نشریه مدیریت اطلاعات سلامت
سال سیزدهم شماره 2 (پیاپی 48، خرداد و تیر 1395)

To successfully implement new information systems in health care, especiallyý electronic medical ýrecords,ý it is important to understand the factors that influence the adoption of these systems in ýthe opinions of users, particularly managers.ý Therefore, the purpose of this study was to ýdetermine the factors affecting the adoption of electronic medical records using the technology ýacceptance model (TAM).
This descriptive-analytical survey was conducted in 2015. The study population consisted of ý235 top and middle managers of teaching hospitals in Shiraz, Iran. The subjects were selected through census method without the use of sampling. Dataý were collected using the standard ýTAM questionnaire and analyzed in SPSS and LISREL software using regression analysis,ý independent t-test, and ANOVA.
The findings of this study showed a positive direct relationship between perceived ease of use ýand attitude of the users (r = 0.46) (P In evaluations and plans, through the consideration of factors of perceived usefulness and ýperceived ease of use, which affect the attitude toward use, the adoption of the electronic medical records system among top and middle managers in hospitals can be improved.

Numerous studies have evaluated health information systems in Iran, but most studies have not ýfollowed a standard format for reporting their findings. The objective of this study was to ýevaluate the compliance of health information systems’ evaluations published in Persian journals ýwith the Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI).
This was a review study in which papers reporting on evaluation of health information systems ýwere assessed in terms of 51 principles of the STARE-HI using a checklist. These papers were ýretrieved from the Persian databases of Magiran, IranMedex, and SID using appropriate ýkeywords. Data were classified and reported based on 13 main sections of the STARE-HI.
From the 727 retrieved papers, 36 were relevant to the study objectives. All paper had an ýintroduction section, but none of the paper had the authors’ contribution and conflict of interests ýsections. The mean compliance of articles with the STARE-HI was 71.4%, with the lowest being ýý52.94% and the highest being 82.35%.
The writing style and structure of studies evaluating health information systems require ýimprovementsþ.þý The quality of study reports can be improved through reporting essential ýinformation in articles and using corresponding guidelines in the design of authors’ instruction ýsections of journals. Improving the reporting format of papers can result in better and higher rate ýof application of study results and increased citation of articles.

Although many studies have been conducted on thalassemia from different aspects, none of ýthem have yet identified the preferences of parents of patients with thalassemia major in ýreceiving health information. Parents of these patients need appropriate and timely ýinformation to manage and resolve the problems of their children and family. This study ýaimed to identify the preferences of these parents in obtaining information to manage their ýchildren’s health.
This was an applied, descriptive, and cross-sectional research. The study was conducted ýthrough interviews with the parents of patients with thalassemia major who were admitted to ýthe pediatric ward of a hospital affiliated to Semnan University of Medical Sciences, Iran, in ýý2014. The data collection tool was a valid and reliable researcher-made questionnaire (Cronbach’s alpha = 0.87). The data were analyzed using descriptive statistics and the ýFriedman test.
According to the results, 39.6% of the parents reported obtaining information about mental ýhealth problems as their first priority, while 56.6% of the parents reported obtaining ýinformation about the side effects of Desferal as their first priority. In addition, 56.6% of the ýparents preferred that the information be given to the patients’ father.
The results indicated the type of information parents prefer to obtain first. Informational ýsupport can help the parents better manage their children’s illness. Transference of valuable ýknowledge through several information sources to the parents can lead to improvement of ýhealth in the society and parents feeling that they are socially supported.

Despite the great importance of comprehensive evaluation of mobile health services, as a part of ýnovel health services, most researches have only focused on the evaluation of the technical ýaspects and have neglected other aspects of these services. The main objective of this study was ýthe identification and prioritization of the indicators and dimensions of mobile health systems’ ýquality by considering all critical aspects including technical, information, and interactive ýdimensions.
This applied and descriptive study was conducted through survey method. A questionnaire was ýused to collect data the validity of which was confirmed by academic experts. The statistical ýpopulation of the study included experts of health services quality evaluation with emphasis on ýmobile health with more than 3 years of experience in this field. Using judgmental sampling (non-ýprobability purposive sampling), 28 subjects were selected and questionnaires were distributed ýamong them. The content validity of the scale was confirmed by experts and its reliability was ýapproved through calculation of inconsistency rate for all pairwise comparison matrixes (less than ýý0.1). The collected data were analyzed using the analytic hierarchy process in Expert Choice ýSoftware.
The interaction quality dimension was the most important among the dimensions of quality ýassessment of mobile health services. In addition, the indicators of privacy, effectiveness, safety, ýreal-time performance, accountability, after-sales service, and patient-centered services were ýrespectively, the most important quality indicators.
It is necessary to study mobile health services in the context of other health services and not just ýsimply as software. The success of a mobile health system is based, first, on the quality of general ýhealth service indicators such as accountability, patient-centered services, and privacy, and then, ýon the quality of software system indicators. Therefore, it is necessary for all stakeholders to be ýinvolved in the process of designing a mobile health service in order to improve the chances of ýsuccess.

Scientific collaboration is a process in which two or more scientists collaborate in a project or ýwrite an article. The purpose of this study was the mapping of scientific collaboration among ýIranian researchers in the field of radiology in the Science Citation Index until the end of ýý2014.
This applied research was conducted using scientometric and network analysis methods. The ýstudy population consisted of all scientific publications in the field of radiology in the Science ýCitation Index until the end of 2014. A total of 1938 documents were retrieved. Data were ýanalyzed using HistCite, VOSviewer, UCINet, PAJEK, and Excel software packages.
The scientific production growth rate was 11.3. The Tehran University of Medical Sciences ýý(661 documents) was the most prolific university in this field. The collaboration network ýshowed high density (63%).
The collaboration network analysis showed that Saghari, Beiki, Eftekhari, Javadi, Assadi, and ýFallahi were the most important authors and the majority of scientific collaboration took place ýamong them. The clustering coefficient of the collaboration network was 0.52.

Librarians in academic libraries should have suitable information literacy skills in order to ýaccess the information they need and meet the needs of their clients. Hence, the present study ýaimed to evaluate and determine the status of the three levels of information literacy skills ýand their related factors among librarians of Mashhad University of Medical Sciences and ýFerdowsi University of Mashhad, Iran.
This applied research was conducted through survey method. The study population consisted ýof all librarians with a bachelor’s degree or master's degree in librarianship or non-librarianship ýfields working in the abovementioned university libraries (n = 120). Through non-proportional ýstratified random sampling method, 80 individuals were selected as the final sample. The ýassessment tool was a researcher-made questionnaire the validity and reliability (Cronbach's ýalpha = 0.86) of which were confirmed. Data were analyzed through descriptive statistics ýý(frequency distribution, mean and standard deviation) and inferential statistics (one-sample t-ýtest, independent t-test, ANOVA, and Duncan's post hoc test) in SPSS software.
The librarians’ information literacy status was less than desirable; neither of the elementary, ýbasic, and advanced levels of information literacy had desirable scores among the librarians. ýThe mean scores of information literacy of librarians with degrees in librarianship and medical ýlibrarianship were significantly higher than that of librarians with other degrees. Moreover, the ýmean information literacy score of librarians with a master’s degree was higher than that of ýlibrarians with a bachelor’s degree. There was no significant difference between the mean ýinformation literacy scores of librarians based on their work experience.
The results of this study showed the undesirable status of information literacy and its three ýlevels among librarians. Moreover, it indicated the effective factors for improving information ýliteracy among librarians for the planners and administrators of the libraries of these two ýuniversities.

Hospital websites can be appropriate and effective tools for attracting medical tourism. However, ýmany structural and content criteria should be considered in designing hospital websites. The aim ýof this study was the evaluation of websites of hospitals affiliated to medical universities in ýTehran, Iran, based on information necessary for attracting medical tourists.
This study was carried out using applied survey method. The study population consisted of all ýhospitals affiliated with Tehran University of Medical Sciences, Iran University of Medical ýSciences, and Shahid Beheshti University of Medical Sciences, Iran, (n = 50). The data collection ýtool was the MDS-Hospital website questionnaire, the validity and reliability of which were ýapproved in previous literature (α = 0.90). Data were analyzed using descriptive statistics ýý(frequency and percentage).
The average score of the structural dimension of hospital websites based on the questionnaire was ýý64.5%. However, the average score of the contextual dimension of hospital websites was less ýthan 50%. The websites of hospitals affiliated with Tehran University of Medical Sciences and ýIran University of Medical Sciences had a more favorable score in terms of structural dimension ýand contextual dimension, respectively.
The websites of the studied hospitals had an acceptable status in terms of the structural ýdimension. However, they did not obtain favorable scores on the contextual dimension. Thus, ýthese hospitals must redesign their websites in terms of the contextual dimension in order to be ýmore successful in attracting medical tourism.

Since the relationship between the user and the web is through the user interface, it is ýessential that health websites be userþ-þcentric. The aim of the present study was to identify the ýstrengths and weaknesses of the user interface of health websites in Iran.
This applied and descriptive research was conducted using heuristic method. Based on their ýAlexa rank and the rate of related pages, 13 health websites were selected. The websites were ýexamined by 5 evaluators (3 graduates in computer sciences and 2 in medical library and ýinformation sciences) using a checklist containing 5 major criteria and 27 items. The data were ýanalyzed using descriptive statistics in Excel software.
The health literacy websites had observed 63.78% of the criteria of the checklist. The criteria ýof flexibility (89%), technical features (81%), and aesthetics and visibility (77%) gained the ýhighest scores, respectively. However, the lowest scores belonged to the criteria of help and ýdocumentation (36.9%) and responsiveness and interaction (35%).
The websites’ user interfaces were in relatively desirable conditions. According to the ýfindings, the criteria of help and documentation and responsiveness and interaction require ýmore attention. It is suggested that these websites resolve the identified problems and ýminimize the gap between them and the users, so that users can visit these websites more ýfrequently.

Strategic thinking is the infrastructure of artistic maneuvers of managers based on creativity and ýtrue perception of business environments. It results in the creation of strategies suitable to the ýpresent changing business environment. Due to the failure of strategic plans and organizational ýchanges in more than half of organizations, it can be concluded that there might be a common ýcause for these failures. The goal of the present study was to assess the relationship between ýreadiness to change and strategic thinking in managers of social security hospitals of Isfahan, Iran, ýbased on the Liedtka model including the five elements of systemic thinking, intensive focus, ýhypothesis approach, intelligent opportunism, and thinking in time.
This practical, analytical, and correlative research was conducted using the Strategic Thinking ýAssessment Questionnaire (α = 87.3) and Readiness to Dunhaim Change Assessment ýQuestionnaire (α = 84) in 2013. The participants consisted of 94 head, intermediate, and ýoperational managers of social security hospitals in Isfahan. Our response rate was 85% (80 ýquestionnaire). Data were analyzed using the Pearson correlation and regression analysis in SPSS ýsoftware.
Strategic thinking (Pearson coefficient = 0.25) (P Since there was an overall relationship between most elements of strategic thinking and readiness ýto change among the managers in this study, education and development of strategic thinking may ýenhance readiness to change among managers of institutions.

Due to the unfavorable condition of sport infrastructure in Iran, including locations, equipment, ýfacilities, and accessories, athletes and coaches are at an increased risk of accidents and ýinjuries. One of the main tools for protecting athletes in case of accidents is insurance. The ýobjective of this study was to determine the status of sports insurance from the perspective of ýinjured athletes and sports administrators in Chaharmahal Va Bakhtiyari Province, Iran.
This applied and descriptive study was conducted through field surveys in 2014. The study ýpopulation consisted of injured sport administrators and athletes in Chaharmahal va Bakhtiari ýProvince (64 managers and 278 athletes). From among them, 103 athletes and 42 officials were ýselected through convenience sampling. The data gathering tool was a researcher-made ýquestionnaire consisting of two parts; one part related to the success rate of insurance plans ýand the other on problems and obstacles to a successful insurance coverage. The validity of the ýquestionnaire was confirmed by sports management professionals, sports medicine experts, ýand insurance management experts. Its reliability was calculated using Cronbach’s alpha which ýwas equal to 0.84. Data analysis was carried out using descriptive and inferential statistics.
From the managers’ perspective, the Federation of Sports’ Medicine has not shown a ýsignificantly favorable performance in regards to mandatory sports’ insurance. Moreover, from ýthe athletes’ perspective, the Federation of Sports’ Medicine has only been significantly ýsuccessful in the prevention dimension (P Based on the findings of this study, the Federation of Sports’ Medicine, as the organization ýresponsible for the development of technical and medical services in sports, must create ýfavorable conditions for success in the treatment and prevention of sports related incidents and ýprovision of administrative services.

Primary health care is an effective approach to improving public health. Providing optimal ýcare requires supplication of various resources including financial resources. Thus, fraction ýof revenues of health care centers is one of the main problems in the domain of financial ýresources management. Therefore, the present study was carried out to identify the ýbottlenecks on dedicated revenues fractions in health centers.
This qualitative phenomenological study was carried out in East Azerbaijan Province of ýIran in 2014. Purposeful sampling method was used for the selection of participants. Focus ýgroup discussion and semi-structured interviews were used for data collection. Data ýcollection was carried out based on prepared guidelines and continued until data saturation.ýþ þThe validity of the guidelines was approved by qualitative experts. Data were analyzed ýusing content analysis method.
Based on the experiences and perspectives of participants, two main themes were extracted ýincluding cash fractions and none-cash fractions. Cash fractions consisted of three sub-ýthemes of discounts fractions, fractions related to deposit of cash revenues by health ýcenters, and registration fractions. None-cash fractions included fractions related to sending ýdocuments, fractions in the insurer's reimbursement, and fractions per capita.
Fraction of dedicated revenues of health centers occurred in all cash and none-cash ýrevenues and also in all stages of conversion of service into revenue. Therefore, special ýattention and efforts are required in order to reduce these fractions.

Medication and its cost in the country's health care system are of grave importance. Thus, the ýaim of this study was to investigate the increase in medication costs in comparison to the ýincrease in medication funding per capita of the outpatients insured by the Iranian Salamat ýInsurance in Isfahan, Iran.
This was a descriptive-analytic study. The data were collected using an information form ýincluding the variables of pharmaceutical expenditure, pharmaceutical expenditure per capita, ýthe number of insured per city, approved cost per capita, operating cost per capita, the number ýof pharmacies, expensive drugs, drugs with the highest rate per capita, and drugs with the ýhighest frequency of use. The collected data were analyzed using descriptive statistics and the ýPearson correlation coefficient.
From 2009 to 2013, the drug costs constituted, respectively, 25, 23, 22, 22, and 31 percent ýof the total health care costs of the Iranian Salamat Insurance. Amount per capita in 2013 ýcompared to years 2009, 2010, 2011, and 2012 were 58, 49, 28, and 21 percent higher, ýrespectively. Drug operating cost and its growth rate had increased during the studied 5 ýyears, compared to the approved costs per capita. More than half of the total drug cost in ýý2009-2013 was allocated to the 35 most expensive drugs. The Pearson correlation showed ýthat with increase in operating cost, the number of visits to pharmacies decreased.
Revision of drug reimbursement, substitution of lower-cost drugs, and modification of the ýprescription pattern used by physicians can be effective in the optimization of drug costs.

The Iranian national excellence award is a quality award which is used as a management instrument ýfor assessment of performance of organizations. The aim of this study was to evaluate the ýperformance of hospitals of Abadan School of Medical Sciences, Iran, based on the Iranian ýnational excellence award.
This practical and cross-sectional study was conducted in the summer of 2014. The research ýsample included 7 hospitals affiliated to Abadan School of Medical Sciences which were ýinvestigated using census approach. Managers and experts attempted self-assessment after ýparticipation in one of three two-day workshops and familiarization with the RADAR structure and ýlogic model through group work. The data collection tool was a 135-item standard checklist of the ýmodel containing categorized in 54 pages based on the criteria and sub-criteria of the model. Scores ýwere analyzed using Excel and SPSS software.
Among the 7ýþ þevaluated hospitals, two had a score higher than 300, two had scores of 200-300, and ýthree hospitals had a score of less than 200ýþ.þý The average total score (from 1000 points) and the ýaverage score of development (total: 500 points) and results sections (total: 500 points) were 222.6 ýý± 71.4, 109.8 ± 32.6, and 112.8 ± 47.9, respectively. There was a significant correlation between ýdevelopment score and size of hospitals (under 64 active beds: 96.5 ± 43.4, and over 64 active ýbeds: 119.9 ± 23.5) (P = 0.02).
The results indicate that the studied hospitals are among beginner and developing organizations, ýand thus, need to improve and develop their organizational performance.

Medical tourism is one of the branches of the tourism industry and, due to its low cost vs. high ýincome, many countries seek to maximize their competitive resources in order to develop this ýindustry. Moreover, improving service quality is considered a key factor in gaining medical ýtourist's satisfaction. In Iran, Shiraz is one of the main destinations of medical tourists; therefore, ýthe present study aimed to determine medical tourist's expectations and perceptions of the ýquality of services provided by hospitals in Shiraz, Iran.
The current study is an analytical,ýþ þapplied,ýþ þand cross-sectional study whichþ þwas carried out in ýý2013. The study populationþ þconsisted of 200 medical tourists who referred to hospitals in Shiraz (Ordibehesht, Doctor Khodadoust, Pars, Madar and Koudak, and Markaziþ þand Dena). In order ýtoþ þcollectþ þinformation, an adaptation of the SERVQUAL questionnaireþ þwas used. The validity of ýthis questionnaire was approved by experts and its reliability was confirmed separately for ýexpectations and perceptions using Cronbach’s alpha (90% and 89%, respectively).ýþ þDataþ þwere ýanalyzedþ þusingþ þpaired t-test in SPSS software.
The findings of this study showed negative gaps in all dimensions of quality. Overall quality gap ýwas estimated to be -0.38. The largest gap pertained to the dimension of reliability (-0.6) andþ þthe ýsmallestþ þwas related toþ þthe dimension of accessþ þ
toþ þcare (-0.08).
The present study showed that theþ þquality of servicesþ þdid notþ þcorrespond to medical tourists’ ýexpectationsþ þand needed improvement. Moreover, improving the reliability aspect of the services provided by hospitals can be an effective factor in increasing the satisfaction of medical tourists.