دکتر فرید خرمی

This study aims to monitor the scientific productions of the faculty members at Hormozgan University of Medical Sciences (HUMS) during the COVID-19 pandemic indexed by Scopus using the citation and altmetrics indexes.

This is a descriptive-analytical study using a scientometric approach in 2023. The study population consists of the articles of the HUMS faculty members during the pandemic (2020-2022) indexed by Scopus. The search was conducted using the affiliation identifier form of the Scopus database with no restrictions on the type of study. The search yielded 956 articles (152 articles related to COVID-19). Altmetrics extension was used in Google Scholar search engine to check the status of works in social networks. Bibliographic information, citations and altmetrics index of the articles were entered in Excel software and then analyzed using descriptive and analytical methods in SPSS software, version 26.

The rate of attention paid to all articles and COVID-19-related articles was 90.27% and 46%, respectively. The attention was mostly paid by capture (68.89%), social media (8.8%) and view (8.4%), according to the altmetric indicators. There was a strong and positive correlation between the citation index and the altmetrics index of the COVID-19-related articles. These articles were mostly visible on Mendeley, followed by Twitter and Facebook.

Information about the visibility of articles in different social networks along with the number of citations can lead to efficient competition among faculty members in social networks.

In the health system, reimbursement methods are an important criterion for the allocation of resources and the performance of service providers. The use of diagnosis-related groups (DRG) system reduces the length of stay and additional costs of the patient, prevents unnecessary treatment, increases resource efficiency and transparency of health care services. The development of the DRG system focuses on the accurate documentation of medical records and the correct coding of diagnoses and procedures. The purpose of this research is to evaluate the documentation and coding requirements of medical records in the implementation of a payment system based on diagnosis-related groups in Iran.

This research was descriptive-cross-sectional and was conducted in 2022. The data collection tool was a researcher-made checklist, the validity of which was confirmed based on the opinion of experts (health information management health economics) and its reliability was obtained by calculating Cronbach’s alpha (0.83). The research population consisted of 418 medical records in five medical training centers affiliated to Urmia University of Medical Sciences, which were selected through stratified-proportional sampling. Data were analyzed using SPSS software.

The results of the evaluation of the documentation and coding requirements of medical records for the implementation of the DRG system showed that the demographic/administrative variables including age, sex, type of admission, length of stay, health insurance, and doctor’s expertise were completely recorded. Evaluation of clinical variables also showed that the main diagnosis, main procedure, secondary diagnosis and other procedures were documented in medical records in 98%, 97%, 88% and 75% respectively. Regarding the coding of the main diagnosis and the main procedure, 100%, secondary diagnosis 68% and other procedures 80% have been done.

Considering that some essential clinical variables for the implementation of DRG, especially co-morbidities, complications and other procedures are not recorded separately and completely, therefore it is necessary to define separate information elements in medical records and HIS for accurate recording of these variables and proper interaction between coders and doctors is established to increase the possibility of correct coding. It is also suggested that the DRG system be implemented in our country in a phased and gradual approach so that necessary changes are made in the documentation process and hospital information systems.

Clinical coding is a complex and error-prone process. Correct clinical coding requires high-quality documentation of medical records. This study aimed to identify the quality of medical records documentation and the accuracy of coding with ICD-10 compared to ICD-11.

This cross-sectional descriptive study was conducted in 2022. The samples were chosen from 11638 medical records of patients admitted at the Shahid Mohammadi teaching hospital with the diagnosis of injury, poisoning, and certain other consequences of external causes. Using Cochran's formula, 500 medical records were evaluated. The research was conducted in two stages to check the accuracy of coding and the defects in the documentation of medical records for coding. The research data collection tools were separate checklists for each stage. Data were analyzed using descriptive statistics in SPSS software.

The number of codes allocated to the studied medical records was 1673 and 1468 codes based on ICD-10 and ICD-11 classification systems, respectively. The majority of records (98%) had at least one type of major or minor error, 23% had only major errors, 46% had only minor errors, and 31% had both types of ICD-10 coding errors. Moreover, 81% and 26% of the medical records contained adequate information to fully or relatively fully describe the codes using ICD-10 and ICD-11 classification systems, respectively.

Compared to ICD-10, there were more defects in the documentation of medical records for coding with ICD-11. Development written documentation guidelines by ICD-11, using templates and reminders, and providing feedback to healthcare providers. Using automated coding support tools, coding audits, and continuous training of coders are essential for coding quality improvement.

 

The payment system based on diagnosis-related groups was created to control the costs of health care services, increase efficiency in inpatient care, and improve transparency in hospital activities. The success of this system depends on complete and accurate documentation of medical records and correct coding of diagnoses and procedures. This research aimed to determine the problems of documenting medical records to implement a payment system based on DRGs.

This research was a qualitative study that was conducted using the semi-structured interview method in 2022. The research population included experts in health information management and health economics at Urmia University of Medical Sciences, who were selected purposefully. Data analysis was done through content analysis using ATLAS.ti software.

From the point of view of the interviewees, the most important problems of documenting medical records in the implementation of DRGs, included the lack of clinical documentation guidelines, the lack of necessary information elements, the lack of accurate evaluation of the quality of documentation, and coding, the lack of continuous training courses, the incompleteness of documentation, and the lack of sufficient interaction between doctors and coders were in the hospital.

The results of this research showed that some essential variables for implementing the DRGs system are not defined separately and clearly in the medical records and the hospital information system, and the quality of the documentation and coding is not accurate and complete. Therefore, it seems necessary to consider separate information elements for the main diagnosis, the main action, and the comorbidity and complications in the standard medical record forms.

The preparation, sale, or use of controlled drugs (CDs) require close regulation, and misuse of these drugs can have irreversible side effects. Therefore, the present study aimed to design a web-based system entitled San-Tech for monitoring of CDs.

This is a practical development study carried out to design and establish a program to monitor controlled drugs. The study was performed in three stages. At first, the informational and functional elements of the program were identified through interviews and investigations. In the second stage, they were reviewed and approved by experts. Then, this system was designed using the C # programming language, the server with ASP.NET Core API technology, and the user with Angular technology.

The informational elements required for this system included 70 items in the classes of the patient, drug, prescription, physician, specialty, pharmacy. Nine functions are also considered for this system to apply more control over the use of CDs. The system was designed and available for pharmacies at https://pharmacy.hums.ac.ir.

This system can record some information, including patient and physician details, type and number of CDs, and the time of visit. According to this information, pharmacies, as well as Food and Drug Administrations, could monitor the sale and use of CDs

The reimbursement mechanism of the cost of treatment is an important factor which directly or indirectly affects the financial management and control of hospitals costs، hence different countries use different reimbursement systems. This study evaluated the prospective reimbursement system (global system); at one of the hospitals in Hormozgan University of Medical Sciences. This descriptive-analytical study evaluated 1286 Global inpatient records in Fekri hospital affiliated to Hormozgan University of Medical Sciences. First the actual cost of care and length of stay for each of the global records was extracted using the hospital information system. Then the average cost and patient''s stay for each of global procedures were compared with the cost and length of stay determined by Iran global system. Data analysis was performed using descriptive statistics and T-test was used to test the research hypothesis. One quarter of all inpatient records belonged to global payment system. 62% of global records belonged to OB/GY operations، 20% to general surgery and 18% to ophthalmic surgery. The analysis of the cost of 86% of surgery global records showed to be beneficial for the hospital، where 91% of these cost differences were found to be significant. For more than 99% of cases in global system، the average length of stay was less than average standard length of stay، and for 64% cases this difference was found to be statistically significant. Regarding the reduction of length of stay of patients in global payment system، the review and implementation of global payment system for other diagnoses and operations is highly recommended.

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. 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. 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. 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.

Given the ever-increasing importance and value of information, providing the 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 of medical equipment offices. This descriptive applied cross-sectional study was carried out in 2008. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy at hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the view points of managers). Of all, 4% of information needs were obtained through the form, 14% through both the form and database, 11% through the web site and 71% had no sources (forms, databases, web site). Since 71% of the information needs of statistic managers had no information sources, development of information system in these offices seems to be necessary. Despite the important role of users in designing information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing information systems.

Proving management with a reliable information system, can facilitate decision making regarding planning, organization and control. This study aims to evaluate information needs of Iranian Nursing Offices. This applied, cross-sectional research utilizes critical success factor (CSF) and business system planning (BSP) methods to assess information needs Iranian nursing offices. Of 78 identified information needs, 56% were initial information needs of managers. 18% of information needs were found to be critical success factors of managers of nursing office. The first priority of managers was "the number of manpower employed at hospitals separated by wards". 5% of the identified information needs were not priorities and thus excluded, 3% were through the web site and 70% were without sources. Despite the important role of users in designing information systems, other scientific methods also need to be utilized in designing information systems.