فاطمه مشیری

Integrated Health Information Systems (HIS) are necessary to achieve national and international goals in health and development, which are facing cooperation problems due to diversity and heterogeneity. Interoperability as a key characteristic of data sharing and the main prerequisite of integration enables healthcare providers to make timely decisions for diagnosis, treatment, action, and patient care. Therefore, this research aimed to provide a category of interoperability concepts in electronic health (E-Health).

This research is a narrative review to categorize the interoperability concepts in E-Health. For this purpose, Scopus, Google Scholar, PubMed, Science Direct, and IEEE databases were searched using the keywords "Interoperability framework" and "Integration" with the combination of AND along with "E-Health". Therefore, all the articles referring to the concepts of interoperability were selected.

The result of the search in the aforementioned databases was 304 articles. By removing duplicate, out-of-reach, and unrelated articles, only 40 articles were examined, and topics related to the concepts of interoperability were classified based on six axes (dimensions, levels, obstacles, integration, architecture, and measurement). Finally, its applications and challenges were described in a narrative review.

Due to the nature of the health system, integrity and intelligence are very important in this area. Therefore, to facilitate the exchange of information and the use of health information systems from each other’s services, paying attention to the presented classification has an undeniable effect, and also, an important role in the integrity and intelligence of the environment, and increases the efficiency and effectiveness in the quality of providing health care services.

Tourism as one of the programs to earn money leads to economic growth; however, due to the non-providing of medical and health services by insurance organizations, the Iranian tourism industry has faced a recession. Therefore, this study aimed to provide a smart tourism health insurance architecture in the context of the Internet of Things (IoT) and cloud to serve tourists.

This practical study was conducted to achieve a smart tourism health insurance architecture. First, its requirements were determined by reviewing the related literature and open interview with four experts from Iran Insurance Corporation. Then, by examining different types of tourism health insurance architectural models, a proposed service-oriented layered architecture was presented on the platform of IoT and cloud. Finally, the proposed architecture was evaluated by the ATAM method.

The proposed architecture has two components (i.e., the requester and the service provider) with user, network, cloud, and database layers that are connected in a service-oriented manner. Also, the evaluation of the proposed architecture by the ATAM method showed that it can respond to the health needs of tourists.

This architecture is presented on the platform of IoT and cloud that provides an intelligent background, and by recording people's data in personal risk profiles, it facilitates providing special tariffs and reducing tourism costs. Therefore, tourists will be able to travel with more confidence in controlling their health status.

Due to the increase of environmental problems as well as microbial resistance against antibiotics in recent years, the efforts to expand and develop bioactive compounds with antimicrobial capability have been greatly increased. Plant extracts are very important as potential sources of these compounds. The present study aims to investigate and compare the antimicrobial activity of aqueous and methanolic extracts of Ferula assafoetida.

In this experimental study, the antibacterial activity of aqueous and methanolic extracts of Ferula assafoetida was evaluated by the disk diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were evaluated. Data analysis was performed using factorial experiment within a completely randomized design and using SPSS 25 software.

Results showed that the aqueous extract had a higher antimicrobial activity compared to the methanolic extract. The highest zone of inhibition with a diameter of 30±0.2 mm was observed for aqueous extract at the concentration of 400 mg/mL against gram-positive Bacillus subtilis. The lowest values of MIC and MBC were observed for aqueous extract against gram-positive Bacillus subtilis at concentrations of 0.77 and 1.55 mg/mL, respectively.

In general, the results of this study showed that the type of solvent and extraction method has a significant effect on the antibacterial effects of bioactive compounds. Different extracts of Ferula assafoetida, having appropriate antibacterial activity against bacteria strains, especially gram-positive ones, can be used as a promising source in health and therapeutic products.

Hospital information system (HIS) as an integrated information system is used for daily operations, planning, care, and treatment of patients. Due to the existence of various and heterogeneous healthcare information systems, HIS encounters interoperability problems. In this regard, this study aimed to propose an integrated architecture for HIS based on the interoperability model.

This research is a strategic-applied study for achieving an integrated HIS architecture, focusing on clinical information systems (CIS). First, the requirements of clinical information systems were carried out through library studies, the review of the statistics office of the Ministry of Health, Treatment and Medical Education, and it was also reviewed and confirmed by information technology experts. Then, different interoperability frameworks and HIS architecture models were studied. Finally, the integrated HIS architecture model was proposed based on the interoperability model.

The integrated HIS architecture based on the interoperability model includes three architecture models as follows: references, software, and information. Reference architecture is proposed generally for the HIS and customized for CIS. For implementing various HISs, software architecture is proposed. And information architecture is used for storing, processing, and transmitting the information.

Considering the necessity of integration in the health system, this study creates the possibility of interoperability and integration between HIS systems by applying the guidelines of integration in the architecture, which leads to cost reduction, quality improvement, and timely decision-making.

Hospital information system (HIS) is a comprehensive software for integrating patient information for sending and exchanging health information between wards and other medical centers in order to accelerate the process of patient care and treatment, improve quality, and increase patient satisfaction. The advent of diverse and heterogeneous health care information systems in the field of e-health has led to interoperable problems. In this regard, this study aimed to provide the necessary architectural styles, to achieve an integrated HIS architecture, classified into six main categories, including distributed, dataflow, and modern systems.

In this strategic applied study, first, different types of HIS architectural models, their requirements, the concept of interoperability and its dimensions, and different types of architectural styles and their categories were examined. Then, according to HIS requirements and interoperability dimensions, the classification of architectural styles was proposed.

The results showed that the use of appropriate architectural styles facilitates the achievement of integrated architecture. The proposed classification of architectural styles is formed of six categories of systems including system of systems, shared memory, dataflow, calling, distributed, and modern systems.

Integration in HIS subsystems is one of the essentials in health systems. Applying the proposed classification supports architects in selecting interoperable requirements properly with the help of different architectural styles and placing them in the integrated HIS architectural design.