نشریه مدیریت اطلاعات سلامت
سال سیزدهم شماره 7 (پیاپی 52، بهمن و اسفند 1395)

Peripherally inserted central catheters (PICC) are utilized in neonatal intensive care units (NICUs) as an instrument to vascular access. The PICCs significantly reduce side effects compared to central and peripheral venous catheters and can be the cause of catheter-related bloodstream infections (CRBSIs). The purpose of this study was to create a fuzzy expert system for the early diagnosis of PICC-related infections in newborns.
This descriptive-applied study was conducted in 2016. The statistical population of this research consisted of the medical files of newborns in Children's Medical Center in Tehran, Iran, and sampling was carried out using convenient sampling method. The research tools were a checklist and questionnaires. Factors affecting infection diagnosis were determined based on pediatric specialists’ comments. The system was designed bilingually (Persian and English) using C# software and SQL Server database. The output of the system is the percentage of infection risk. The system evaluations were carried out using data from the medical files of newborns in a hospital in Tehran, Iran. Data was analyzed using Excel software.
Based on system assessment and comparison of the system output with the diagnosis of the specialists, the sensitivity, specificity, and accuracy of the system were 95%, 88%, and 91%, respectively.
The non-specificity of clinical signs and laboratory findings of blood infection in newborns have made its diagnosis difficult and uncertain. Using a designed expert system can be effective in the diagnosis of CRBSIs.

Health information technology (HIT) experts can work in any position that requires knowledge related to HIT. The aim of this study was to identify current and future occupational opportunities for HIT graduates and appropriate strategies to increase it.
This was a descriptive and cross-sectional study. The study population consisted of graduates in medical records (109 people) and HIT (30 individuals) working in hospitals in Tabriz, Iran, and all managers of the related centers (40 individuals). Data were collected using two researcher-made questionnaires through interviews. The reliability of data was calculated using Cronbach’s alpha (α = 0.85(. Data were analyzed using descriptive statistics.
Most HIT experts were working in the medical records department of hospitals. The most preferred job positions among HIT graduates were in research centers (60.2%) and health insurance (66.6%). Non-hospital managers believed (40%) that the main reason for graduates’ lack of employment in organizations was the unfamiliarity of relevant organizations with graduates’ abilities.
Introducing HIT graduates’ scientific and practical abilities to society seems to be an essential measure. Accountability to the information needs of health and non-health environments requires a suitable balance between theoretical and practical courses.

Medical Terminology is one of the specialized courses of the Health Information Technology (HIT) educational program, requires the recollection of numerous words, and educational tools could improve learning in this course. Mobile applications have been used as educational software and have recently received much attention. This study was conducted with the purpose of determining the effect of mobile educational content on study frequency, motivation, and educational improvement among HIT students.
This quasi-experimental study was performed on 12 HIT students (in their second semester) of Tabriz University of Medical Sciences, Iran. Educational improvement of students was examined using pretest and posttest scores and the effect of the software on students’ motivation and study frequency was determined using a researcher-made questionnaire. The validity of the questionnaire was confirmed by professors and its reliability was confirmed using Cronbach’s alpha. Data were analyzed using descriptive and analytical statistics (paired t-test and McNemar’s test).
The use of educational software had a meaningful relationship with educational improvement (P The use of mobile educational software along with traditional methods of study can lead to academic improvement and motivation among students in the medical terminology course.

Health information is one of the key pillars of effective management of health care services, and has been recognized as the main factor in the operation and integrity of health systems. As most health information is provided by the medical records department, the use of risk management is necessary to protect information assets. The aim of the present study was to investigate risk management in the medical records department of Alavi Hospital of Tabriz, Iran, using failure mode and effects analysis (FMEA) technique.
This study was an action research. The study population consisted of the medical records department staff of Alavi Hospital. Data gathering tools was a FMEA checklist. The validity and reliability of the checklist were approved. Data were gathered through the observation of the medical records process and focus group discussion with medical records department staff.
There were 31 possible failure modes; 10 failures were related to inpatient admission process, 8 failures to medical filing, 8 failures to releasing medical record information, and 8 failures to quantitative and qualitative analysis of records.
FMEA technique is an effective method for risk management in the medical records department. In this approach, risks are identified and assessed. Then, a series of intervention measures are planned to control risk levels. These procedures lead to reduced risk level.

In order to design and develop an efficient electronic health record (EHR) in Iran, the assimilation of health information systems based on a common language for the interpretation and sharing of information with HER is essential. The current research provides an object-oriented design for gynecology data management based on unified modeling language (UML). By applying this model, it is possible to improve interoperability capabilities of Iranian EHR.
This applied, developmental, and cross-sectional study was carried out in 2015. First, published minimum data sets on gynecology and prenatal care in Iran were evaluated. Then, experts assessed and verified the most comprehensive minimum data set for Iran. In the next step, an object-oriented model was designed based on specific data patterns which were extracted from international standards matched with Iranian EHR to satisfy the interoperability requirements of healthcare information. Finally, the object-oriented design was created by applying UML in visual paradigm software package and the prototype of the system was developed.
The designed system was directly used by 3 people as main users (clinical secretor, physician, and system administrator). Moreover, this system can interact with the Iranian EHR as an external actor. Use case, activity, sequence, and class diagrams were drawn. Data elements were coded based on national coding standards.
Coordination of standardization of different components using software analysis and design is necessary for the successful implementation and pervasive acceptance of EHRs. Object-oriented analysis and design provide a suitable tool for the modeling complexity in software systems. Applying content and technical standards in the design and implementation of EHRs render it useful and applicable in terms of information integration and interoperability. Keywords: Electronic Health Records; Gynecology; Object-Oriented Design

Data in death certificates are a basis of epidemiological studies. Since registering causes such as signs and symptoms is not informative in data processing, this research aims to determine their rate of registration in death certificates.
This study was a descriptive, cross-sectional research. The study population included all death certificates with R00-R99 codes for cause of death. Data were collected using a checklist. Chi-square test was used to calculate the significance of relationships.
The findings show that, in 11.3% of death certificates, symptoms and sign were reported as the cause of death. The use of symptoms and sign as causes of death was higher in private hospitals (33.7%) than other hospitals. The use of symptoms and signs as causes of death was 51% in the age group of over 60 years of age which was higher than any other age groups. Based on the findings, reduction in the length of hospitalization resulted in increased rate of recording of symptoms and signs as causes. Most reported symptoms and signs (50.9%) were in ill-defined and unknown causes of mortality (R95-R99).
The results of this study show that symptoms and signs are often recorded as cause of death. Therefore, it is necessary to take steps in order to improve the data of health records.

The resource-based relative value scale (RBRVS) system is used to reimburse physician services in health care systems. The aim of the present study was to study the features of RBRVS system in order to provide a framework to estimate reimbursement of physician services based on the resources used. This narrative study was carried out by surveying 90 articles and other documents. The adoption of the RBRVS system required the use of the Current Procedure Terminology (CPT) code to determine Relative value units (RVUs) of physicians’ work and practice expenses as major components. Geographic practice cost index (GPCI) and conversation factor were the modifier factors. With the employment of this system, the actual costs assigned to each medical service, even in offices, are determined and patient’s out-of-pocket payment is conducted fairly.