نشریه مدیریت اطلاعات سلامت
سال دهم شماره 5 (پیاپی 33، آذر و دی 1392)

Development of electronic health records and application of international terminologies to obtain semantic generalization is one of the challenges of healthcare system. Therefore، it seems essential to register nursing care in electronic health records in a standard fashion and on the basis of one of classification systems. The aim of this research was validating of mapping and usage ability of Clinical Care Classification system in nursing documentation in Neonatal Intensive Care Units. This descriptive research was a content analysis study and research population، were babies'' records and nursing care were performed on hospitalized newborns in Neonatal Intensive Care Units. Sampling was done by surveying 503 reports and extracting nursing care for hospitalized infants in the first quarter of 1390 and observational checklists were used to access 48 unregistered care in mentioned above records. Data gathering tools were questionnaire and observational checklists that their validity and reliability were assessed through content validity and inter-rater coefficient. Recorded reports of nurses were analyzed by content analysis and obtained expressions were adapted with the diagnoses and coding system’s interventions and clinical care classification. Credibility of gain adaption was approved using the Delphi method in two rounds. Findings showed most components of care in Neonatal Intensive Care Units were related to respiratory care and drug administrative component (16. 5 %). The most frequent of nursing diagnoses was related to respiratory condition of infants such as mechanical ventilation-dependency (21. 1%) and the most nursing interventions were related to ones that were performed by physician order such as blood sampling and medication (23. 9 %). In next step، performed nursing cares in Neonatal Intensive Care Units were specified and adapted to classification system of clinical care and adaption rate was 36. 1%. Low adaption rate showing lack of standard record and as result coding and classification system is required to register care in standard fashion. Using coding system and classification of nursing care، the problems of lack of usage the nursing process framework، lack of standard care and problems of registration the nursing reports in electronic health record will be solved largely.

Supporting a therapeutic approach and medication therapy management، pharmacy information system acts as one of the central pillars of hospital information system. This ensures that medication therapy is being supported and evaluated with an optimal level of safety and quality similar to other treatments and services. The present study was an applied، descriptive and analytical study which was conducted on the pharmacy information system in use in the selected hospitals. The research population included all the users of pharmacy information system. The research sample is the same as the research population. The data collection instrument was self designed checklist developed following the guidelines of the American Society of Health-System Pharmacists، Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and pharmacy information system pharmacists and users. The findings of the study on the pharmacy information system revealed that the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists، the highest rank in observing the input standards belonged to Social Services hospitals with a mean score 32. 75. While teachingEducational hospitals gained the highest score both in processing standards with a mean score of 29. 15 and output standards with a mean score 43. 95 and the private hospitals had the lowest mean score of (23. 32،17. 78، 24. 25) in input، process and output standards respectively. Pharmacy Information System (PIS) is composed of three data banks، namely patient information، medication information (managerial، financial and scientific data) and medication prescriber information. It is expected that this system be effective in three fields of operational management، financial management and scientific support to the medication services in hospitals. In addition، it is also expected that administering and using these data banks entail reduction of errors and increase of the speed of managing the orders and dispensing the medications. Hence، when PIS is to be administered، informational requirements and hardware، software، manpower and educational resources needed for establishing the medications plans، standards، policies and laws must be taken into account. In sum، the findings of the present research showed that among the 8 information systems in question، the Social Services System and Pouya Samaneh gained the highest ranks in observing the input standards، while the highest mean score in meeting the standards related to processing and output standards belonged to Sayan Rayan e Ekbatan System and Modiriat e Amar System respectively. It is worth noting that due to inattention to such system''s capabilities، all of them suffer from some deficiencies that need to be obviated Since one of the most significant and effective elements of PIS، i. e. medication''s scientific data bank has been ignored and the PISs in question have not been equipped with some software suitable for providing the prescriber with scientific backup in his/her making decision process، the prescribers have just contented themselves to their own information making medication errors in health care domain inevitable. Before designing and administering PIS، due attention must be given to the users'' informational requirements as well as their expectations from the system. The availability of informational elements effective on managing and monitoring the medication related complications، reducing medication errors، checking the medication therapy information to ensure the suitability of medication regimen and medication warns to identify drug allergies، system potential relation with other systems supporting physicians in their making decisions and at last، recording the prescribers'' orders are some capabilities that can promote this system so that it can be regarded as a clinical system with a treatment approach.

Electronic health record contains a wide range of information systems that makes possibility of all information about nursing care plans، Prescription، physical evaluation، current complaint and immunization based on known standards، usability of this system by its users، particularly physicians is vital and important considering complexity of EHR. So، this study was conducted with aim to investigate the physicians'' expected factors result from implementation of EHR in Hormozgan University of Medical Sciences in 2012. This study was an applicable and descriptive- analytical research and was conducted in Hormozgan University of Medical Sciences in 2012. Research population was included 129 people composed of faculty physicians and residents according to Census Method. Research tool was a questionnaire from Morton'' PHD thesis in Drexel University. Validity of the questionnaire was measured by ideas of specialists and experts and its reliability through test-retest that was %78. Collected data from this questionnaire was analyzed using SPSS19 Software، descriptive statistics methods (frequency distribution and percentage tables، statistical indicators، mean and standard deviation)، statistical test، T-TEST and one way ANOVA. The most obtained scores were related to management support factor (3/65) and lowest ones were proper and adequate Training (3/17). Based on implementation barriers of HER the highest percentage was related to economic costs (84%) and the lowest one was personnel resistance against new technology (50%). The most important benefit of HER is including increased control over business activities (82/9%) from view point of physician. According obtained results from Hormozgan University of Sciences، physician faculty members and residents are agreed to implement HER in this university and there is ability and readiness to implement HER considering provided ideas.

Although nurses are among the main users of hospital information systems، sometimes their resistant to using information technology are reported. The main objective of this study was to compare nurses’ satisfaction with، and expectations of، hospital information systems in Firoozgar and Imam Khomeini teaching hospitals. This was an applied research study. The study population was nurses worked in Firoozgar and Imam Khomeini teaching hospitals. The study sample was 267 nurses. Data were collected using two questionnaires. Content validity and coefficient Cronbach Alpha were used to check the validity and the reliability of the questionnaires. Data were analyzed using descriptive and inferential statistics (t-test). The results of the study showed that most of the nurses’ expectations of the system were not met in Firoozgar (n=88، %92. 6) and Imam Khomeini (n=74، %89. 2) teaching hospitals. Also، the results showed that there was a significant relationship between the nurses’ expectations confirmation and the perceived system usefulness (P<0/001)، between the nurses’ expectations confirmation and their satisfaction with the systems (P<0/001)، and between the perceived system usefulness and nurses'' satisfaction with the systems (P<0/001). The findings of the study suggested that the nurses’ expectations of hospital information systems were not met in most areas. It seems that more attention should be paid to the nursing processes and nurses’ information needs. Moreover، it is necessary to involve nurses in the process of designing and developing hospital information systems.

Because of increasing incidence of burn injuries، prevention programs become more important. Accurate information is the essential requirement for implementation of such programs which obtained based on correct and high quality coding. In this research، coding quality for burn injuries in deceased and non-deceased patients'' records in Tabriz Sina Hospital were studied and compared.

This was a cross-sectional comparative study. Research population was included 1500 medical records of hospitalized burned patients in Sina hospital، Tabriz in 2010-2011. The sample size based on pilot study was determined 75 cases from each groups and was performed using systematic random sampling. Data were collected using a data extraction form that content validity was confirmed by panel of experts. SPSS software version 16 has been used for data analysis and descriptive and inferential statistics such as frequency، percentage، mean، SD and Mann-Whitney test were applied.

The accuracy of 41. 8% and completeness of 61. 4% were obtained from the deceased patients’ record while it was 47. 3% and 71. 2% for the non deceased patients respectively. The fifth character were not been coded in neither deceased nor non-deceased group. Timelines was average 50 day that there was great distance with standard of WHO (2 days).

To improve the coding quality in the deceased patients، coding of other diagnosis and activity should be considered by coders. Accordingly some attraction، punishments، or relative regulations should be defined for coders to attract them to do their best and on time coding in line with entrance of codes into Hospital Information System.

Weblogs as one of the web facilities، are used for information exchange and interaction between people. There is a wide variety of medical information on the internet and there is not adequate monitoring on the quality and accuracy of these information. It seems nessesary to measure the quality of these information with standards. The aim of this study was to compare Persian obstetrics، gynecology and midwifery blogs with selected criteria In a descriptive study، Google advance search engine was searched for Persian obstetrics، gynecology and midwifery blogs and 45 blogs selected and evaluated by a checklist. The blogs selected from three blog Service Providers: Blogfa، Blogsky and Persianblog. All blogs with at least five posts related to obstetrics، gynecology and midwifery and meanwhile the posts that were released from Augest 2010 to December 2011 included to this webometric study. The data were analyzed using SPSS 16 and Excell software. Comparing selected blogs with 23 criteria in the cheklist، showed that the rate of blogs was good in 9 criteria، bad in 9 criteria، fair in 3 criteria. It was impossible to comment in 2 criteria because of interval data. One of the blogs titled Pezeshki-e-Balini was the best blog with a highest score (1618. 65). According to the results، Persian gynocological blogs suffer from poor qualification. Regarding the role of such information sources in improving women and mothers’ awareness، it seems that much more efforts and attention by managers to improve the quality of these blogs is essential.

Nurses need to have extended information in their profession and their decision may have a vital slue for patients. Up to date information may lead to easier decision making for them. Due to the fact that how nurses get their information from sources and what’s the barrier to access to the sources and evidence، we decided to study the information-seeking behaviors of nurses in educational hospital in Yazd، Iran. Research community of this analytic study was consisted of 320 nurses that have been worked in Yazd Academic Hospital with at least one year history of professional working. Data gathering was done via a questionnaire that its validity was approved with Cronbach''s Alpha 0/78، it included sources of information، goals of research، Problems of access to information and information needs. Data analyzed by SPSS 17 software and tested with chi-squire test. Our study showed that most of nurses had license certificate and was female with mean working history of 9. 81±7. 29 year. The most important informational needs knew about new developments in nursing filed. Time limitation was the important preventing factors in 74. 8% of nurses. For information searching the internet was the most used source (public search engines) for updating their knowledge. Nurses know that information is important in their occupational. Availability to new and up to date information in nursing filed needs some training and having some special skills. Upon to our study we suggest that hospital managers must take some special time for nurses training and research activities.

Knowledge sharing is one of the most interesting and challenging issues of management in the new millennium. This study aimed to investigate individual factors affecting knowledge sharing among faculty members in universities and research centers. This survey was mixed and applied. Statistical Population was 3430 faculty member worked at medical research centers and 12428 faculty members worked at medical universities in Iran during 2012-13. According to stratified random sampling at least 423 faculty members selected as sampling population. The tool used in this study was questionnaire that face and content validity were confirmed by experienced professors. The Cronbach's alpha coefficient for each scale dimension was greater than 0.6, so the reliability of the instrument was confirmed. For data analysis, descriptive and inferential statistics, statistical software SPSS15 and Pearson Correlation Coefficient was used. The findings of the study showed that about 49 percent of faculties had a positive view of knowledge sharing. About 53 percent of the faculties were very willing to share knowledge with others. 35 Percentage of faculties share knowledge with different incentives. About 52 percent of the faculties expressed the role of trust and commitment for sharing knowledge very high. The results of this Study will provide empirical basis for planning and implementing knowledge sharing mechanisms.

Today، the increasing production of information in the health has caused the use of modern technologies for the utilization of information in this area. In order to link the health with information technology، today in most world industrialized countries especially European countries، smart cards have a special place in the health system. Health smart card is Issued in order to facilitate access to people information and is replaced the Insurance Prospectus. The purpose of this study was identification of the Health Smart Card effects Identify in Promoting quality of health care from Experts views. The method of this study was the descriptive- survey and the purpose was the application that was conducted in 1390. The study population consisted of Manager، Assistants، Senior، Heads of Branches and Premium Sectors Deputies Department of Mazandaran Province Social Insurance and a number of doctors that had at least 10 years of experience that among these، 30 of the experts were selected as sample. Research tools for data collection included Refer to the documentation، Observation and Especially Interviews and questionnaires and Data collection were with methods of library and field studies. Designed questionnaire validity was confirmed by the experts and Reliability was confirmed according to the questionnaire compatibility rate (0/07) that is less than 0/1. Finally data which collected through paired comparisons questionnaire، were analyzed using descriptive statistics and with the software of Expert Choice 11. General attitude of research society that 60 percent of them were men and 40 percent of them were women was positive about the effect of health smart card in promoting quality of health care. Results represents superior of service quality criteria with the final weight 0/277 in current situation. Then customer satisfaction index، Education index، Health knowledge index and Organization performance index with The Importance coefficients of 0/273، 0/257، 0/115، 0/077 was in the second to fifth priority. Based on the results to promoting the quality of health care with health smart card، attention to the service quality and customer satisfaction will be critical. Also it should take steps to establish the necessary infrastructure، setting appropriate standards، check of patients satisfaction from quality of health care and ongoing research in the field of health and e-health systems by researchers.

By diabetes outbreak in these days، prediction of tablet daily usage like Glibenclamid and Metformin helps doctors to recognize number of tablets، and prevents from drug abuse side effects. Also، it should be considered that the need of diabeticto drug is critical. So، in this paper we have used data mining techniques to predict the number of daily usage of tablets for diabetes. At the end، in evaluation process the algorithm that causes better results will be chosen. This study done by descriptive-cross sectional method. It done by Census sampling method and contains all 2783 patients from March 2008 to May 2012. The community research consists of Yazd Diabetes Research Center data dependent to Shaeed Sadoughi University of Medical Sciences Yazd and diabetes center agency confirms the records contents. In data preprocessing step، the records with missing value in some fields have been removed by the experts’ opinion and the number of patients reduced to 740 cases. These results have achieved by referring directly to the Yazd Diabetes Research Center and data gathering method validity confirmed by supervisor and specialists. Also reliability value have compared to each other for two used algorithms by measurement of test dataset accuracy. In this study Clementine 12. 0 has been used for data analysis and data mining algorithms application. Two different algorithms namely CHAID and C5. 0 have been used on data and then the generated models accuracy has been achieved. At the end، to confirm the accuracy، we have used clustering method. The obtained values for generated models accuracy by C5. 0 and CHAID algorithm''s execution on dataset was 45/52 and 28/38 respectively. The high accuracy of C5. 0 model shows the better performance of this algorithm for number of tablet usage prediction. In other hand، the low accuracy of C5. 0 model shows some values have not classified directly in own location، due to the comparison of actual and predicted values for number of tablet usage in model generation shows the reasons of low accuracy of each model. The reason was dependent to predicted values which had low accuracy and confidence. The clustering of obtained results of C5. 0 algorithm executing، put 3، 5، 6 and 7 of tablet usage with 46/83، 36/36، 55/71 and 15 percent of predicted value accuracy، respectively، in one cluster because the cases which have low accuracy or have low samples will be located in the same cluster. Also the clustering of CHAID algorithm executing results put 5 of tablet usage with 20/93 percent of predicted value accuracy in a cluster. This paper was done by Data Mining group''s research of K. N. Toosi University of Technology. Finally it has been completed by team work and resulted into present research. In Diabetes Center، an organized approach to predict number of daily usage tablets and prediction from side effects of false recognition in number of tablets is necessary. In order to prevent dangerous effects of diabetes، it is better to invent novel approaches by the help of expert consultant and use of computerized technologies، internet and analytical softwares.

Nowadays، major changes have made in governmental structures، particularly health systems. In these organizations، increasing costs and customer expectations have shifted government attention towards the proper management of resources. Undoubtedly the decision to manage resources properly requires information including financial information which provided by accounting system. There are two types of manner of cash and accrual which used in the public accounting system. In the cash accounting، disadvantages such as lack of relevant information on how to manage the assets and liabilities has led that nowadays، many countries are moving towards accrual accounting. About this reform in governmental accounting system، the researchers were prompted to determine the challenges of deploying such a system. This study is a systematic review، aimed to consider the challenges of implementing accrual accounting in the public sector in 2012. For this purpose، 28 articles with keywords of accrual accounting+challenges، accrual accounting، accrual accounting+challenges were explored from domestic databases like SID، magiran and international sites such as Google scholar، science direct، Emerald، Health Business and their content were analyzed. Challenges to deploy the accrual accounting in public sector were grouped in six categories of management and leadership (Justified and supported by senior management of the implementation)، followers (Accounting auditors and specialized consultation teams in executive levels of the system)، environment (Surveillance system)، structure (organizational structure relevant to mentioned change and development of a system for evaluating the performance of the work)، manpower (Expertise، motivation and satisfaction of manpower) and work processes and standards (Development of strategy and action plan and feedback from the performance and existence of a specific theoretical framework to the public sector. Based on the results، it was recognized that three concepts of management and leadership، followers and environment are as three driving factors in the deployment of accrual accounting in the public sector which influence the lower levels namely structure، manpower and process as independent factors and technology and knowledge are key factors in relationship between mentioned categories. So، according to these variables، it is recommended that a Road Map is developed for change in financial system and change management is done by it.

Telemedicine has been created interaction between the health care and information technology. Telepathology is considered as a supporter scientific for pathologists in telemedicine technology and can help accurate diagnosis and treatment of disease. In this research، we have studied about possibility of telepathology implementation with point of view the presence of manpower standards as a requirement for implementation in Training Hospital Of Tehran University of Medical Sciences. This study was an applied research، that the cross-sectional descriptive study was conducted in 2012. Training Hospitals of Tehran University of Medical Sciences، purposefully four hospitals selected and research conducted at these centers. Due to certain limitations of the study، the sampling was not used، and the study population was included 8 chief and administrator، 20 pathologist، and 8 authorities informatics. The data gathering tool was the researcher made questionnaires، which was prepared separately for each group of the study population. Reliability was evaluated. The average validity coefficient of correlation for the three questionnaires was obtained 0/98. And data were analyzed by SPSS statistical software. As a result، the awareness average of pathologists about telepathology was 2/98 with 1/17 standard deviation. The awareness percent average of managers and directors about telepathology was 57/5 percent and the awareness average of informatics staff was 27/5 percent. Managers and directors have declared that there was skilled manpower in the field of telepathology only 37/5 percent. Also the possibility of telepathology implementation with point of view the presence of manpower was 2/9 with 0/86 Standard deviation. Given the importance of telepathology، and manpower as an important contributing factor in the successful implementation، and also، according to research findings that manpower status was inappropriate for telepathology implementation، It is recommended that hospitals should provide skilled manpower for telepathology implementing.

Access to health care is a fundamental right of people in communities. Universal health insurance coverage by reducing financial barriers to access to health services is one of the important strategies. Achieving universal coverage is not a simple process. Many countries already have universal coverage، most of it has lasted decades. Studying of health insurance history in different countries is helpful to localizing certain situations due to local conditions، culture and Islamic countries and the many other intent to prevent errors and accelerate the implementation process effectively. The present article analyzed and evaluated the past experience of the development of universal coverage by social health insurance in 5 countries use of reviews the literature. Results show that all countries have increasingly followed the approach and development of the system، some took longer than others. The maximum transition period of 127 years in Germany and the lowest South Korea to 26 years. In all countries surveyed، the process moves to full coverage health insurance، a growing community with a population coverage of a systematic expansion in terms of the transfer. However، the preliminary findings are presented to achieve this expansion is different. Membership in the sickness fund was raising stable in some countries، but in other countries the expansion of membership by the Central Government has led medical insurance.