نشریه مدیریت اطلاعات سلامت
سال نهم شماره 5 (پیاپی 27، آذر و دی 1391)

Non-integrated health information has forced health sector to utilize information and communication technology (ICT). National health information infrastructure (NHII) integrates clinical and health information, decreases medical errors as well as costs, and increases patient’s safety. Thus, this article aimed to review the feasibility of NHII implementation in Iran from perspective of ICT experts in Ministry of Health and other health-related organizations in 2009. This survey was conducted after identifying the NHII. The study population consisted of ICT managers and experts, and sample size was equal to the sample population. The data were collected through interviewing and by means of questionnaire. The questionnaire was confirmed by health information management and ICT experts. The validity of the questionnaire was confirmed by content validity and its reliability by test-retest method (r = 0.84). Data were analyzed by descriptive statistics. Despite a relationship between Ministry of Health and other health-related organizations, only 14.28% of the organizations had fully integrated computerized information system and were ready to connect to the Ministry of Health. Cultural, economic, and infrastructural problems were 92.30% and lack of standards and legal issues with 84.61% were the most important barriers for implementing NHII in Iran. Due to the lack of required infrastructures, implementing NHII in Iran is impossible. Developing culture, privacy laws enactment and ICT in addition to governmental supervision for establishing required infrastructures should be implemented.

Quantitative evaluations are considered as one of the appropriate criteria in accepting or rejecting the selection of information resources in libraries. Through these assessments, one can evaluate how much the selected resources meet the needs of the users. The present study aimed to review the cost-benefit analysis of the Persian books on Department of Library and Information Sciences in Jundishapur University of Medical Sciences, Ahwaz, Iran. This cross-sectional survey described the current situation, evaluated how much the books in the field of Library and Information Science are used and did a cost-benefit analysis of these books in Jundishapur University of Medical Sciences in Ahwaz. The study population included all the Persian books related to the Library and Information Sciences at the aforesaid university's libraries. Data collection tool was a researchers-made checklist, and the data were collected using the Library software. Descriptive statistics and cost-benefit formula were used for analyzing the data. Findings showed that average total cost for using each of the books once was approximately 4589 Iranian Rial rate (IRR) which was considered to be a relatively high price. The lowest cost for using each book once was related to those published in 2002 (2913 IRR) and the highest cost for using each book once was related to those published in 2005 (31413 IRR). Cost-benefit analysis of the books showed that the lowest cost-benefit was for the books related to the "library collection" (755 IRR), then in a growing rate for books related to the "references" (2777 IRR), "library management" (2877 IRR) and "organizing" (5693 IRR). The cost-benefit analysis showed that use of each of these books every time is expensive and is not affordable for the libraries. The Persian books related to the "library collection" had a higher rate of use by the users than other books in the field of Library and Information Sciences, and therefore have been more affordable.

Based on individual independence rights, patients can refrain from being treated or can voluntarily discontinue their treatment after receiving full information. This study aimed to review the reasons of treatment refusal and the status of informed refusals for patients. This was a cross-sectional descriptive study. The study population included 135 patients who refused to be treated in university hospitals of Kashan (except for the Psychiatric ward) during summer 2010. Data were collected through a 35-item questionnaire by means of interviewing. The data were analyzed using SPSS software. The most important common reasons for treatment refusals were patients’ inappropriate feelings for hospitalization continuation (83%), low quality of hospital services (49%) and receiving advices from their friends and families (35.5%). Providing information before signing the consent form (64.2%), understandability of the consent form (69.2%) and interaction between the patient and the physician (72%) were items with adequate or somewhat adequate status mentioned by the patients. Improving status of hospitalization, mental condition, and patient tendency to be hospitalized and also promoting health quality can result in decreasing personal satisfaction for discharges against medical advices. To improve the status of informed refusals, more information about alternatives, their benefits and complications, and content of consent forms should be provided to patients. Physicians should understand patients’ reasons to refuse treatment and try to eliminate obstacles and persuade them to continue their treatments.

It is necessary for every organization to periodically study its structure. The aim of this study was to identify the organizational structures of libraries of university of medical sciences in Iran based on‏ Stephen Robbins model. This was a descriptive survey. The study population included all the central library managers of medical university libraries in Iran in 2010-2011 (n = 44). Fifteen managers were selected through simple random sampling method. Data were collected using the standard translated questionnaire of Robbins. The validity of this scale has been confirmed using seven library and management professionals and specialists. Its reliability was obtained 87% using Cronbach’s alpha coefficient. Data were analyzed by SPSS software and descriptive statistics. Libraries in universities of medical sciences in Iran lack efficient structures and are not in an acceptable rate, i.e. the complexity was less than the average level, and the formalization and centralization were greater than the standard level. The study results suggested that the organizational structures of universities of medical sciences in Iran are not efficient. Dimensions of the given structures need to be revised.

Prior to offer and implementation of new jobs, the readiness of staff for fulfilling these jobs and the factors affecting on their readiness should be investigated. This study aimed to determine the relationship between the readiness of staff working in the medical records department, in undertaking new roles of health information management and the motivational and inhibitory factors of their participation in the continuing educational courses. This was an applied research study. The study population composed of 40 graduates in the field of “medical records” working in the hospitals affiliated to the social security organization in Tehran. Due to the limited number of participants, no sampling method was used in this study. Data were collected using Likert scale questionnaire. To confirm the validity of the questionnaire, experts’ views were investigated and the reliability of the questionnaire was also confirmed using the test-retest method (r = 0.945). Descriptive and inferential statistics, such as Spearman’s rho (rs) and t-test, were used to analyze the data. The results showed that there was a significant relationship between the participants’ awareness of new jobs in health information management (HIM) and their age, work experience and graduation year. Moreover, there was an inverse significant relationship between the awareness of new jobs in the field of health information management and the motivational factors for attending in the continuing educational courses. No significant relationship was found between the awareness and inhibitory factors for participating in the continuing educational courses. It is important to offer necessary training courses to increase the level of awareness and improve staff skills before offering new jobs to them. Staff participation in the training courses will be facilitated if motivational factors are identified and inhibitory factors are controlled.

Research has shown that medical consents are not valid. In fact, consents are usually provided by unauthorized persons whose identification is not accurately approved. This research tried to specify the effects of an admission guideline form on validity of medical consents. This experimental study was conducted in four teaching hospitals in Sari, Iran during 2010. After reading the admission guideline, the case group had to present the necessary documents to prove their identity and be able to consent for their patient’s admission. The control group included patients who had been admitted before the beginning of this project. Two copies of the admission guideline form had been prepared (one for the hospital and one for the patients). The names of patients who had received the form were recorded in a list for further follow-up. The patients who had the form on the day of admission entered the study. A number of variables such as the validity of the consents for "treatment and surgery" and "using medical information", patient’s age, sex, and place of residence, the relation of the consenting person with the patient, and the patient, his/her attendant, and the receptionist’s education level were recorded. Using previous research, primary evaluations, and the formula of sample size, 66 persons form each hospital were selected. Content validity was determined based on the relationship between the patient and the consenting person. Data was analyzed by descriptive statistics and chi-square and binominal tests in SPSS. P values less than 0.05 were considered significant. Employing the admission guideline form increased the validity of consents for treatment and surgery and using medical information by about 18.6% and 15.6%, respectively. The validity of consents provided by patients younger than 19 years of age and 55-60 years old was higher than the other age groups. The validity of consents was higher in the case group than in the control group. In addition, the validity of consents was not significantly related with the receptionist’s education level. Using the admission guideline form was improved the validity of the provided consents. This form can be a beneficial tool to educate patients about the necessary documents in the hospital. Furthermore, training the personnel and/or using the validity of consents as an evaluation index in their promotion will also be warranted.

In today’s changing world, in addition with establishing human capital, supporting social capital is one of other challenges in organizational behavior. Furthermore, social capital is a public characteristic, but it is resulted from individual efforts in making trust, relationships and cooperation. Without social capital, staff would not have willingness to share information and knowledge. This article investigated the social capital and the learning organization.

This was a descriptive-correlational study with practical and fundamental objectives. The study population included 120 staff of Qom University of Medical Sciences. The sample size was 92 subjects according to the Morgan’s table. They were randomly selected and their viewpoints concerning the social capital were collected. The views were analyzed through inferential statistics by SPSS software.

The results showed that there was a significant correlation between the social capital and learning organization in Qom University of Medical Sciences (P < 5%).

Since social capital influences on improving and promoting the learning organization, this type of capital in addition with other weaker aspects of social capital in administrations and departments of medical universities must be identified and strengthened.

Cosmetic surgery tourism, as one of the leading industries in the world, can be the solution to strengthen the health and economic growth. The aim of this study was to identify cosmetic surgery tourism potential in Isfahan, Iran. This was a qualitative study conducted in 2011. Research participants included managers, plastic surgery and ear, nose and throat (ENT) specialists of cosmetic surgery centers who were selected based on the purposeful sampling. Data collection tool was a semi-structured questionnaire that was developed through interviews and observation in statistics of deputy of treatment of Isfahan University of Medical Sciences. The framework analysis was used for analyzing the interviews. Seven themes were identified as the key factors related to the potentials of medical tourism in the field of cosmetic surgery: demand potential, environmental potential, human resource potential, infrastructure potential, inter-organizational relationship, competitive conditions and promotion strategies. In terms of the medical tourism demand potential, the majority of the patients were Iranians residing abroad and few of the patients were those in neighboring countries. Environmental and human resources factors were in good conditions. Participants believed that in cosmetic surgery centers, infrastructure potential, developed planning and clear guidelines, standardization of prices and considering to an efficient liability insurance were not in an appropriate status. In addition, they mentioned that inter-organizational collaboration and promotion strategies were in a desirable condition. Furthermore, competitive condition in cosmetic surgery centers in terms of cost advantage was desirable but in competing with medical centers was undesirable. Isfahan has a good potential capacity in terms of cosmetic surgery; therefore, in order to promote medical tourism in this city, having appropriate plans, strengthening basic infrastructure and coordination between the organization and effective marketing are necessary.

Medical Records Department (MRD) is important for evaluating, planning and prioritizing health care services. The major aim of this study was to evaluate the performance of the MRDs of hospitals using multi-criteria decision-making approach in the selected hospitals of Isfahan city, Iran. This was an analytical and cross-sectional study that was conducted in spring 2008 in Isfahan, Iran. The study population consisted of the MRD of Al-Zahra, Kashani and Khorshid hospitals in Isfahan. Data were collected through brainstorming technique. Expert Choice software was used to analyze the data. The results showed that relative weight of archiving unit had the higher degree of importance than others in terms of information management. However, in terms of customer aspect, relative weight of admission unit had the higher degree of importance than others. Relative weight of medical records departments in Al-Zahra, Kashani and Khorshid hospitals in Isfahan were 0.394, 0.342 and 0.264, respectively. It is necessary for managers to allocate and prioritize resources according to Multiple Criteria Decision Making (MCDM) ranking at every units of the MRD.

Computerized clinical decision support systems (CDSS) can be effective in reducing certain types of medical errors. This study aimed to assess the viewpoints of physicians and nurses about practical use of these systems to prevent or decrease the incidence of errors. In a two-month cross-sectional study using two valid and consistent researcher-made questionnaires, the viewpoints of one hundred physicians and nurses from university hospitals of Kerman University of Medical Sciences were collected concerning some of the important errors in treatment process and nursing care that are preventable by alert or reminder systems. All of the study subjects i.e. 65 females and 35 males from physicians and nurses filled out the questionnaires. Among them, 86% of the physicians and 90% of the nurses believed in the possibility of medical errors and 88% of the participants agreed that using efficient computerized systems reduces medical errors. According to most of the responses, computer systems have positive effects on reducing bed sore and emboli occurrences, eliminating physicians’ illegible hand-writing and improvement of quality health care services due to accessing to the up-to-date information. Moreover, nearly all the participants believed that computer systems have positive effects on reducing drug allergies and interactions as well as improvement of prescription quality through availability of patient’s medical history. The top priorities for physicians were access to up-to-date information and alert about severe drug allergies and interactions, respectively; while for nurses, the top priorities were preventing bed sore and emboli and important issues in high-traffic wards. Staff of hospitals of Kerman University of Medical Sciences believed that computerized CDSS, either through reminders or alert systems, are effective to reduce errors in patient care. These findings might be influencing for development and use of these systems.

Fungi are biological threatening which exist in all the environments. Libraries and archive centers are a suitable environment for the growth of fungi. The aim of this study was to identify fungal life-threatening factors for librarians and users in libraries of Isfahan University of Medical Sciences, Iran in 2011. This was a cross-sectional and descriptive-analytical study. The study population included libraries of Isfahan University of Medical Sciences in 2011. 126 samples were chosen in seven libraries at three different day times (morning, noon and evening), from the atmosphere, books and surfaces (desks, computers, book shelves etc.). Culture media (Sc) containing samples were placed at 25-30° C. After the growth of fungi, they were identified by macroscopic and microscopic criteria. A total of 2140 colonies belonging to 26 fungal genera were isolated from the seven libraries. The highest amounts of colonies (555) were isolated from the library of School of Dentistry and the lowest amounts (70) were isolated from the library of School of Management and Information Sciences. Cladosporium, Penicillium, Yeasts, Aspergillus Niger and Aspergillus had the highest prevalence and Aureobasidium Rhizopus, Scopulariopsis, Botrytis, Neurospora and Curvularia had the lowest prevalence. There was no significant correlation between the sampling times and fungal contamination. Cladosporium Penicillium, Aspergillus, and Aspergillus Niger, which had the highest prevalence rate, are the opportunistic pathogens that may cause infection for those prone to them.

Public service motivation (PSM) is one of the few motivational theories, which investigates the motivation and its organizational outcomes such as job performance in public and governmental sectors. By emphasizing on direct effect of PSM on job performance, previous studies led to contradictory results. In this study, it is supposed that the effect of PSM on job performance is indirect; thus individual-organization and individual-job proportion were investigated as mediator variables in this correlation. Since nursing is one of the best jobs that the PSM might be observed in, this study was conducted in governmental hospitals. Similarly, 103 nurses, who were employed in governmental hospitals of Isfahan, were randomly selected and then answered to PSM, individual-organization proportion, individual-job proportion and job performance questionnaires. Thereafter, the data were analyzed through SPSS AMOS™ structural equation modeling software. Findings indicated that the PSM had a significant and positive correlation with both individual-organization proportion (β = 0.371, P < 0.01) and individual-job proportion (β = 0.561, P < 0.001). In addition, positive correlation between individual-organization proportion and individual-job proportion with job performance was also significant (β = 0.367, P < 0.001) and (β = 0.482, P < 0.001), respectively. However, according to what was assumed and hypothesized for the individual-organization proportion and individual-job proportion, PSM did not have a significant correlation with job performance; therefore, the individual-organization proportion and individual-job proportion confirmed these two variables to serve as a mediator. While private organizations could rely more on material rewards such as financial aid for motivating their employees in the direction of employer’s goals and interests, governmental organizations should focus on requesting their employees in order to attempt for advancing the community goals as well as satisfying individual needs in order to increase their efficiency.

The current world is the era of wisdom and knowledge. Endowments, natural and tangible assets are not the key factor for success of communities and organizations; instead, management of intangible assets in this turbulent and challenging environment for the organizations are the key success factor for them. The organizations which are able to recognize these assets and manage them properly would perform better than their competitors. In order to manage these assets, organizations are to be aware of the current situation, and in order to eliminate such deficiencies, they are required to do the necessary actions. This article seeks to review and compare the common components and models of intellectual assets and properties in the organizations through online review literature of Persian and Latin references. Human capital includes knowledge, skills and experiences of employees, managers and their effective response to the future. Structural capital refers to the daily activities required in the learning and knowledge, and it is considered as the supportive infrastructure of the human capital. The relational investment represents formal and informal relationships in an organization with external beneficiaries as well as their perceptions concerning the organization and information exchange between them. Nowadays, various models are used in organizations for understanding and measuring intellectual capital such as the balanced scorecard model, technology Broker's IC audit model, Scandia navigator, intellectual capital index, and intangible assets navigator each of which with unique features and benefits. Products and organizations run based on the knowledge in the knowledge-based economy. Meanwhile, the most successful organizations are those utilize intangible assets better and faster. Currently, the intellectual capital is used to create and increase organizational value, and success of an organization depends upon its ability to manage this scarce resource.

The present review article aimed to identify, introduce and compare models and frameworks used for the impact assessment of medical research. Comprehensive searches were conducted in various databases in order to identify models and frameworks. Those works that proposed a model or framework were chosen for the review and comparison. Thirteen different models and frameworks were identified. The level of assessment, items that models evaluate, and the type of impact they assess showed some differences. In terms of the type of impact, Research Excellence Framework was the only framework to cover all social, economic, cultural, and scientific aspects. There is still not a single standard model to assess the impact of medical research. However, among the proposed models, the payback model appears to be more widely used and accepted. There is also ambiguity in the utilizations of the terms “impact” and “outcome” and in some works they have been used interchangeably.