نشریه مدیریت اطلاعات سلامت
سال یازدهم شماره 5 (پیاپی 39، آذر و دی 1393)

A patient accounting system is a subsystem of a hospital information system which provides comprehensive information to identify patients’ charges from admission to discharge. The main aim of this research was to compare the data elements of patient accounting systems with users’ requirements. The current research was a quantitative study completed in 2012. The participants were the users’ of patient accounting systems used in the hospitals affiliated with Tehran University of medical sciences. Stratified sampling method was used to select the participants (n=216) from 2 hospitals, and six patient accounting systems used in these hospitals were selected to compare their data elements with the users’ requirements. The research instruments were a questionnaire and a checklist. The content validity of the questionnaire was confirmed by experts and its reliability was checked using internal consistency test (α0.95). Face validity of the checklist was confirmed by the experts. The mean value of > 3 showed the importance of each data element. The most important data elements were identified and compared with the systems’ data elements to determine the fitness between these two. To compare users’ views, Mann Whitney U test (α=0/05) was used. The results showed that among the data elements of an inpatient billing, the charges of healthcare services were the most important data elements from users’ perspectives. There was a significant difference between the views of managers and other users about the importance of the ‘type of insurance’ (P=0/025) and ‘the type of patient medical records’ (P=0/036). Generally, the findings showed that the current patient accounting systems were able to meet 70 -80% of users’ information needs. User involvement in designing and developing health information systems is one of the influencing factors on information systems’ success. As a patient accounting system covers an important part of the hospital’s financial information, it should not be excluded and weaknesses should be identified and addressed properly.

With regards to the growing use of computers in the triage along with other parts of healthcare systems, and by considering this fact that the Ministry of Health and Medical Education of Iran suggests the Emergency Severity Index (ESI) as an appropriate triage system, this study was conducted to develop a domestic model for an electronic triage system. The intelligent Electronic Triage System (ETS) was developed based on ESI version4, using PHP programming language and MySQL data base. The system designed to be a web based application. The purpose of this structure was to improve the triage process in terms of precision, speed and ease of use. The ETS, based on input data, determines triage level and treatment room automatically. The ETS was designed to be used in Emergency Departments (EDs) in hospitals. Its main users are the triage nurses, ED physicians, ED head nurses and supervisors. Besides performing triages automatically, the ETS has some advantages such as search and report functions, and also calculating two indexes suggested by the Ministry of Health and Medical Education on triage, including average triage time and the under-triage and over-triage rate. In this study the domestic Electronic Triage System was developed in Tabriz University of Medical Sciences, for the first time in Iran. With current trend of implementing computerized systems in hospitals, the Electronic Triage System can be used as a model for computerizing triage at EDs.

Physicians when interacting with technology like other people are worried due to the mismatch of information technology with their information needs. This can be a reason for their unwillingness to information technology. This study was conducted to investigate barriers and facilitators in physicians’ adoption towards information technology in health area. This descriptive - applied study was performed on doctors in Semnan city in 2012. This study was census and all of the population (200 people) was studied. Data collection was conducted by a valid، reliable and researcher- made questionnaire which its valid was measured based on literature review and expert opinions and its reliability was performed based on test and re-test. Data were analyzed by descriptive tests and SPSS 16. 43 (35. 5%) reported structured data، 31 (38. 8%) selected the speed in obtaining information and 18 (29%) chose error reduction as the first to third priorities for their desire to use clinical information system. 59 (50. 4%) reported the lack of integrity of clinical information system in medical issues as the main obstacle to use of computers in clinical areas. 69 55. 6%) selected the increasing of awareness towards clinical information system as the first solution to increase doctors’ willingness to information technology. It seems the resolving of the barriers and the strengthening of the facilitators through cultural promotion cause to increase physicians’ adoption towards information technology in health area and it leads to change physicians’ culture and organizational behavior and reduce their cultural resistance toward information technology.

The materials of library must be organized based on international standards, so that the user's information needs are met favorably and accessibility to the library materials is facilitated. This research aimed recognizing the approaches of increasing theeffectiveness of the organization of materials courses in view of the University of Isfahan and Isfahan University of Medical Science's students in BA. A descriptive survey method was used. The population included 154 BA. Students in the second to seventh term of 2011-2012 in University of Isfahan and Isfahan University of Medical Sciences. Out of these, 87 students were sampled. It was used a researcher made questionnaire for gathering information. The questionnaire was scrutinized by 4 experts for the validity and the Crunch's alpha was calculated %96 for the reliability. In order to analyzing the data SPSS was deployed for calculating percentage, average, standard deviation, One sample t- Test, and HotellingsT2. The p-value of t-test (Sig= /001) showed that the amount of all factors was higher than the average. On the other hand, HotellingsT2 showed that effectiveness of improvement of professional skills and facultie's abilities (4/15) is more than the other factors and effectiveness of preparing the facilities (3/79) is less than the other factors. Teaching the organization of materials courses is not enough, but it must be paid attention to various factors too, such as improvement of professional skills and facultie's abilities, the contents of the organization of materials courses regarding to student's needs and interests, and preparing the facilities.

Due to its close relationship with the health care and biomedical engineering position in society and Iran’s Position in the world in this field of science, this study compares the world scientific outputs and scientific cooperation in biomedical engineering in the Science Citation Index, between the years 2002-2011. Research method is analytical in which scientometric indicators in analysis of co authorship are used. Research society consisted of 12044 research and academic outputs in biomedical engineering which are indexed in the Science Citation Index during 2002 - 2011. To extract data, we used from version 5/7 Web of Science database and counting and data analysis was performed using Excel software. America (4427), China (990), Germany (869), Canada (818) and England (754), held the most biomedical engineering outputs. The most sub-subject area belonged to materials science (5896), biophysics (1904), and sport science (863).The trend for top subject areas was the cooperation of more than four authors. America (1207), Germany (484), England (478), China (341), and Canada (335), had the most share of cooperation, in scientific documents of biomedical engineering. Elsevier, Wiley-liss, Springer and IEEE were the most active publishers. Top world authors were from America, Portugal, and the Netherlands. The documents with 4 (2268) and 3 authors (2190) exceeded other co-authored documents. Top world research centers consisted of: Calliff System University (America), Montreal University (Canada), Harvard University (America) and Toronto University (Canada). From among 90 countries, Iran (55 records) holds 28th world rank and the third rank in South West Asian countries. No significant relationship was found between the number of co-authors, number of scientific works of the authors and citation absorption. The countries had the more collaboration with other countries were the most productive ones. So there were the direct relationship between the scientific collaborations and the rate of scientific outputs. For the reason that biomedical engineering has the interdisciplinary nature itself, numerous scientific groups’ specialists are required and the rate of scientific collaborations of this field is daily exceeding. Finally, it may be asserted that the growth of team cooperation and products of researchers of biomedical engineering in the world is ascending and scientific ideals of our country seriously require professionals and the government supports and programs.

Scientific trend analysis can help inform Research topic trend, challenges, and solve these challenges. The purpose of this study is to identify World current Status in the field of health information management and informatics. In this Content analysis and scientometric study, 1502 articles published in the Health Information Management and Health informatics were analyzed from 2008-2012. Data were analyzed using Histcite, SPSS 16, Bibexcel, VOSviewer. Data were categorized in to 14 conceptual fields by Health information management professionals. In this research four main clusters were identified from 100 most cited articles in health information management. Data were collected by Health information management in to 14 subfields. With most papers classified in the information systems, information technology, interoperability and security and safety. Social networking, web-based systems and mobile phone technology, new approaches in the literature of health information management. The diversity of research, innovation in research, applied research or implementation experience of being a major feature articles in the field of information management in the world.

Information seeking behavior is the most important subject of researcher’s interest for identifies the real needs and problems of the users in retrieving and using information. The outcome of the process at the Search Information Review the manner and type of information that can be referred Gnndgan offered. The aim of this research is Comparison on Information Seeking Behavior of the Post Graduated Students in Isfahan University of Medical Sciences and Isfahan University in Writing Dissertation based on Carol Kuhlthau Model of Information Search Process in 2012. Research method is survey and data collected tool is Narmenji questionnaire that is based on kracker questionnaire, namely "research process questionnaire” and it is localized. Validity tools confirmed by LIS professionals. The population of the study was all master students of Isfahan University of Medical Sciences and Isfahan University who entered the University. The sample size was determined 196 people based on the Cochran formula and sampling was simple random. Type of statistical was description (mean and frequency) and inferential (Independent T-test and Pearson Correlation) and the software which is used was SPSS20. The findings showed that there were some major differences in following up the Kuhlthau model between students of Isfahan University and Isfahan Medical Sciences University, so that Isfahan Medical Sciences University followed only In one or more stages the order steps of this pattern. In the first stage (uncertainty) and sixth (relief), no significant difference was found between students at the two universities. While none of the stage of thoughts, there was no difference between the two universities. Differences in actions (total stages) were significant between these two universities. Also there was a significant and inverse relationship between the third stage (Exploration) of feelings and age of students. The results showed that in writing dissertation Isfahan University students did not act in accordance with the stage of Kuhlthau model and only Isfahan Medical Sciences University student 20% act in accordance with its order. There are significant differences between some of the stage of feelings and actions of student's information seeking behavior of two universities. There is significant relation between fourth stages (Formulation) of feelings Kuhlthau model with gender in a way that men show greater confidence in the information seeking process.

Most of the errors occurred in otolaryngology department are preventable; This study was aimed at assessing the selected processes Otolaryngology surgery Department using Health Failure Mode and Effects Analysis (HFMEA). This was a descriptive research that quantitatively and qualitatively analyzed some failure modes and effects used five steps of health care failure modes and effects analysis methodology which was presented by VA national center for Patients’ Safety. Eindhoven classification model was applied to identification of root cause of the analyzed failures. It was determined recommendation by TRIZ model. To analyze the qualitative data the descriptive statistics (total score) and for analyzing quantities data content analysis and consensus opinions of team members were employed using Excel software. The five high risk process were prioritized by “voting method using rating” for HFMEA. The HFMEA team identified; 22 processes, 48 sub-processes and 218 possible failures withinthese process. 8(3.6%) failure modes (hazard score>=8) were identified and entitled as "failures with non-acceptable risk” and were moved into decision tree. The main root cause for (hazard score >=4) were: (14.34%) technical- related factors; (31.9%) organizational- related factors; (45.3%) human- related factors and (7.6%) other factors. The cause of failures allowed intervention to be recommended. Creation and review policy and Clear and transparent procedure”;” Patient participation in treatment process”; “Reengineering work and monitoring processes”; “Training of guidelines and recommendations” and “improving communication between hospital departments” were used as actions for optimization and quality improvement

In present condition of the offered system of hospital emergency services, increased morbidity and mortality in patients with acute myocardial infarction and the bustle of emergency units and the delay in admission and offers of emergency interventions in acute coronary syndrome patients have high stats. The necessity of reducing the time of emergency interventions and improving the quality of services provided to these patients has importance and high regard. That is the most important indicator inthis field, to assess patient's satisfaction of services provided. This study aimed at determining the relevance of patients’ satisfaction and quality indicators of emergency interventions in patients with acute coronary syndrome that referred to heart emergency unit of selected educational and treatment center of Isfahan. In this analytical cross-sectional study with a simple sampling, 81 patients with symptoms of acute coronary syndrome that referring to selected educational and treatment center of Isfahan participated to determine quality indicators of emergency interventions and patient satisfaction of interventions, with completion three questionnaires after measuring and analyzing the validity and reliability of questionnaires (α-kronbakh=93%). Data were analyzed by descriptive statistics (mean and standard deviation) and inferential statistics (Pearson) and were processed by SPSS20 software. Patient's satisfaction rate of the quality of emergency interventions was 81.4±12.4. Pearson correlation coefficient indicated inverse relationship between the times of emergency interventions with patient's satisfaction. (P = 0.07, r = -0.16). Present results suggest that emergency interventions have been effective in increasing patient's satisfaction. Increase the level of patient's satisfaction can be provided with employing codified medical programs in order to improve the quality indicators of this center’ services and a continuous monitoring of the services.

On one hand, risk management is capability of recognition available risk factors. And on the other hand it is risk analysis and the selection of appropriate strategies to control and eliminate it. The purpose of this study is to identify, assess and provide appropriate actions to control, reducing and eliminate risks in the ICU ward in Azahra hospital in 2012, with the FMEA technique. The present study is a qualitative research conducted in 2012 through direct observation, interview with the officials and authorities in the ICU ward, and available document review. The participants include nurses who identify the process of ICU ward. 4 people were selected purposefully. To collect the data, the standard worksheet of the failure mode effect analysis (FMEA) technique was used. The finding suggested that 58 failure modes were identified in the ICU ward in Alzahra hospital in Isfahan from among which 13 potential failure modes were related to general practices, 5 cases to neurological care, 8 cases to gastrointestinal care, 6 to the sampling, 5 to the medication, 4 to skin care, 17 to respiratory care. Of course some errors were discovered were common. According to the findings, several causes underlie errors in nursing cares. Overuse of nurses by setting the sequential shifts and rely on nurses who have been trained under and also stressful work environment shortage of qualified and expert nurses, endanger the patient's health due to the possibility of errors in nursing work. The best solution is to promote the improvement of hospital staff. The results of this study can be nurses and nurse managers are made aware of the dimensions underlying operating errors and a new approach to planning and greater attention to patient safety and Health Maintenance can be explained.

Effective and suitable Customer Relations Management is an important subject especially in service organization. Customers’ satisfaction is a critical and important factor for achieving goals in new organizations approach, and organizations have known that to achieve their corporate goals there is no way except making an appropriate relationship with customers and gaining their satisfaction through implementation the Customer Relations Management. However research shows that many of CRM projects (about 60- 70 percent of them) had not succeeded in practice, that different factors influence these unsuccessfulness. The main objective of this study is to determine the main factors that cause failure of the organization is customer relationship management. In this study, the descriptive section of the questionnaire survey and interviews with managers, consultants and experts of the system (Forty people) is utilized. Also, with help nonparametric methods and statistical analysis using SPSS software and using student T test, factors affecting accuracy wasconfirmed. The faculty and administration of questionnaire was confirmed by experts and its reliability using alpha Cronbach's 81%, respectively. In this research, monitoring and management system for outreach ministry in 2011 as one of the most comprehensive customer relationship management projects within the health system at the headquarters of the Ministry of Health and Medical Education are examined. Based on the results, it was found that, organizational processes with statistic number 9.067, Technology with statistic number 8.122, Organizational Culture with statistic number 13.259, management with statistic number 8.658 and cost with statistic number 7.964, in Student t test with Error level of 0.05 as main factors in the success of the project in the health sector, are effective. Although variety of factors can influence unsuccessfulness of health CRM projects, this research funding shows identified five factors introduces as key factors.

One of the main preferences of Ministry of Health and Treatment is organizing emergency department as one of the busiest wards in hospitals. To gain goals, hospital management is of most importance. This study aimed to assess the relation of demographic and professional characteristics of emergency ward managers and structure, process and practice in these wards. In this cross-sectional study, data were gathered by a checklist and a researcher-made questionnaire. The validity and reliability of questionnaire were proved. The demographic and professional characteristic of emergency ward managers and structure, process and practice in these wards of 12 teaching hospitals associated with Tehran University of Medical Sciences, Iran were assessed. The checklists and questionnaires were completed by observation, interview and use of dossiers and instruments. Finally, the data were analyzed using SPSS soft ware. There was not any significant relation between the manager's sex and work experience in emergency ward with management, human resources, space, equipment and materiel, teaching process, and recipes and practice aspects in these wards. Only, the relation between work experience and human resources was significant (P = 0.040). According to our study, male and female managers are similar in direction of emergency ward. Job history is no different in management manner, too. Only, the managers with less job history have tendency for presence in emergency ward, cooperation with other specialists, and nursing training.