مجله انفورماتیک سلامت و زیست پزشکی
سال ششم شماره 2 (پیاپی 20، تابستان 1398)

Admission and medical record system (AMRS) is one of the most important subsystems of hospital information system, which is used by many users in admission, discharge, and health information management. Interface usability problems can reduce user speed, precision, and efficiency in user-system interaction. This study aimed to identify the usability problems of AMRS in a hospital information system.

In this descriptive cross-sectional study, five health information technology experts evaluated AMRS in a hospital information system using heuristic evaluation. Then, the system usability problems were categorized according to Nielsen's 10 usability principles and their severity were determined.

Totally, 62 unique usability problems were detected. The most frequent problems were related to "consistency and standards" (n=9) and ''recognition rather than recall" (n=9), and the least frequent ones was related to "flexibility and efficiency of use" (n=1). 59.7% of the identified problems were categorized as big and severe problems. The highest average severity of problems belonged to "system’s visibility" and "aesthetic and minimalist design", and the least average severity belonged to "error prevention".

Using heuristic evaluation, a large number of usability problems in AMRS were identified. According to experts' opinions, most of the HIS interface problems were big and severe, and they need to be modified by designers and developers of these systems.

Nowadays, smart systems and advanced tools such as wearable systems have grown significantly in order to monitor patients and keep their condition under control. The aim of this study was to determine the requirements for designing a wearable smart blanket system (WSBS) to monitor patients in ambulance instantaneously.

After reviewing the characteristics of wearable systems by conducting a comparative study, the requirements for designing the proposed system were determined using appropriate data collection methods. In the first step, studies were conducted to identify the requirements for the development of wearable systems, and in the second step, a questionnaire obtained from the studies was distributed among specialists, and based on the results obtained from the questionnaire, the requirements for designing the system were determined.

Wearable Smart Blanket System (WSBS) has special functional features such as monitoring of vital signs, ability to communicate with the environment, instantaneous processing of vital signs, the ability to alert when vital signs exceed the threshold, and the ability to record all the patients' vital signs. The main non-functional features of WSBS include easy installation and operation, interoperability, error tolerance, low power consumption, accuracy of signs recording, data evaluation and analysis.

The WSBS records all the vital signs needed for the control of patients seamlessly and provides interpreted data for the ambulatory treatment team. All patients' medical, diagnostic, and monitored health information are stored in the physician assistants' system, and therefore, allows them to provide early diagnosis.

Different factors are effective in detecting heart abnormalities. The greater the number of these factors, the greater the uncertainty in the detection of heart abnormalities. In the uncertainty condition in response of prediction model, the fuzzy systems are one of the most effective methods for generating an acceptable response.

In this applied study, 3240 records related to heart abnormalities were reviewed, each record contained heart sounds of healthy and unhealthy groups. Then, using fuzzy system, the rules of data for the input samples were extracted and the rules were used to categorize the heart abnormalities. Due to the dependency of the effective factors on heart abnormalities, many identical rules with a similar function that result in additional processing and reduced efficacy, will be produced. In the proposed method, the Hummingbird algorithm were used to choose the optimal output rules. Then, using the optimum output rules, the inputs data were categorized into normal and abnormal classes. Data were analyzed using the root mean squared error (RMSE) method.

It was revealed that the mean accuracy and time of diagnosis of heart abnormalities in the proposed method were 99.6% and 0.56 seconds, respectively, indicating higher efficiency compared to the other similar studies.

Compared to the other methods, the proposed model provides more accurate diagnosis and classification.

In the field of studying information systems, qualitative approach is one of the ways to extract the system requirements from the perspective of the users. Therefore, this study was performed to identify the functional requirements of the pharmacy information system from the perspective of the pharmacists using a qualitative approach.

This qualitative study was performed using conventional content analysis approach. In this study, 15 pharmacists who worked at hospitals affiliated to Fars University of Medical Sciences, were selected using purposive sampling. The data were collected through semi-structured interviews (30-40 min) in 2016. Data were analyzed using Graneheim and Lundman's method by MAXQDA v.10 software. Lincoln and Guba's criteria were used to ensure the accuracy and trustworthiness of the study

After analysis of the data obtained from interviews, five main categories and 13 subcategories were obtained. The main categories include the ability to accurately reconcile medication lists (medication reconciliation), update and flexible reporting, systems interoperability, integration with the decision support system, and access to the clinical information.

According to the results, evaluation of the systems before purchase and comparing them with the expected functional requirements of the users, are necessary. Also, in the case of intraorganizational design of these systems, skilled analysts who are familiar with health organizations should be employed to extract the users' needs.

The combination of mobile technology and medical expertise introduces a new feature called mobile health care, which provides new opportunities for improving patients' health. Physician's acceptance of mobile health services is an important factor in the establishment and adaption of such services. The present study investigated the factors affecting the acceptance of health services by physicians.

In this descriptive-analytic study, 150 physicians working in Shiraz and Kazeroun were included using cluster sampling. Data were collected using questionnaires adapted from other studies. The validity and reliability of the questionnaires were confirmed. Data were analyzed using Structural Equation Modeling (SEM) by Amos version 21 and SPSS version 23 software.

The effect of technology anxiety, adaption and resistance against change on perceived usefulness was significant. In addition, the effect of self-usefulness, adaptability, social norms, and resistance against change on perceived usefulness was significant. Moreover, parameters affected the intention to use via mediating variables of usefulness and perceived usefulness. The final research model had good fit indices.

According to the results, policymakers are recommended to take into account the five factors mentioned in this study, which are related to the acceptance of systems investigated here, for promoting an appropriate culture for the adaption of mobile health services by physicians.

Waiting time is one of the factors affecting patients' satisfaction with the quality of services, therefore, reducing the waiting time has an essential role in the improvement of services and clients' satisfaction. The present study was performed to study the client patients waiting time in referral restorative dentistry department of dental clinic using Six Sigma model.

In this descriptive study, 300 patients who referred to the restorative dentistry department of dental clinic, were included. Finally, 30 subjects were selected using random sampling method. Data were collected by waiting time measurement forms and researcher-made checklists. To determine the process quality, six sigma model was used. Finally, data were analyzed using SPSS version 16.

The highest mean waiting time belonged to the oral diseases department (mean=31 min) and the lowest one belonged to the examination unit of restorative dentistry department (mean=15 min). The most important factors extending the waiting time were simultaneous entrance of patients (mean=4.6 min), lack of medical students' skill and experience (mean=4.2 min), lack of employees and integration of reception unit with cash desk (mean=4 min), respectively.  

Therefore, by analyzing reception process, appropriate management, and using Six Sigma model, waiting time will reduce, clients' satisfaction will increase, and the quality of services will improve.

The cattle tick Rhipicephalus spp. causes significant economic losses due to diseases in animals and human. Bm86 is a midgut protein and vaccine candidate, which its sequences among the isolates of Ripsephalus spp are geographically separated, variable, and are the main reason for reducing effectiveness, and subsequently, the failure of the recombinant vaccines.

In this bioinformatics study, the sequences of R. microplus and R. annulatus were retrieved, aligned, and edited. Then, the variation plot and phylogenetic tree were constructed. Afterwards, grouping and taxa marking for designing evolutionary vaccine, COBRA antigen, center of tree and ancestral were done. Also, over COBRA vaccine sequences, modeling analysis and superimpose test were done.

In both R. microplus and R. annulatus, the most variable region were residues 177-181, 270-276, and 351-352, respectively. 6 sequences were selected as appropriate sequences for design of evolutionary vaccine, and 12 for the realignment of and achieving sequences for design of COBRA antigen. On the other hand, R. annulatus sequences were in sister branches and more similar to each other compared to Bm86 protein sequences in R. microplus except ADQ19687. The sequences selected for vaccine design based on the center of tree and ancestral, were AJE29931, AJE29932, and ATW75472, and ATW5476, ADM86722, ACZ55133 sequences, respectively.

Anti-tick COBRA-based vaccines of Bm86 could be more cost-effective and better alternative with broader spectrum, compared to the commonly used recombinant vaccines.

The prevalence of Chronic Kidney Disease (CKD) reached about 13.4% in 2016. Among available treatment methods, hemodialysis is the most common way used for the treatment of patients with End-Stage Renal Disease (ESRD), the last stage of CKD. On average, these patients refer to hemodialysis centers three times a week. The high patients referral rate indicates the importance of proper management and planning as well as the optimal and efficient allocation of hemodialysis resources.

This overview study was conducted to investigate the applications of spatial analyses in the management and allocation of hemodialysis resources. By designing a search strategy, related articles indexed in the MEDLINE database, were reviewed.

Studies related to spatial analysis in the field of hemodialysis can be categorized into three groups including: 1) measurement of access to hemodialysis centers, 2) relationship between access to these centers and mortality as well as patients' quality of life, and 3) allocation of hemodialysis resources in a geographical area.

Spatial analysis as a geographical information system-based methodology, can be used for analyzing data associated with hemodialysis centers to optimize resources management and help policymakers to make better informed decisions in this area. Most of the studies investigated the access to hemodialysis centers and the relationship between access to these centers and mortality as well as the patient's quality of life. However, few studies have been conducted on the optimal allocation of hemodialysis resources in a geographical area.