دکتر حمید مقدسی

Pharmacovigilance is definedas “the science and activities related to the detection, assessment, understanding, and prevention of adverse drug reactions or any other drug-related problems”.The framework of the national pharmacovigilance system illustrates the general pattern of howthe health system approaches the care of health products, defines the philosophy of supervision and policy orientation, and outlines the structure and development priorities of pharmacovigilance. The present study was conducted with the aim of presenting a framework of the national pharmacovigilance system framework for developing countries. The present study is of an applied study that was conducted descriptively in 2023. To present a framework of the national pharmacovigilance system framework, the main components of the national pharmacovigilance system framework were first identified and determined through a review of valid scientific sources and texts and national pharmacovigilance systems of the countries under study, considering the conditions and requirements of these countries. Then, the proposed model was put to the opinion of 65 experts for validation, and the Delphi method was implemented with a three-point scale in two rounds. Based on the results of the present study, the main components of thenational pharmacovigilance system framework include: functions, infrastructure, and network. Each component includes sub-components and related operations and was agreed upon by experts with an average agreement rate of 95%. The framework of the national pharmacovigilance system is essential as a guide for the implementation of the national pharmacovigilance system. This framework enables a comprehensive evaluation of the structures and national and regional institutions affecting pharmacovigilance and canlead to the optimal implementation of the national pharmacovigilance system in developing countries. The national pharmacovigilance system can reduce drug-related problems, and its ultimate result can be a reduction in mortality and morbidity rates.

Medication errors in patients’ medical records can influence the healthcare quality and cause risks for them. It is, therefore, crucial to apply appropriate procedures to reduce these errors. This study sought to develop a software for detecting medication errors through qualitative analysis of patients’ medical records.

The software was developed using object-oriented analysis and Java. The text was first pre-analyzed using a framework known as Stanford Core NLP. In the next stage, the text was turned into a semi-structured passage to be connected to Dr Onontology using Apache Jena framework. The name and dosage of available drugs were then extracted in the physician order forms and the patient progress notes. The areas of mismatch were identified through comparing the data obtained from these two forms.

Software assessment was conducted in two stages. In the first stage, the capability of the software in proper recognition of medicine’s name was measured, as100 completed forms containing physician order forms with a total number of 1014 drugs were used for text mining and error detection. After running the analysis in the error detection software, 93% of the drugs were properly recognized. In the next stage, comparisons were made between the physician order forms and the patient progress notes to find possible mismatches. Out of 1000 recorded drugs in the analyzed forms, the software was able to properly detect mismatches in 91.8% of the cases. The medication data available in i2b2 were used for conducting the assessment.

Given that medical records are of paramount importance and their human analysis is a complicated and time-consuming process, deployment of a text miner with the capability of quality analysis could facilitate error detection efficiently and effectively.

Effective information management in the emergency department (ED) can improve the controland management of ED processes. Dashboards, known as data management tools, efficiently provide informa-tion and contribute greatly to control and management of ED. This study aimed to identify performance indica-tors quality dashboard functionalities, and analyze the challenges associated with dashboard implementationin the ED.

This systematic review began with a search in four databases (Web of Science, PubMed,Embase, and Scopus) from 2000 to May 30, 2020, when the final search for papers was conducted. The datawere collected using a data extraction form and the contents of the extracted papers were analyzed throughED performance indicators, dashboard functionalities, and implementation challenges.

Performanceindicators reported in the reviewed papers were classified as the quality of care, patient flow, timeliness, costs,and resources. The main dashboard functionalities noted in the papers included reporting, customization, alertcreation, resource management, and real-time information display. The dashboard implementation challengesincluded data sources, data quality, integration with other systems, adaptability of dashboard functionalitiesto user needs, and selection of appropriate performance indicators.

Quality dashboards facilitateprocesses, communication, and situation awareness in the ED; hence, they can improve care provision in thisdepartment. To enhance the effectiveness and efficiency of ED dashboards, officials should set performanceindicators and consider the conformity of dashboard functionalities with user needs. They should also integratedashboards with other relevant systems at the departmental and hospital levels.

Accurate information can be accessed in a timely manner through the Integrated Mental Health Information Network (MHIN). As Iran has no MHIN, this study was undertaken to propose an architectural model.  This research is a sequential mixed method. The organizational structure and database structure of the MHIN was identified, and the architectural model of the NMHIN was presented in two main phases. In the first phase, a quantitative study was conducted in a scoping review with an extensive review of the background, documents, information, and available resources about the mental health information network. In the second phase, to validate the proposed architecture, the Delphi technique was implemented. Questionnaires were distributed and collected both in person and by e-mail, and finally, the data were analyzed using SPSS-19. The model of national MHIN was provided in five dimensions: MH entities, organizational ownership of databases, data elements of each database, linkage among databases, and exchangeable data elements among the databases. This model can be applied as a suitable platform to effectively and efficiently store and use mental health information. So, the available information can be used for providing mental health services more comfortably and appropriately. The results showed that connecting mental health entities can create a flow of information, coordinate MHIN activities, and improve performance, efficiency, and quality of mental health.

The crisis management information system (CMIS) is a mission-critical system that enables the crisis management team for understanding, diagnosing, interpreting, analyzing, structuring, and making decisions faster by providing timely and high-quality information at the right time. The purpose of this research is to provide an architectural model of a CMIS for managing natural disasters in the process of finding trapped victims and relieving them.

This applied study was conducted in 2020 in two stages. First, data on CMIS used in selected countries were collected from electronic resources and digital libraries and were then analyzed. Next, a preliminary model of CMIS architecture including three aspects of informational content, applications, and technological requirements, was prepared using these systems and experts’ interviews. Finally, the architectural model of CMIS validated by the Delphi technique and the focus group.

The analysis of experts in three rounds of Delphi test for three aspects of informational content, applications and technological requirements in the architectural model was performed with the presence of experts at the national level and the consensus rate over 75% was obtained for 7 modules and 28 proposed components of the CMIS.

The architecture of information systems has a direct impact on the performance of these systems. Using an appropriate architecture for CMIS can be an effective step towards reducing the costs and consequences of crises in Iran and countries with similar conditions and have a significant impact on saving human lives in emergency situations.

Context: 

According to the wide range of patients with type 2 diabetes and their unique characteristics, the process of treatment should be personalized for them. The most important step towards treatment and care of them is preparing daily reports by patients in logbooks. Diabetes organizations and associations have provided various logbooks for diabetic patients, with different structures.

In this reviewstudy, articles and documents relating to type 2 diabetes logbooks were collected from relevant databases. From 60 articles, 28 titles including 23 articles related to type 2 diabetes and five logbooks from various diabetes organization were selected. Thecriterion for the selection was the validity of the organization offering the logbooks. Then, their data elements were compared.

The findings showed that the data elements of blood glucose, physical activity, meal and medication are fundamental data to record in type 2 diabetes logbooks. However, different organizations have considered different data elements for their logbooks and the number of their data elements is different from each other. In addition, few logbooks included all data elements.

To achieve the best results from personalization of care in type 2 diabetes patients, it is necessary to record measurable self-care behaviors so that the process of the disease is completely controllable. Therefore, it is necessary for diabetes logbooks to have all these necessary elements so that the physician would make decisions based on sufficient data and the process of treatment would come in effective.

The health information governance (HIG) program is an extensive organizational framework for information management across its lifecycle. This program is important as a strategy for the materialization of high-quality care for individuals, social health, and the reduction of the costs of care and the reliability of health information. Considering the spectrum of this program in pioneering countries, the current review aimed to study the HIG program in the selected countries.

This review article was conducted in 2017 by searching for relevant English language articles in PubMed, Scopus, ScienceDirect, and Google Scholar databases, along with the websites of relevant organizations such as Infoway and the American Health Information Management Association. The key terms included, but were not restricted to, ‘health information governance program’, ‘health information management’, and ‘health information governance components’. Finally, the data were analyzed with respect to the aim of the study.

The components of the HIG program, which are classified into 18 main groups, are the principles of this program including nine dimensions of accountability, goal, transparency, integrity, satisfaction with collection and disclosure, protection, compliance, availability, along with retention and disposition. Some officials and legal and natural roles are common among the three countries while some others are specific for each country.

Considering the results of the present study, it is suggested that a strong governance structure together with the policies and regulations of health information technology should be taken into consideration in establishing a HIG program. By developing such a program at a national level, new roles are required to facilitate the implementation of the program.

The National Health Information Network (NHIN) is one of the key issues in health information systems in any country. However, the development of this network should be based on an appropriate framework. Unfortunately, the conducted projects of health information systems in the Ministry of Health of Iran do not fully comply with the concept of NHIN. The present study was aimed to develop a general framework for NHIN in Iran.

In this study, in the first stage, the required information about the concept of the NHIN framework and related NHIN documents in the USA and the UK were collected based on a literature review. Then, according to the results of the first stage and with regards to the structure of the Iranian health system, a general framework for Iranian NHIN was proposed. The Delphi technique was conducted to verify the framework.

The proposed framework for Iranian NHIN includes three dimensions; components, principles, and architecture. Over 80% of experts have evaluated all three aspects of the framework at an acceptable scale. In total, the proposed framework has been evaluated by 83.8% of the experts at an acceptable scale.

The proposed framework was expected to serve as the starting point for moving towards the design and creation of Iranian NHIN. At any rate, the framework could be criticized, and it could only be used for the countries whose health system is similar to the structure of the health system in Iran.

Context: 

The prevalence of Multiple Sclerosis (MS) in the world has grown and has attracted particular attention on the international level and governments, has considered prevention interventions and managing the symptoms of the disease to reduce the economic burden and has improved the quality of life of these patients necessary. One of the most important strategies in this field is MS population-based registry. Accordingly, this study was designed to identify the components of MS population-based registries within the developed countries. Evidence Acquisition: The present study is a review article that was conducted in 2018. The population of the study consisted of MS population-based registry systems of developed countries such as USA, France, and Denmark. Based on the combination of related keywords, about 60 papers appropriately and after extraction, categorization and integration were formulated in the form of proper sequence for the purpose of the study.

The main components of MS population-based registries in developed countries included registry goals, information resources, Minimum Data Sets (MDS), types of processes, types of reports, quality control measures, data transmission time limits, responsible for recording and collecting data, responsible organization and executor, data transmission method and the privacy practices

With regard to the results, it is suggested that the developing countries must consider creating an MS population-based registry as a national program due to their health system and the MS population-based registries structure in developed countries, so that they can adopt a suitable strategy for preventing and controlling the disease.

As a cheap and affordable tool, smartphones technology has provided an opportunity for effective treatment of addiction and relapse prevention.

This study aimed to design and evaluate a mobile application for relapse prevention to methamphetamine use disorder.

This study was conducted in two stages in 2018. Initially, the features of Marlatt’s cognitive-behavioral model were studied. The conceptual model of the application was then developed according to identifying the users’ needs and features of the Marlatt’s model and based on object-oriented analysis. The coding was performed using Java Script, CSS, and HTML. After developing the application and its installation in an addiction recovery center, the application was quantitatively evaluated with the participation of five experts in psychology and addiction studies and five patients.

The main requirements of the software were identified in the form of a daily plan for recovery (learning and training materials, relaxation), motivation (motivational messages and encouragement for continuous use of the software), and evaluation of the recovery process. The results of the evaluation showed that 89% of the participants were satisfied with the software usability.

The prevention of relapse to substance use disorders, such as methamphetamine, requires motivation and education. Design and deployment of mobile-based application could be a cost-effective approach for recovery of a variety of addictive behaviors and the follow up of recovery.

The natural crises national information system (NISNC) has a key role in promoting natural crisis management by analyzing and understanding the situation, managing and allocating the resources, coordinating actions and supporting of decision making and exchanging of information. The purpose of this paper is to examine the NISNC general and technical characteristics and functional capabilities in Germany, the Netherlands, Romania, and Turkey. Evidence Acquisition: This comparative study was conducted using databases like Google Scholar, Science Direct, PubMed and Scopus in the period from 2000 to 2017. The following featured were under the focus: being nationalized and computerized and availability of information. From among the 41 available studies, 24 were examined among which 12 belonged to Germany, 6 to the Netherlands, 3 to Romania and 3 to Turkey. Finally, the information obtained from different countries was compared on the basis of comparative tables.

In all countries, the Interior Ministry was in charge of NISNC and NISNC is used in the entire cycle of crisis management (the Netherlands is used only in the reaction phase). This system has a modular design, distributed database, and mirror server. Synchronization allows the data recording in a system gets registered in other systems. NISNC is designed for static and dynamic data collection, with offline access allowed only in the Netherlands. The most common functional capabilities of the NISNC in selected countries were resource management, communication and reporting, status management and geographic information system. 

NISNC leads to the improvement of cooperation, information exchange and coordination in the management of natural crises through providing methods, terminology, information formats, and standard operating procedures.

Worldwide prevalence of Multiple Sclerosis (MS) is growing, and given the huge burden on the patient, the community and the healthcare system, prevention interventions and symptom management in order to improving the quality of life of these patients are of utmost importance. One of the most important strategies in this regard is providing the existence of an MS population-based registry. Accordingly, this research was aimed at providing a population-based MS registry model. This is a qualitative study, carried out within the years 2016 and 2017. The population of the present study consisted of models of multiple sclerosis population registries. In this study, a model was provided using library resources, informational networks and information retrieval from databases of PubMed, Google Scholar, Springer, Science direct, and Wiley and also through studying the registry of developed countries. Then, this model using Delphi technique and questionnaire tool was validated and after data analysis, the final model was presented. In the present study, a demographic MS registry model including the following eight main criteria was proposed: registry goals, data sources, minimum data set, data set, data processing, various types of reports, quality control measures and patient follow-up procedures.  Considering the prevalence of MS in Iran and the need for optimal data management, it is recommended that measures be taken to establish and use a national MS population-based registry and be one of the priorities of the Ministry of Health and Medical Education.

 The healthcare in different countries faces challenges in enhancing the quality of services and reducing the costs. Information governance provides a tool for effective and efficient management of information, the use of which contributes to improved productivity, and effectiveness of services and reduced costs. Identifying the applications and benefits of using this tool paves the way for its accurate and effective deployment in a variety of healthcare organizations. This study was conducted to identify and classify the applications of information governance program within healthcare systems. The study reviewed English studies related to the information governance applications in healthcare published during 2000 and 2017. The publications were identified by searching the Pub Med, Google Scholar, ProQuest, Scopus and Science Direct databases. The key words included, but not restricted to, information governance, health information governance, information governance program and impacts of information governance in health care. Having completed the search, 128 studies were retrieved, of which 23 were reviewed. The Information Governance program applications were categorized into five general groups, including improving healthcare and patient safety, reducing the costs, enhancing the quality of data and information healthcare, enhancing the security and confidentiality of patient information, improving the management of information and healthcare organizations. Through developing and implementing of Health Information Governance programs, updating information and upgrading information technologies, healthcare organizations could improve the quality of healthcare services and reduce the subsequent costs to achieve competitive advantages.