جستجوی مقالات مرتبط با کلیدواژه « Electronic Health Records » در نشریات گروه « پزشکی »

Healthcare-associated infections (HAIs) pose a significant challenge to patient safety and healthcare systems worldwide. These infections, acquired during medical care, can lead to prolonged long hospital stays, increased morbidity and mortality, and substantial healthcare costs. Identifying and managing risk factors associated with HAIs is crucial for effective prevention and control strategies.

This study aims to systematically review the application of artificial intelligence (AI) techniques in Healthcare Associated Infections (HAIs).

A systematic review was performed that follows the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. PubMed was used to search for HAI publications with an emphasis on AI that were published during and post-COVID-19 pandemic. The terms “artificial intelligence” and “HAIs” were used to search for the publications.

A total of 29 articles were included in the systematic review. The most commonly studied healthcare-associated infections (HAIs) were ventilator-associated pneumonia (VAP) and hospital-acquired pneumonia (HAP). However, other HAIs such as hospital-acquired bloodstream infections (BSI), urinary tract infections (UTIs), surgical site infections (SSIs), Klebsiella pneumonia bloodstream infections (Kp-BSI), incubator infections, skin infections, central nervous system infections, meningitis, central line-associated bloodstream infections (CLABSIs), and tracheobronchitis were also examined, although to a lesser extent.

By providing a comprehensive overview of the current landscape of AI solutions in HAI research, this review seeks to facilitate knowledge exchange, promote further research collaborations, and ultimately contribute to the development of effective strategies for preventing and managing HAIs.

 This study presents the legal obligations set for the main stakeholders in the establishment and implementation of electronic health (e-health) records in Iran and investigates the fulfillment of these obligations.

 This qualitative study was conducted using document analysis. The research population comprised all the documents, laws, reports, and policies of the establishment and utilization of electronic health records in Iran. Sampling was purposive, and all the internal documents of Iran were included until the end of May 2022. A data extraction form was used to collect the data, and Scott's criterion was used to select the documents. Descriptive analysis was used to analyze the data.

 Based on the documents, 56% of the sentences were implemented, and 22% were not enforced according to the assigned tasks. The status of the execution of tasks by the main players was also extracted. The most important of these included the drafting of the electronic health security and privacy regulations, not providing the conditions for receiving electronic copies in the e-records, creating internal automation for the Ministry of Health and Medical Education instead of the e-health records system, instability of the integrated portal for exchanging health information and disconnection of the majority of service centers, eliminating the extension of the validity of paper booklets, operationalizing the online entitlement system, using the first phase of the electronic prescription project, not inserting nursing notes in the records, recording financial and administrative information instead of clinical ones, refusal of numerous doctors to write electronic prescriptions, using an alternative method of two-step verification instead of electronic signature, the progress of coding and drug authenticity, and the non-implementation of medical equipment coding.

 Reviewing the status of the enforcement of approvals also revealed that the format of actions since 2018 has ended with a positive result. The main achievement so far has been electronic prescription, while it should be noted that prescription is only part of the electronic health record project.

Over the last few decades, several theoretical frameworks have been proposed to evaluate electronic health records (EHRs). These frameworks provide a theoretical basis for assessing the impact and outcomes of technology adoption in healthcare settings. This can help identify areas for improvement and ensure that EHRs effectively support healthcare delivery and patient care.

The purpose of this study is to present a comprehensive review of the use of validation methods in Electronic health records.

Out of a total of 62 EHR evaluation frameworks in our previous literature review, at the final stage, 34 relevant articles were included for analysis. Variables such as participants and study setting, analysis software, data gathering methods, missing data, and outlier handling, theoretical basis models to develop the EHR evaluation model, the relationship between variables of the EHR evaluation models with evaluation items, sampling technique and sample size reliability assessment methods and values, and statistical validation methods and criteria values were extracted.

Among the 34 papers that disclosed the validation methods utilized, the most widely used technique was Structural Equation Modeling (SEM), employed in 26.5% of the studies. Other methods utilized were Confirmatory Factor Analysis (CFA), and Exploratory Factor Analysis (EFA). A reliability assessment was performed in 82% of the articles. Cronbach's alpha and composite reliability (CR) were popular reliability (internal validation) methods on identified papers.

It is our belief that the results of this study can assist researchers in examining and modifying EHR evaluation frameworks to suit their specific needs. Additionally, we believe that our findings serve as a solid foundation for the creation of new EHR evaluation frameworks. Furthermore, we recommend that researchers utilize the findings presented in this article to enhance the implementation and utilization of SEM, CFA, and EFA methods in EHR evaluation models.

Hospital management issues have been one of the most important concerns of governments. These challenges involve medical staff and health policymakers more than ever during crises such as the Covid-19 epidemic. Lack of hospital beds and special-care facilities, medical staff shortage, and immediate reduction of drug inventory is among the most important problems in critical situations. Designing technological management solutions and using existing potentials to evaluate the condition of hospitals at the macro level can greatly reduce the incidence of such problems.

In this study, an attempt is made to prevent the aforementioned problems using a technological solution in Hospital Information Systems (HISs), where a directorial analysis in evaluating the facilities and limitations of medical and healthcare centers on the one hand, and the architecture of the Electronic Health Record (EHR), on the other hand, is performed. Launching an online system transferring the live status of beds between the HIS and EHR systems is the first step, and adopting macro-management approaches to use the available treatment capacities for optimal patient coverage is the second step.

This system is launched nationally based on the current platform of Iran's EHR at a low cost. Collecting patient data during the stages of admission, treatment, and discharge, while facilitating the monitoring of the hospital beds, helps to enrich the content of the EHR, as well as the launch of online management-monitoring dashboards.

Patient status monitoring, bed vacancy, and the discharge rate of hospitals could be monitored offline and lately, and we improved it by providing a novel model.

Electronic health can lead to health preservation and promotion using information and communication technologies to receive and record accurate data, appropriate storage, and retrieval, as well as the health information management approach. The present systematic review aimed to assess the E-health application during the COVID-19.
Information &

The present systematic review was done based on PRISMA protocols. The study data were retrieved using the E-health and COVID-19 keywords in the related studies from August 4, 2021, in PubMed, Scopus, Magiran, and Sid databases. Moreover, the inclusion criteria were original research studies that used E-health to manage patients with COVID-19.

A total of 10 articles were included in the study, 40% of which focused on the impact of E-health on reducing fear and anxiety caused by COVID-19, 30% on the E-health in early diagnosis and progression of the disease, 10% on the E-health application in the field of prevention, 10% on E-health in the field of disease control, and 10% on E-health for quick investigations of the disease process and access new medical information. The used technologies included virtual training through WhatsApp video calling, Instagram, iGap and Telegram voice and text messaging, artificial intelligence, and data mining techniques.

E-health tools played a prominent role during the COVID-19 in the prevention, diagnosis, control, and fear reduction of coronavirus disease. Various practical strategies such as financing, implementation and legal requirements can be considered to effectively use the capabilities of eHealth tools in disease management.

Electronic referral system (e-Referral system) in Iran was launched to increase access to care and improve interaction.

The present study aimed to design an appropriate model for evaluating the performance of the e-Referral system in Iran.

This study was conducted in three stages: 1) review ofliterature related to electronic referral systems, 2) qualitative phase, and 3) quantitative phase. Participants in the qualitative phase included 42 managers, policymakers of the Ministry of Health, medical universities, service providers, and recipients who were purposively selected for this study.Data were analyzed through content analysis. In the quantitative phase, the target group consisted of 604 staff of medical universities implementing the e-Referral system. Data were analyzed using the EQS (version 6.3) and SPSS (version 20) software. Chi-square test, degree of freedom, the goodness of fit index, root mean square error, adjusted goodness of fit index, and the Friedman test were used to investigate the suitability of the model.

Fourteen main themes were identified and classified for the model design Based on the results of the present study. The components of developing rules and regulations, stakeholder advocacy, economic evaluation, and quality of health services hadaverage ratings of 13.99, 13.00, and 11.35, respectively, regarding their role in designing the evaluation model for the e-Referral system in Iran.

The results of structural equation modeling showed that the components play an essential role in designing the performance evaluation model of e-Referral in the Iranian health system.This study addressed various aspects affecting the e-Referral and provided the possibility of performance evaluation in the health sector in a principled and systematic format. Health managers and policymakers can use the present studyfindings to discover the strengths and weaknesses of the e-Referral performance.

The Electronic Health Record is a collection of medical information about a person's health status. The development of electronic health records has occurred worldwide, and developing countries, including Iran, have been no exception and have tried to take action in this regard. Therefore, this study aimed to review the types of Electronic Health Records designed in Iran.

Information & Methods:

This systematic review was conducted without any time limitation until 12 June 2022 by searching the keywords "Electronic Health Record", and "Iran", and their synonyms in the Web of Science, PubMed, Scopus, SID, and Magiran databases, and Google Scholar search engine. Published articles on the development or design of electronic health records in Iran were reviewed.

Among 28 papers, 11, 6, and 11 records were designed in Electronic Health Record, Electronic Medical Record, and Personal Electronic Record formats, respectively. Approximately 46% of the studies only designed electronic records but never implemented them, and the rest (54%) had completed the electronic record development. Among 15 implemented records, 7, 4, and 4 were in Personal Electronic Record, Electronic Health Record, and Electronic Medical Records formats, respectively. In addition, implementation platforms for records were in the form of web-based, mobile-based, and windows-based applications. Most of the minimum data set in the designed records were demographic data, medical history, therapeutic procedures, and laboratory tests.

Designing various Electronic Health Record systems for different diseases and clinical conditions can be an effective step toward developing a national Electronic Health Record.

The Integrated Health Record System, locally known as the “SIB,” is the most used information system for recording public health services provided to the Iranian population. The objective of this study was to evaluate the success rate of the SIB using the Clinical Information System Success Model (CISSM).  

This is a psychometric and evaluation study. The CISSM has a 26-item instrument that assesses 7 constructs in 3 following stages: (1) the socio-technical stage (facilitating conditions, social influence, information quality, and system performance(;  (2) the integrated stage (system use dependency and user satisfaction); and (3) success outcome stage (net benefit). A Persian version of the CISSM instrument was validated and applied in this study. Based on this instrument, the reliability and the validity of the CISSM were assessed. The SIB success rate was evaluated using a validated CISSM. The study participants were 758 SIB users from different disciplines and different levels.  

Assessment of content validity, construct validity, internal consistency, and test-retest reliability showed acceptable psychometric properties of the CISSM instrument. The results demonstrated that the SIB success rate was in the moderate range (59.6%). Facilitating conditions and information quality were strong predictors of use dependency and user satisfaction, while both of these 2 constructs significantly influenced net benefit.  

The SIB success was in the moderate range, and it needs to be enhanced. Therefore, Iranian healthcare policymakers should consider working on the most important factors influencing SIB success (facilitating conditions, information quality, use dependency, and user satisfaction) to improve SIB success.

Information systems enable the managers to access the proper information needed to make decisions. Management decision making based on real information leads to increased efficiency and effectiveness. Problems related to information system will lead to incorrect information and consequently incorrect decisions. Therefore, this study was conducted to investigate and identify the challenges of ISs in healthcare organizations.

This study is a systematic review. PubMed/Medline, Scopus, PMC and Iranian databases such as Magiran and SID were searched from 2013 to 2018. English and Persian studies were searched using keywords including IS, Hospital Information System, Health Information Technology, Health Information System, Medical Information Reporting System, Electronic Medical Record, Electronic Health Record, Medical Informatics, Health Informatics, Nursing Information System, Nursing Informatics, hospital Management Information System, Nursing Clinical Information System, Pharmacy Information System, and Electronic Medical Record System. In the initial search, 300 studies were identified. After screening the studies using the exclusion criteria, 101 of them were selected. Then, through complete reviews of full texts of the studies, 54 of them were excluded from the study. The rest of the articles were coded by Esterberg method and 6 themes of challenges were extracted.

The results showed that the challenges of IS in the health system included structural, manpower, financial/support, security, process, and organizational challenges.

To achieve the success and effectiveness of IS and make the right decisions based on the proper information, it is necessary to eliminate the issues that lead to problems in these systems.

The purpose of the Electronic Healthcare Record is to improve the service quality by reducing medical errors, prevention, monitoring, diagnosis, prioritization, treatment, follow-up, provision of effective ways to communicate and share information between health care providers, and better health information. While benefiting  EHCR, physicians just like to practice medicine. These changes have created a new level of complexity that makes physicians feel frustrated and dissatisfied with medical practice. Therefore, one of the factors that affect EHCR is the physician's authority, which  affects the acceptance or non-acceptance of EHCR. The present study aimed to investigate the effect of using electronic health records on physicians’ authority. Qualitative data collection was performed by a semi-structured interview with eight physicians, three specialists and four psychologists. The data collected show the users’ perceptions of the impact of EHCR on the physicians' careers. All participants experienced the use of EHR in the health care system. A total of three dimensions were identified to assess the impact of the perceived threat of professional independence on the physician’s acceptance of EHCR, increased managers’ control, loss of professional privacy and professional authority, data trust, and security. When technology negatively affects the job roles, professional status, and independence, resistance is more likely to occur. The results of the study show that the design and implementation of EHCR should be in a way that does not threaten the autonomy of physicians. If the electronic health record system is designed and implemented without regard to the issue of autonomy, it will be nothing but a "cookbook" for doctors, and they will not welcome it.