فرحناز صدوقی

Spinal muscular atrophy (SMA) is the most frequent neuromuscular disorder affecting spinal motor neurons. It is important to collect quality and consistent data on this disease at the national level by developing a minimum data set (MDS). Therefore, the present study aimed to develop an MDS for the SMA registry in Iran.

This is a descriptive-comparative study that was conducted in 2020. In the first stage, the data elements were extracted from the medical records of patients with SMS in Iran. In the second stage, the data elements were compared with those in the national and international registries. In the third stage, to validate the initial MDS, a questionnaire was designed whose validity was confirmed by 16 experts, including neurologists and geneticists, in two Delphi rounds. Finally, the data elements that obtained an inter-rater agreement of 75% or more were included in the final MDS. The data were analyzed using descriptive statistics in Excel software, version 2019.

The MDS developed for the SMA registry included 65 data elements in 10 subsets of demographic data, patient clinical history, family history, diagnostic and genetic tests, respiratory status, mobility status, nutritional status, pharmaceutical and therapeutic measures, service provider, and mortality.

The developed MDS is recommended to be used to collect integrated information about the SMA in Iran, which can play an important role in improving the quality of information, evaluating the treatment and disease progression, planning and health policy at the national level and reducing medical costs.

To identify the main causes of malnutrition in childhood, it is necessary to collect quality and coherent data at the national level, which requires the creation of a minimum data set. Therefore, the present study aimed to design a minimum set of malnutrition data for children under five years of age.

This quantitative applied study was conducted in two stages in 2019. In the first step, the descriptive-comparative method was used to compare the data elements needed for malnutrition in children under five at the national and international levels. In the second stage, the initial MDS was designed and then validated by experts in two rounds using the Delphi method. The study population was composed of 30 experts in nutritionists and pediatrics who were selected by non-random purposive sampling (criterion Sampling) finally, the cases reached a collective agreement of more than 75% were included in the MDS. The items with a score below 50% were excluded from the proposed MDS. The collected data were analyzed by using descriptive statistics and Excel software.

Approved MDS for malnutrition in children under five had 56 data elements and seven subsets, including child development, demographic and management, clinical and diagnostic examinations, nutritional status, medical history, and tests.

The development of MDS plays an important role in improving the quality of information management and early detection of childhood malnutrition. In order to gather uniform data, achieve an integrated information system, and facilitate the sharing of malnutrition data, it is recommended to use this MDS.

One of the most effective ways to improve the management of asthma in primary care is using guidelines in the patient management process; but due to lack of time, their use is very limited. One way to solve this problem is mechanized guideline in a form of decision-support system that requires computer-interpreted guideline (CIG). In this study, a CIG was developed for asthma management in primary care.

This qualitative study was performed using mini-Delphi method uses a workflow-based approach to develop a CIG. The workflows and data components were extracted through Business Process Model and Notation (BPMN) language and Enterprise Architecture (EA) software. Afterwards, they were confirmed through an expert panel of five asthma specialists.

The developed CIG included three major workflows, four sub-workflows, and 21 data components. Main workflows included treatment, drug interaction, and follow-up time. Sub-workflows were related to treatment workflow that were developed based on the patient visit number and age.

Because the accuracy of this workflow was confirmed by asthma specialists, it is expected that the design of this CIG will lead to development of a cost-effective software for the management of asthma and better detection of drug interactions.

Asthma is uncontrolled in more than half of asthma patients due to inadequate and incorrect management. The main reasons for inadequate management are non-adherence, inadequate knowledge of a general practitioner about patientchr('39')s clinical condition, and not following asthma management guidelines The purpose of this study was to develop a conceptual model for the asthma management system in primary care

In this study, according to the guideline of the Global Initiative for Asthma, workflows for the management of asthma were extracted. Then, the conceptual model of the system was developed with unified modeling language and evaluated by an expert panel, including five asthma and allergy specialists, three informatics specialists and two health information management experts who were selected through non-probability sampling method. Data collection tools were the discussion framework with open-ended questions that reached a collective agreement after discussion on the conceptual model. The collective agreements were applied simultaneously to the diagrams of the conceptual model.

The conceptual model was developed and evaluated in 10 diagrams, including business use-case, use-case, activities, sequences and class diagrams. The diagrams were reported after evaluation. The business use-case shows the main use-case, and the use-case diagrams show the more detailed use-case which is used for the system. The activity diagram shows how the patient was admitted, visited, and managed. The sequence diagram and the class diagram also present the order of asthma management operation, the objects required by the asthma management, and how they are related, respectively.

Given the validity of the conceptual model by asthma and allergy specialists together with informatics and health information management, it can be expected that the current conceptual model will significantly help to design and implement efficient systems that meet the needs of users.

Internet of things is a hot topic in the modern age of information and communication technology has become pervasive in various industries, particularly in healthcare sector. The security and privacy issue has attracted a lot of attention and has become a controversial issue in this area. The purpose of this study was to identify security mechanisms of Internet of things in health and non-healthcare industries.

 The present study was a systematized review conducted by searching the Web of Science, Scopus, PubMed, IEEE Xplore, and ProQuest databases from 2005 to 2019. After the elimination of duplicate cases, studies related to the purpose of the study were selected on the basis of inclusion and exclusion criteria.

We found 71 out of 2340 studies, related to security mechanisms of Internet of things in the healthcare (four studies) and non-healthcare (67 studies) industries, which were then reviewed. Security mechanisms have been organized into 11 major categories, including cryptography, key distribution and management mechanisms, digital identity management, and system life-cycle maintenance management in both the healthcare and non-healthcare industries. The findings showed that six types of security mechanisms, including energy saving, secure design and physical protection of system hardware, intrusion detection and prevention system, trust management, secure routing, and fault detection and tolerance had not been addressed in the health industry.

Given the emergence of this technology in the healthcare industry and its security sensitivity to other industries, the findings of this study provide a broad insight for researchers, managers and information security professionals to encounter threats and attacks and develop a secure Internet of things architecture.

Self-care in breast cancer patients undergoing chemotherapy is an important factor in controlling and reducing the side effects of chemotherapy which leads to a greater adherence to chemotherapy and improved quality of life. Given the role of smartphones in individuals' lives and their apparent capacities for self-care, the aim of this study was to present a mobile-based self-care application for patients with breast canceundergoing chemotherapy.

This applied developmental research was conducted in two stages. At first, needs assessment was performed to identify the needs of oncology and general surgery specialists and patients with breast cancer undergoing chemotherapy. Then, the prototype of the application was designed under the Android platform. Finally, to evaluate the usability and satisfaction of users, the standard Quiz questionnaire version 5.5 was completed by 30 patients for one week. The data were analyzed by SPSS software version 21 using descriptive statistics.

According to the findings 32 elements (among 36) of the needs assessment questionnaire were considered as necessary by the participants. General features of the program included: patient profiles, side effects management, life style and system capabilities. The usability assessment of the application showed that the users rated the application as good with a mean score of 7.9 (out of nine points).

Mobile-based care applications can be used to help patients with breast cancer undergoing chemotherapy in managing side effects and obtaining self-care skills.

Clinical Governance (CG) is a strategy for providing responsive, accountable, patientcentered, high quality, safe and effective healthcare services through creating an appropriate organizational structure and culture. Development, implementation and monitoring clinical standards are also included in CG. This study aimed to assess the success of clinical governance implementation in hospitals in Khuzestan province, Iran.

This descriptive questionnaire survey was conducted in 2014 in 40 hospitals using a valid and reliable questionnaire covering seven dimensions of CG (i.e., management and leadership, employees’ education and management, clinical effectiveness, clinical audit, risk management, patient involvement, and information management). All clinical governance officers of hospitals were asked to complete the questionnaires. Overall, 40 questionnaires were returned. Data analysis was done using SPSS software. Ethical issues such as informed consent, voluntary participation, participants’ anonymity, information confidentiality and researchers’ objectivity in data collection, analysis and reporting were all considered.

The mean score of CG implementation success was 65.6 percent in Khuzestan province hospitals. About half of the hospitals were moderately successful in CG implementation. Hospitals achieved more success in employees’ education and management and less success in clinical effectiveness dimensions of clinical governance. Top managers’ and employees’ commitment and involvement in CG activities was critical for CG successful implementation.

Clinical governance was slightly successful in Khuzestan hospitals. However, strong management and leadership, managers’, employees’ and physicians’ participation, education and training, patient centeredness, evidence based practice, and clinical audits are necessary for successful implementation of CG in hospitals.

Knowledge management and intellectual capital are key factors for organizations to achieve competitive advantage. The purpose of this study was to determine the relationship between knowledge management and intellectual capital in faculties affiliated with Iran University of Medical Sciences.

The participants of this applied study, conducted in 2018  consisted of 283 non-faculty instructors teaching at Iran University of Medical Sciences. Two standard questionnaires, Lawson’s Knowledge Management and Bontis’s Intellectual Capital questionnaires were used to collect data which were then analyzed by using SPSS software version 22. Moreover, Pearson correlation coefficient was used to measure the relationship between knowledge management and intellectual capital.

According to the findings, the knowledge management status in the faculties of Iran University of Medical Sciences was 2.92 which was lower than the average. While the intellectual capital status in was 3.05 which was higher than the average. Also a positive and significant relationship was found between knowledge management and intellectual capital (r = 0.697, P = 0.001).

Considering the existence of a positive and significant relationship between intellectual capital and knowledge management, the officials are recommended to focus on strengthening the components of knowledge management and intellectual capital dimensions to enhance the intellectual capital, make the optimal use of human capital and implement knowledge management and expand it within the organization.

Cardiovascular diseases are common and chronic diseases that impose many financial and health burdens on individuals and communities. Patients with these diseases have always experienced a high rate of death, disability and poor quality of life. Telemedicine is a promising approach to improving the care of these individuals.The aim of this study was to evaluate the efficacy and effectiveness of telemedicine in the management and monitoring of heart disease.
Information sources or data: This study is a systematize review in which all papers related to the effectiveness and efficiency of telemedicine in the management and monitoring of heart disease between March 2011 and July 2017 were extracted from ProQuest, Sciencedirect, PubMed, Scopus, and Google Scholar databases with keywords.
Selection methods for study: After screening the titles and abstracts of all the papers, finally 21 studies were selected and analyzed. For screening articles, the criteria for entry included the publication of articles in English, the relevance of articles to the efficacy and effectiveness of telemedicine in the management and monitoring of heart disease and access to full text articles.
Combine content and Telemedicine has had an effective and unique effect on the timely diagnosis of heart disease, facilitating access for patients to professionals, reducing the length of stay and allocating resources efficiently, and reducing costs and improving quality of life. The findings also indicate that advanced countries have been ahead in using telemedicine to manage and monitor heart disease ever more than other countries. The use of telemedicine can be provided as a practical solution to overcome time and space constraints in the diagnosis and treatment of various diseases, especially cardiovascular diseases. This technology has also maximized the health status by motivating patients, self-control, managing clinical symptoms and providing a screening program.

The advanced technologies in hospitals promises the entry into a novel era. Real-time locating systems are one of such technologies which could enable the tracking of patients, physicians, nurses and valuable equipment. The purpose of this study is to presenting the technologies used in real-time locating systems in healthcare field.
 

This study was a review-descriptive type and the research population was included documents related to the healthcare real-time location system. The search of databases (IEEE Xplore, Elsevier, Springer, Wiley online library, Science Direct, Emerald, PubMed, DOAJ, Web of Science, Taylor) and google scholar search engine between 2005 and 2018 was performed. 652 sources were retrieved, and then 19 sources were studied. For this purpose, the initial draft of data gathering form was designed in Excel software and the validity of the final form was confirmed after receiving the experts' comments and making necessary corrections. Then, the selected resources based on the objectives of the study were entered into the data gathering form and narrative synthesis was performed.
 

At present, different technologies are employed in real-time locating systems which could reduce costs and increase speed in the process of presenting healthcare services. These systems rely on radio communications and their positive dimensions include precise exchange of data and control of processes. Tracking patients and physicians as well as moving equipment in emergency cases, having access to information, satisfying the patients and staff, and reducing medical errors are among other fundamental applications of such system. 
 

According to the findings, the importance of using real-time location systems in healthcare field is very impressive and its performance is reliable. Thus, the necessity of using modern technologies in order to improve these systems is highly required.

Health care systems are known as complex systems, which are difficult to analyze and reengineer. Health system engineers often rely on Unified Modeling Language (UML) to model and simulate various parts of these systems. The purpose of the current study was to identify the most widely used and least-practicable UML diagrams as well as the range of applications of this language in the field of health care for documenting, analyzing, and designing an efficient system. The study was a systematize review. All the articles related to UML applications in the field of health care were extracted from March 2010 to July 2017 using valid keywords from the Web of Science, PubMed, ProQuest, and Elsevier Scopus databases. After screening, 48 articles were selected and analyzed via two 12-hours concurrent sessions. Three diagrams of class, activity, and use case were the most usable UML diagrams, and four diagrams of component, collaboration, object, and profile were the least used diagrams in designing and modeling in various fields of health care, respectively. In addition, in the domain of applications, infrastructure group, disease management, and knowledge discovery had the highest use of UML, respectively. Considering the fact that UML applications scopes over all aspects of the system in three areas of disease management, knowledge discovery, and health care infrastructure both in software and hardware systems, designing and modeling this application domain with UML will facilitate the reengineering and promotion of organizations, and develop interactive systems to support the linkages between different parts of the health care system and collaboration between project partners

Mobile technology has provided new opportunities for health care systems. Improvement of health services outcomes in different patient groups is one of the benefits of using this tool. Although the use of mobile in Iran is expanding, there is no evidence of the state and the use of this technology in health system. The aim of this study was to review published researches on the application of mHealth in the health system of Iran.
In order to carry out a review study, Pubmed database was searched by the keyword "mobile Health" and its equivalents which have derived from the "Medical Subject Headings". Iranian databases including Iran medex, Magiran and Scientific Information Database (SID) were also searched for Persian and English terms of mobile health. Retrieval citations from information databases were sent to the endnote software and evaluated based on the considered criteria.
The research sample consisted of 26 articles that met the criteria of the study. In most of studies, text messaging was the main intervention tool of mHealth. The results indicated significant effect of mobile health in improving the patient's care.
In Iran, mobile health can be effectively used in the health system due to population structure and geographic extent. According to the results of this study, the use of mobile health, especially in educating patients for self-care and preventing the spread of diseases, can be very effective.

Nowadays none of the fields of human knowledge has remained unaffected by informatics and information technology. Health and treatment categories are no exception to this, too. Therefore, this study was conducted aiming at evaluating the financial information system of educational hospital of JundiShapuor University of Medical Sciences in Ahvaz.
This research was an applied type in nature drawing upon a descriptive method. The study was carried out in hospitals affiliated to JundiShapuor University of Medical Sciences in 2013 to 2014 in Ahvaz. A questionnaire was made to evaluate the strengths and weaknesses of the financial information system. Data received from participants who were willing to answer the questions. Content validity of the questionnaire was confirmed by the experts and its reliability was measured using SPSS software and Cronbach’s alpha method (89%).
The findings revealed that financial information system indices such as precise and correct financial calculations, support and classification of information, detailed services to patient report, report of purchase requests of sections, insurance bills of patients, and provision of processed financial information to the internal beneficiaries (as strong points) had a higher average than the features of communication with the internal and external information system and maximization of capital (as weak points).
The results of this study showed that the financial information system is in a moderate upward situation, which has improved and upgraded the financial information system of Ahwaz hospitals..

Background and The office of disaster management and emergency medical service is one of the most important subdivisions of the Ministry of health. Analyzing the tasks and functions of this office is critical to its evaluation. This study aimed at analyzing the information needs of this office to develop statistical indicators required.
This qualitative-quantitative study was carried out during 2015. The study population included the managers and expert panels in disaster management and emergency medical service in the Ministry of Health and Medical Education of Iran. We interviewed 14 individuals in different departments within the office and reviewed the administrative tasks and the available documents. After analyzing the data, different information needs of all departments were identified and classified.
According to the administrative tasks and practices, 69 groups of information needs were identified of which 17.4% are not met. 45.3% of the information needs did not have any standard sources or forms to collect the data required.
Lack of standard sources for the most identified information needs, decentralized information systems, and out-of-date information are the major problems of managers and expert panels. So, designing national standard forms to collect data, designing a comprehensive statistics and information system and reviewing current paper forms and databases seem to be essential.

The ability of managers to use accurate, reliable, and up-to-date information is an important factor for organizational success. The aim of this study was to investigate the role of information management in the successful implementation of clinical governance in the hospitals of Khuzestan province, Iran.
This descriptive-analytical study was conducted in 40 hospitals of Khuzestan province in 2014, using a valid and reliable researcher-made questionnaire included 35 questions about 7 dimensions of clinical governance. All clinical governance managers of the hospitals were asked to complete the questionnaire. Data were analyzed using descriptive statistics and inferential statistics (such as correlation coefficient and logistic regression) by SPSS 19.
The mean success rate of clinical governance in the hospitals of Khuzestan was 65.6 percent. The mean score of information management of clinical governance was 62.4 percent. There was statistically significant relationship between information management and successful implementation of clinical governance (P=0.01). Appropriate use of health technology and information systems by the staff, staff training in data documentation, and using hospital information in decision-making process, planning, control, and evaluation had great effect on the successful implementation of clinical governance.
Due to the important role of accurate, reliable, and up-to-date information and information management system in the successful implementation of clinical governance, hospital managers should provide necessary facilities for collection, analysis, and use of hospital information. Hospital staff should be trained in data documentation.

Providing fairly accessible and economical services for rural communities is one of the main challenges of health systems in many countries. Geographical information system (GIS) can be used as useful tool for analyzing and modeling the accessibility of rural communities to health services. This study aimed to perform geographical analysis on the accessibility of rural communities of Khozestan Province, Iran, to rural health houses.
This was an applied and descriptive-analytical study. The study population consisted of all villages of Khozestan Province. After gathering spatial data, and defining descriptive indexes and reforming them, this data was entered into ArcGIS software. Then, major levels were defined and the operational area of the health houses was determined.
Findings: The results of this study showed that 3315 of the total 4547 villages (72.9%) had permanent inhabitants, 146 (3.2%) had seasonal inhabitants, and 985 (23.9%) had no inhabitants. Only 2223 (48.9%) villages had asphalt roads. Moreover, 358 villages which had permanent inhabitants were located outside the health house accessibility boundary.
In Khuzestan Province, geographical accessibility to rural health houses has some challenges. Some of these challenges are due to the inappropriate condition of rural roads, geographical isolation and scattered villages, and unbalanced development of villages. GIS can be used to improve the efficiency of the rural network extension plan.

Electronic prescription system as a sample of multidisciplinary, socio-technical information systems has numerous complexities, various users and subsystems. Therefore, the present article is developed with the purpose of reviewing the national models of electronic prescription systems in some selected countries.
This comparative reviewing study describes the electronic prescription system models in a number of EU countries (Denmark, Sweden, Finland, and the UK) and the US. Data related to the prescription system were extracted through searching the keywords related to electronic prescription along with the names of the countries in search engines and the related data bases, as well as visiting the websites concerned with electronic prescription system of each country. Next, the gathered data were entered on the data collection form. Data analysis was performed using a descriptive-comparative analysis method.
Electronic prescription system in the countries under study covers the whole prescription process or a major part of it; and the models used in the system varied in different countries and even within the same country. Also, the electronic prescription system in the four European countries under study had centralized architecture and national database of electronic prescription system, but the US applied a decentralized and diffused architecture for this system.
Based on the experiences obtained from reviewing of the leading countries in the field of implementation of electronic prescription system, this system should be part of national health care infrastructure and the necessary platform should be provided for a safe and secure electronic transmission of prescriptions between the prescribers and the dispensers.

The progressive increase in the elderly population in many developed countries leading to focus on health in this age group. Recording adequate data for the elderly people is considered as the basis for future planning for this part of society. Therefore, this study was aimed to compare the minimum data about elderly health in selected countries.
This is a review article was carried out through internet and library studies. The Keywords were extracted from search engines and databases including Google, Yahoo, Google Scholar, PubMed and Proquest, and the Iranian National Medical Digital Library using inclusion criteria included English language and no time limit. All papers, research projects, theses, guidelines and progress reports were retrieved from America, Sweden, Japan and Iran. Also, Web sites of organizations responsible for elderly health in each country were visited and their documents were reviewed. The results of this search were presented narratively and within comparative tables.
The results of this study showed that in selected countries, elder’s data collected in four axis. Most of demographic data is completed in America. In Sweden, Iran and Japan some data from medical histories and health assessment are considered as well as some financial data in Iran.
Given the importance of the health minimum data set for future planning, using the experiences of the pioneer countries in health is necessary, but localization of it according to the country’s needs is inevitable.

In some rural areas of Iran three decades passes the establishment of rural health houses, and during these years, demographic, economic and social patterns in many rural areas have changed. One of the challenges in the health sector is the allocation of health houses due to the changes in rural areas. The aim of this study was to investigate the distribution of rural health houses based on GIS and determination of its optimal model in Khuzestan province. This study was an applied and descriptive - analytical research. The population of study consisted of all villages and rural health houses in Khuzestan province in 2012.First, Spatial and descriptive required data were collected and corrected. Next, important criteria and sub criteria for optimal site selection for rural health houses were determined from the viewpoint of experts. Then, relative weight of criteria and sub criteria were determine by using Analytical Hierarchy Process (AHP). Finally, by overlapping weighted layers in ArcGIS software a model was presented for locating rural health houses in Khuzestan province. Total of 886 rural health houses in Khuzestan province, 128 rural health houses (14.4%) did not meet the criteria for health network expansion plan. The 358 with residents’ villages has lack proper access to rural health houses. Of experts’ opinion, the main criterion for locating the optimum distribution of rural health houses, the most important criteria was of the rural original population relative weight 0.506. The result showed that using GIS can help to experts of network development plan to manage and distribute the rural health houses. It is recommended that GIS utilized in order to improve the efficiency of healthcare network development plan.

Currently, the important role of personal health record (PHR) system is underlined due to increasing global concentration on the concept of patient-centered healthcare. Generating national standards and data sets as well as its advertisement by health providers will increase the wide-spread acceptance of PHR systems. The aim of this study was to determine optimal data set of electronic PHR system for Iranian students of medical sciences.

The study was conducted in three steps, i.e. qualitative comparison of data sets in USA, Australia, and UK; quantitative-descriptive assessment among 301 subjects, who was the students of Tehran University of Medical Sciences and their healthcare providers; and finally qualitative Delphi technique to take the outcomes of the comments of 60 specialists and experts in six classified field, i.e. management, medicine, dentistry, nursing, rehabilitation, and mental health, in 2014. Data collection questionnaire was arranged based on the common data sets of emerging countries and the available national student health records, approved by the Ministry of Health and Sciences. Its content validity has been approved by three experts and its reliability was confirmed with Cronbach's alpha value of 0.97 using internal consistency through SPSS20 software. The requirements assessment of stakeholders to achieve the required data collection and descriptive analysis was performed by calculating the distribution function of its frequency through Excel software. The questionnaire was prepared based on the results of the requirements assessment phase and Its content validity were approved by three experts in the field of clinical and management, Reliability analysis of research tool at this step of research was not possible, because in Delphi method respondents could completely change Its reply In each round. Descriptive analysis was performed based on the average through Excel software. The data elements those were higher than 4 in averages have been considered in proposed Data Set.

344 data elements were evaluated, 280 items among them was resulted from the requirements assessment step and 64 items among them were added in Delphi step. 271 data elements are approved, which five items were approved with perfect (100%) agreement. Finally, the data set and its subsets were determined.

Modifications and evolutions of data set elements over the study period underlined the important role the comments of both stakeholders and the experts for determining optimal data set among diverse range of possible fields. It can be concluded from the results of this study that more details, such as mental health, can be added to the PHR data set. Moreover, Student Health Certificate, which is used in most universities of Iran is incomplete and it has to be modified.

IT Governance includes IT management and the way to make IT decisions in line with the related IT processes, resources, and responsibilities. This study aimed to determine the current state of IT governance in education and training centers in Iran University of Medical Sciences. This is a practical qualitative study. In the first step of the study the population centers including the related documentation, and in the second step the units responsible for information technology, computing, informatics and hospital administrators who work in the center were included. Data collection tools in the first step was the data collection forms, and in the second step was interview guide. Content analysis of the documents and all the propositions were extracted. The final step is data processing and interpretations of the results. After interviews were collected, the data were identified, coded and classified. Finally, the sub-topics were combined, the topics were selected, and the thematic analysis was performed. 40% of center's information technology administrators studied computer software at university and 40% of the managers were graduated from medical centers. The results showed that the president, the director, the IT department administrators, and the director of the Department of Statistics and Information Technology in many areas have made their decision in technology-related fields. In some centers also the IT department administrator provided the staff with job description after being approved by the hospital manager. The structure of the studied center's IT departments was vague and complex, so that the trustees, policy makers, administrators and IT operators in hospitals were not exactly clear.

Telepathology is one of the medical subdivisions that is specifically has been taken into consideration in recent years. Telepathology is the practice of digitizing histology and microscopic images to be transmitted by telecommunication for diagnosis, medical advice or continuing education. It includes electronic images production to be examined in one site or another site. At the present research, we have studied the possibility of telepathology implementation considering the presence or lack of presence of requirement and legal standards in medical centers of Western Azerbaijan province. This study is a cross-sectional descriptive study which was conducted in 2013. All public and private hospitals were selected in the city of Urmia. The public sector hospitals in the other towns of West Azerbaijan province were chosen as well. The study population was included hospitals directors and administrators, pathologists, and informatics staff. The sample was considered as the study population. The data gathering tool was a questionnaire which was prepared separately for each group of the study population. Reliability was evaluated, and the data were analyzed by SPSS statistical software. As a result, the average awareness of study population was 2/43 with 0/89 standard deviation about telepathology. There was a significant difference between the average awareness of the hospitals directors and administrators, pathologists and informatics staff, about telepathology. Also the possibility of telepathology implementation by considering the presence of requirement and legal standards was 2/18 with 0/51 standard deviation. Findings show that telepathology implementation can increase the quality of health care and the speed of patient handling, and it can lead to reduce the health costs. Also according to the rule of legal issues, confidentiality of information, sense of responsibility and accountability in telehealth systems, it is necessary to provide new rules and guidelines in this area. It is recommended that hospitals should take necessary proceeding for telepathology implementing.

BBackground and Objectibe: Self esteem and organizational commitment play important roles in quality of work life. This study aims to gain a better understanding of the relationships between SELF ESTEEM and OC among health information management staff in ‎tertiary care ‎hospitals in Tehran. This was a descriptive correlational and cross sectional study conducted on the health information management staff of ‎tertiary care ‎hospitals in Tehran, Iran. A total of 155 participants were randomly selected from 400 staff. Data were collected by two standard questionnaires. The Self Esteem was measured by Eysenck Self Esteem scale and Organizational Commitment by Meyer and Allen's three component model. The collected data were analyzed with the SPSS (version 16) using statistical tests of of independent T-test, Pearson Correlation coefficient, one way ANOVA and F tests. The Organizational Commitment and Self Esteem of the employee's were 67.8‎, out of ‎‏120 and 21.0 out of ‎‏30, respectively. The values for ‎‎affective commitment, normative commitment, and continuance ‎‎commitment were respectively 21.3 out of 40‏‎, 23.9 out of 40, and 22.7 out of 40 (moderate). The Pearson correlation coefficient test showed a significant Organizational Commitment and Self Esteem was statistically significant (P< 0.05). The one way ANOVA statistical test (P< 0.05) did not show any significant difference between educational degree and work experience with Self Esteem and Organizational Commitment. This research showed that Self Esteem and Organizational Commitment ‎are moderate. Self Esteem and Organizational Commitment have strong correlation with turnover, critical thinking, job satisfaction, and individual and organizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.

Human resources in hospitals are one of the most important factors that play a key role in the information management plans success. This study was carried out with the aims of proposing an organizational jobs and positions model for health management and information technology department in Iranian hospitals. Our descriptive study was completed in two phases. In the first phase، the organizational positions of the mentioned department were extracted from the selected countries and in the second phase a total of 22 unique organizational positions were sent to 36 experts to ask their opinions. Checklists and the researcher’s questionnaire were tools used to collected information in the first and second phases، respectively. After collecting questionnaires، their agreement and disagreement with various dimensions of the suggested model was appraised using descriptive statistical indicators and SPSS Software. The organizational positions related to management department are health information manager and health information senior manager. The organizational position of management and IT is IT manager، statistician، Health information management expert، Information storage and retrieval expert، information analyzer، health informatics and IT expert، IT expert in-charge، and clinical coder. Lack of an organizational structure proper with a department may be problematic for employees of that department who intend to fulfill their jobs. Since in Iran Medical Records departments work mostly based on manual activities and information technology has been marginalized، it is stressed that information management and IT departments perform in concert information related affairs of hospitals، which helps them to achieve their main objectives

Studies indicate that using behavior changing interventions may improve medical record documentation. This study aimed to examine the effect of feedback and incentive mechanisms on medical record documentation among surgery residents in Kashan University of Medical Sciences.
This quasi-experimental study examined the effect of feedback and incentive mechanisms on 19 surgery residents’ medical record documentation in Kashan Shahid Beheshti Hospital in 2013-14. During three phases of pre-intervention, post-intervention and 3 months after intervention, five medical records for each resident (total=95) were selected and assessed using a checklist. Data were analyzed by means of t-test and Wilcoxon test.
There were significant changes in surgical residents’ medical record documentation during pre- intervention, post-intervention three months after intervention (P=0.0001). Findings showed that the rate of documentation in medical history form, course of disease, reception and discharge summary, and surgery report had significant changes after the interventions (P= 0.0001).
Since the results showed that feedback and incentive mechanisms had positive impacts on improving residents’ documentation behavior, it is suggested that residents’ documentation performance should be regularly assessed and feedbacks be provided for other residents and stakeholders.