was collected via library sources, websites, and consultation with specialists in and out of the country. The validity of the data was confirmed by experts. Finally, the recommendations were provided for medical record retention in Iran.Results: The study revealed complete and transparent record retention schedules in the selected counties. In fact, retention situations for adults, minors, emergency, outpatients and deaths records are clearly determined. However, in Iran, either no specific laws and procedures exist for medical records or they are unspecified.Conclusion: Lack of a complete, transparent and updated medical record retention schedule in Iran has led to confusion for hospitals. Some hospitals maintain medical records more than the determined retention period and some destroy them before expiring of the essential retention period. In order to optimize the situation of health records retention in Iran, it is necessary to review, correct and complete medical records retention schedule on the provided recommendations for different kinds of medical records.

Until recent time, the publishers of scientific articles owned the intellectual and economic copyright by providing the facilities for reviewing and publications. Nevertheless, based on the recent technological advancements, a modern policy called “open access policy” has been developed in reviewing and publications of the scientific articles. In this new method, authors own the copyright of their articles by paying the necessary costs to the publishers. Therefore, as soon as an article is reviewed and accepted, it will be published online and everyone can freely access it. Given the importance of the topic, the present review article dealt with these changes in publications of scientific articles within health domain.

Introduction: Deductions are a part of hospital revenues. However, they mostly remain unpaid due to incorrect documentation. This study focused on the rate and causes of deductions made by hospitals affiliated to Kashan University of medical Sciences, Kashan, Iran, according to available documents.Methods: This was a descriptive cross-sectional study conducted in the first half of 2009 in hospitals of Kashan University of Medical Sciences. The research population included 7907 medical records covered by the Social Security Insurance. The data was collected by a standard checklist. It was then analyzed through descriptive statistics.Results: Based on available documents, the most important causes of deductions were lack of a physician’s order in drug forms (427), lack of laboratory report in laboratory forms (2195), lack of radiology report in radiology forms (226), incorrect operation report in surgery forms (429), lack of an anesthesiologist’s signature in anesthesia forms (322), and lack of consultation order in consultation forms (226). The study also showed that in general, among all evaluated forms, drug forms had the maximum of deductibles.Conclusion: The most frequent cause of deductions is incorrect documentation. On the other hand, insurance organizations only pay costs according to registered data. Therefore, it is really essential and helpful to pay enough attention to documentation principles. In addition, it is important to use diagnosis related group (DRG) and healthcare information systems.