Journal of

Background and Aim: Population aging in most of developed countries should be subjective to more attention, regarding health issues of aging group. Different organizations and institutions have launched several programs related to elderly center. This paper is aimed to compare performance of different programs of active organizations in the field of elderly care in Iran.
Materials and Methods: This overview of research, used library resources and online databases Proquest, Pub med, Science Direct, Ovid and Scientific Information databases using keywords that  Aged care services, relevant organizations, and Iran.
Results: There are various classifications of geriatric services. However, these services can be divided into three groups including infrastructure, social services, and health care and preventive services according to concept, level and type of services.
Conclusion: In Iran, agencies and institutions relevant to elderly, take measures to support elderly people given their current tasks and allocated budget. But, these measures do not seem adequate, because solving aging problem, as a problem with evident influences which its impacts will be intensified in future, requires responsibility and cooperation of more agencies and public institutions.

Background and Aim: The aim of this study was structural monitoring of the articles in knowledge and information science field in five Iranian journals. Today, the publication of papers constitutes one of the written scope among scientific broad cost productions.
Materials and Methods: The research method was analytical-survey. The articles were analyzed by the variables such as author distribution by sex, field of study, scientific notation, types of articles by original papers or translated papers, individual or group articles and their publication dates, and by statistical methods used in the articles in two periods from 2002-2006 and 2007-2011.
Results: The results showed that most of the articles were written as original. International cooperation between authors was minimal. Using qualitative research methods among the articles were low. Majority of the authors had masters degree. There was a significant relationship between the authors’ grades, number of authors and journals, and used statistical methods.
Conclusion: The written articles in the field of knowledge and information, followed by special patterns. The journals policies in publication of articles process is the most important issue. Also, lack of international cooperation between Iranian with foreign authors, type and format of the articles were similar according to mentioned variations.

Background and Aim: Inclusive implementation of Electronic Medical Records (EMR) is more serious because of physicians’ perception. This study was carried out to identify the effects of organizational contextual factors on physicians’ perception regarding EMR’s adoption in 2013 (The merger of Tehran University and Iran). 
Materials and Methods: This was a descriptive, analytical and cross- sectional study in which a sample of 270 physicians working in hospitals affiliated to Tehran University of Medical Sciences was selected. Physicians’ perception toward adoption of EMR has been assessed by Technology Acceptance Model or TAM questionnaire and organizational context variables. Collected data were analyzed by SPSS. The study model was tested by Structural Equation Modeling (SEM) and represented by AMOS. 
Results: The findings showed that perceived usefulness (PU), perceived ease of use (PEOU), management support, physicians’ involvement, physicians’ autonomy, and physician- patient relationship have direct and significant effect on physicians’ attitudes toward EMR adoption. However, training has no significant effect on TAM variables. Moreover, the results showed authorizing proposed conceptual path model explained about 56 percent of the variance of EMR adoption.
Conclusion: The present study revealed that organizational context factors had significant effect on physicians’ attitude toward EMRs’ adoption. The study clearly identified six relevant factors that affected physicians’ perception regarding EMR adoption. These factors should be considered when comprehensive implementation is pursued.  

Background and Aim: Computerized physician order entry system is the process of entering orders electronically. It is a replacement for manual system and is considered as a part of a clinical information system. The appropriate design of this system leads to the enhancement of its capabilities, ensures orders accurately and comprehensively, and transfers information to different parts rapidly. Therefore, transfer time and the error related to the wrong path or misinterpretations will be omitted; in the end, efficiency will increase. This study aims to present different perspectives on design principles of computerized physician order entry system for stakeholders.
Materials and Methods: In this review article, Google, Google Scholar, Pub Med, Web of Science and Scopus databases were searched with some keywords related to design principles of computerized physician order entry system.
Results: Based on the performed studies, factors such as inappropriate design of links, display page, set of orders content, drug database, structure of order environment, rules, formats, mechanism of getting reports of errors, and finally clinical decision support system have led to the decrease of doctors’ performance, increase of new errors, and reduction of patients’ safety.
Conclusion: Inappropriate design leads to the increase of new errors after the implementation of system; therefore, proper and principled design of this system can lead to the improvement of practitioners’ function, decrease of prescription errors and drug side effects, reduction of costs, efficiency increase, workflow 

Background and Aim: Hospital is a complex ecosystem in terms of diversity of services, clients, personnel, equipment, technologies, data and information which are generated. Since the ultimate goal of a hospital is to improve quality of care along with reducing cost, using intellectual tool such as dashboard can create strategic value.

Materials and Methods: This review article was performed based on a literature review and internet search through such scientific databases as PubMed, EBSCO host research, Proquest, Emerald, Web of science and search engine such as Google, Google Scholar. In this study, the articles about intellectual capitals as well as the application of dashboard in healthcare between year 2009 and 2013 were reviewed.

Conclusion: Application of dashboard in hospital can create strategic values such as respond to environmental changes rapidly, identify new market opportunities, become a learning organization by discovering new patterns and relationship among data, achieve best practices by analyzing patterns of treatment and results and achieve the highest efficiency.

Background and Aim: In attention to hospital beds serves as an invaluable resource in health system and necessity for appropriate hospital beds utilization through the reduction of patient inappropriate stay, this study aimed to assess the proportion and causes for hospital inappropriate stays. 
Materials and Methods: The proportion and causes for hospital inappropriate stays were analyzed in a cross-sectional survey using a sample of 1925 days of hospital stay based on the Appropriateness Evaluation Protocol. The study was conducted at the tertiary care University Hospital Shahid Beheshti, 510 – bed teaching hospital which is located in the central part of Iran.
Results: Hundred and twenty one days (6.3%) of 1925 days of patient hospitalization were inappropriate. There was relationship between inappropriate stay and patients’ age and types of insurance. Findings relating to analysis of patient non demographic causes revealed that among hospitals, physicians and patient causes, Hospital-related causes and Physicians related causes have the most impact 42 (33.1%) and 37 (29.1%) on patient inappropriate stay  respectively. 
Conclusion: AEP list of reasons provides base line data for performance improvement in health care organizations. For conducting improvement process, developing a multidisciplinary team under title of Utilization Review committee is recommended to pave the way for targeted interventions based on identified potential causes. 

Background and Aim: One of the main steps of optimization process in diagnostic imaging is quality control of X-ray devices. If the control quality process and the quality of X-ray equipment are not ensured through a systematic procedure, it can increase the risk of unnecessary exposures among the population. Therefore, this study can reduce the risk of unnecessary exposures in the entire population. 
Materials and Methods: In this study, six quality control tests including voltage measurement accuracy test, time accuracy test, output repeatability test, output to time linearity test, output to milliamp linearity test, and radiation quality measurement test were evaluated in all centers of Ilam in accordance with what the international Atomic Energy Agency and the Atomic Energy Organization of Iran has presented. 
Results: The result showed that diagnostic X-ray devices available in Ilam had a relatively good quality in all quality control tests that were done except the associated with the radiance quality of (HVL). However, almost all these devices need to add additional filters to the X-ray tubes to resolve error in their HVL. 
Conclusion: Adding additional filters to radiology devices in Ilam Province and modifying the thickness of filters seem to be necessary and desirable which will prevent the unnecessary increase in patients' dose. The accurate and regular implementation of quality control tests in imaging wards should change into a culture. On the other hand, the relevant organizations which have the great responsibility to protect people against radiation are recommended to monitor and supervise radiology centers more accurately and responsibly to repair diagnostic radiation devices.

Background and Aim: Electronic Medical Record system collects and stores laboratory data, digital images and electronic versions. It plays a major role in reducing medical errors and duplication and health care providers immediate access to patient medical records. This study aimed to examine the viewpoints of Hormozgan University of Medical Sciences' administrators on the role of electronic Medical records system.  
Materials and Methods: The study was a descriptive-analytical research to examine the viewpoints of Hormozgan University of Medical Sciences' administrators and physicians on the role of electronic medical records system. The study population consisted of 61 managers, matrons and health information managers of Hormozgan hospitals and 121 faculty physicians and residents. Data collection tool was a researcher-made questionnaire. The validity was determined and verified by content validity method and experts' views. Cronbach's alpha coefficient was used for assessing reliability, which was 83%. Data collected from the questionnaires was analyzed using SPSS software and descriptive statistics and analytical statistics.
Results: Results indicated that "data management" (N=146) with 77.5%, "job objectives and processes" (N=160) with 87.9%, "communication" (N=163) with 89.6%, "data privacy and security" (N=152) with 83.1% had the most important roles in the health system. 
Conclusion: Generally, managers and physicians attitudes about the role of electronic medical records system in the health system was evaluated satisfactorily. According to the advantages of the system and removing major obstacles in its implementation, a new step would be taken in order to promote health.

Background and Aim: Bacterial meningitis detection is a complicated problem because of having several components in order to be diagnosed and distinguished from other types of meningitis. Fuzzy logic and neural network, frequently used in expert systems, are able to distinguish such diseases. The purpose of this paper is to compare Fuzzy logic and artificial neural networks for distinguishing bacterial meningitis from other types of meningitis.
Materials and Methods: In this study to detect and distinguish bacterial meningitis from other types of meningitis, in the first step 6 attributes were selected by infectious disease specialists. In the second step, systems were designed by Matlab software. The systems were evaluated by 26 records of meningitis patients, and results were analyzed by SPSS software.
Results: The evaluation showed that the accuracy, specificity and sensitivity of fuzzy method were 88%, 92% and 100% respectively and those of neural network methods were 92%, 94% and 88% respectively. The Kappa test result in fuzzy and neural network methods were 0.83 (p<0.001) and 0.83 (p<0.001). The areas under the ROC curves were 0.94 and 0.91 respectively.
Conclusion: The sensitivity, the Kappa test results and the areas under the ROC curve of the fuzzy logic method were better than neural network method. However the fuzzy logic method is more reliable to distinguish bacterial meningitis from other type of Meningitis, the evaluation result were obtained from 26 records of meningitis patient which were hospitalized in the same center leads to the study be still open.

Background and Aim: The objective of this study was to design electronic card of health for schizophrenic patients to better manage their clinical information.
Materials and Methods: The study was conducted year 2014. The population of the study included 40 psychiatrists. The information, based on minimal clinical and demographic data, was gathered through field study and survey using a questionnaire. Referential and inferential statistics techniques were used to analyze the data.  To schizophrenic patients' electronic health cards, various software were studied to design database, card and card reader.
Results: According to the results and observed frequencies, it was confirmed that the components of demographic and clinical information be inserted in the electronic card of health. The project includes hardware of card reader machine, card and visual studio software. Microsoft SQL Server, 2008, was applied to design database. 
Conclusion: The electronic card of health for schizophrenic patients helps the treatment team to provide effective health care as well as medical records and hospital admission's staff in better management of patient information. It also reduces the problems of relatives and family members of the patients in the medical centers and facilitates, and the process of treatment of schizophrenic patients significantly. Using schizophrenia patient’s electronic health card, hospital in better management of patient information puts in good condition. 

Background and Aim: In attention to pressing need to cost containment and service efficiency, laboratory services serve as a central locus for controlling health care expenditure. This study intents to investigate proportion of laboratory utilization in Iran to pave the way for future interventions.
Materials and Methods: A cross-sectional study was conducted to investigate the proportion for laboratory utilization through the retrospective analysis of 384 medical records at the tertiary care Kashan University Hospital Shahid Beheshti. To pave the way for future intervention, over utilization tests were classified into two categories, inappropriate and resulted in laboratory errors.
Results: Nine thousand five hundred forty one laboratory tests were ordered, 2522 (26.40%) of the tests were inappropriate and 143 (1.5%) of the over utilization tests have occurred due to laboratory testing cycle errors. According to reviewers’ judegment relevancy to medical intervention was considered as the most accepted appropriateness criteria 5012 (52.53%) for laboratory tests 
Conclusion: Since, the laboratory tests over utilization is multifactorial, forming a multidisciplinary team including physicians, nurses, laboratory staff, medical education experts, health care management and health information technology staffs in terms of Utilization Committee to develop more targeted strategy based on root cause analysis of over utilization behavior seems necessary. 

Background and Aim: The most important issues that always absorb accuracy and effort of hospital, is the mastery and control over the financial status for the hospital resources management. In all countries, the medical centers are considered as a vital community resource and must be managed in line with the interests of society. Hence, these studies aimed to investigate the causes of insurance deductions and were made to assist hospital administrators in reducing the deductions against them. 
Materials and Methods: This descriptive research is retrospective study in year 2012. The study population consisted of 100 insurance experts deployed in insurance centers (including Health care’s, Social security, Armed forces, Help Committee) from which 25 experts were randomly selected from each Insurance Center. Researcher madden questionnaire was used to collect data. For validating of questionnaire justifiability, questionnaire was provided to insurance expert, professors and ambiguities were resolved. Test-retest procedure was used to ensure the Stability of the questionnaire. The collected data was analyzed and classified using Excel software.
Results: These findings indicate that between all parts of surgery wards deductions are the highest (%45/55), and between surgery wards, orthopedics surgery had the highest amount of deductions (%40/75).
Conclusion: Healthcare provider should be more careful and minimize documentation errors in reporting and documentation. Also the hospital administrators for reducing deductions against patient records must provide educational course for correct documentation.

Background and Aim: Organizations must collect, process and analyze different types of necessary information and give them to managers and other individuals. Such information includes the management of medical records and documents in insurance companies. This study aims to evaluate the potentialities of medical records management electronic systems in such companies.
Materials and Methods: In this cross-sectional applied research, the systems existing in insurance companies were checked using researcher-made checklists to study the capabilities of medical records management electronic systems in all governmental and private insurance companies of Gorgan. For data-analysis, descriptive statistics (frequency, percentage) was used.
Results: In data register and entry, the share of insurance companies as well as the amount of deductions was 92%. In the ability to search, store and retrieve, the search based on the names of persons had the highest percentage (100%). Security was one of the features considered in the software of insurance companies. In the reporting section, the possibility to report the titles of medical documents was 92%. Lack of physical and electronic documents manageability through check-out method was 14%. 
Conclusion: In terms of functional capabilities, softwares observed in insurance companies have both strong points (security feature) and weak points (classification and indexing capabilities). The management of medical records and documents can be enhanced in the softwares of insurance companies by using the mentioned capabilities of the existing softwares.