Journal of

 Background and Aim: X-Ray departments are among the most essential and expensive parts of any healthcare organization. Meanwhile, the proper application of hospital information systems (HIS) leads to the quality enhancement of health services and to the cost reduction of medical departments. The purpose of this study is to evaluate the knowledge of radiology department staffs in hospitals affiliated to Hamadan University of Medical Sciences (HUMS) about HIS applications.

 Materials and Methods: In this descriptive research (2012), the knowledge of radiology department staffs in HUMS hospitals was studied using a two-part questionnaire including a demographic part and standard items to evaluate the HIS knowledge of radiology department staffs. Finally, the obtained data were analyzed statistically by SPSS (version 17).

 Results: The results showed that 3.8% of staff members had a weak awareness, 65.4% an average awareness, and 30.8% a good awareness about HIS applications. Perfect awareness was not observed in this study.

 Conclusion: According to the results of this study, running related and up-to-date courses for staff members working in radiology departments is recommended. 

 Background and Aim: Evidence Based Medicine (EBM) is the explicit use of current best evidence in making decisions about the care of individual patients. Hospital information system (HIS) can act as a bridge between medical data and medical knowledge through merging of patient's data, individual clinical knowledge and external evidences .The aim of this research was to determine the Capability to establish EBM by HIS.

 Materials and Methods: This descriptive cross-sectional study was carried out on HISs of 30 hospitals from March to October 2011. Data were collected using a researcher- constructed checklist including applicant’s background information as well as information based on research objectives. Validity of the checklist were assessed by the qualified specialists and then the data were analyzed using descriptive statistics and SPSS software.

 Results: HISs lacked the essential components for providing access to CDSS, Reference databases and internet-based health information in 19, 16 and 20 hospitals were 63.3%, 53.3% and 66.7%, respectively. Twenty-two hospitals (70%) had more than two-thirds of the essential components to access clinical and administrative data repositories 23 hospitals (76.7%) had at least one essential component to access contextual and case specific information.

 Conclusion: The Capability of HIS is better in order to place EBM in having access to the clinical and administrator data repositories while it needs more attention in other areas.

 Background and Aim: The lack of paying attention to overlap between two databases cause purchase of duplicate resources waste of funds. This study examined overlap of articles in the field of cardiovascular which was indexed in Scopus and Web of science databases during years 2001 to 2010.

 Materials and Methods: In this study, at first, sub-headings in cardiovascular field from medical thesaurus (Mesh 2012) was extracted, then each keyword in the title of the articles in both databases were searched and articles retrieved. Then bibliographic information of these articles entered into Endnote X3 software and afterwards was arranged based on alphabetically title. As a result common articles between the two databases and unique articles to each database was determined. Using SPSS version 0.1.0.8 the amount of relative and traditional overlaps was calculated between the two databases.

 Results: Totally 45,680 articles were retrieved. There were 27,979 common titles, 14,875 articles belonged only to Scopus and 2826 articles belonged to Web of Science. Finally traditional overlap was 61/5%. Overlaps of Web of Science with Scopus 65/28% and Scopus with Web of Science were 65/28% and 90/82% repectively.

 Conclusion: The amount of relative overlap between the two databases as well as relative overlaps from Scopus with Web of Science is more than the relative overlaps from Web of science with Scopus. It means many articles that have been indexed in Scopus don’t exist in the Web of science.

 Background and Aim: In order to better design an electronic health record system in the country, determining standardized data elements for creating an integrated information system is important. In this study, the minimum data set of radiology reporting system is determined.

 Materials and Methods: In this descriptive cross-sectional study, 13 radiologists, 3 anesthesiologists, 3 general practitioners and 3 insurance experts working in the Imaging Center of Imam Khomeini hospital in Tehran were chosen. The research tool was a questionnaire having 11 parts. Content validity and test-retest method were used to measure the validity and reliability of the questionnaire, respectively. Data analysis was performed using the SPSS software.

 Results: The highest means reported were radiologists' written explanations and suggestions (9.6), image interpretation (9.5), the name of contrast material (9.4), the name of imaging procedure (9.3) type and date of previous measures (9.1), and the final diagnosis (9) and the lowest averages belonged to referring physician's address (4.8), relationship between patients and the primary individual insured (4.3), and religion (2.2).

 Conclusion: In an electronic health record system, due to the importance of radiology reports for the diagnosis and future management of a patient's clinical problems, it is necessary to pay attention to the minimum set of data related to these reports such as administrative, insurance, patient identity, and clinical data, and the results of radiological examinations for exchanging with electronic health record system.

Background and Aim: Nurses are major end-users of hospital information systems (HIS). Therefore their views about strengths and weaknesses of the system are important, and, if addressed, could improve the software system and, in turn, the hospital performance. The purpose of this study was to assess the nurses' perspective about the impact of HIS in Farabi Hospital on nursing process in terms of precision, accuracy and speed .

 Materials and Methods: This was a cross-sectional study . Validity of the adopted questionnaire was approved by a panel of experts in the field. Its reliability was confirmed by Cronbakh-α coefficient test.

 Results: Sixty one percent of responding nurses were somehow satisfied with the implemented HIS, while a remaining 30.5 percent had a complete satisfaction. Also, nurses comments on HIS showed, in general, it enhanced the effectiveness of their related processes.

 Conclusion : According to the nurses, HIS has improved the speed, precision and accuracy of the processes. However, at the same time references was made to some shortcomings in the system, such as low-speed and lack of envision for some important processes, such as appropriate forms for documentation.

Background and Aim: Purchasing hospital equipment is one of the most important decisions made by managers and health professionals. Gray systems theory is an approach to deal with issues under uncertainty conditions where decision makers are facing a small number of unspecified data. The purpose of this paper is to apply the gray theory for the purchase of anesthesia machine .

Materials and Methods: This study was a survey in which mathematical analysis was used. Data collection devices included documents, interviews and questionnaires. In order to solve multiple criteria decision making in uncertain conditions, a model based on gray system theory was used. Data analysis was performed using Excel software.

Results: The findings show that among anesthetic equipment bought by public and private hospitals, brand A is superior to other brands. However, the gray possibility degree for the other brands is significantly different from brand A.

Conclusion: In addition to helping to purchase anesthetic equipment for hospitals, the results of this study are also useful for companies manufacturing medical equipment to evaluate their situation in terms of the studied criteria and take appropriate measures to develop their strengths and improve their weaknesses.

Background and Aim: Online submission and peer review systems are formal channels of communication among authors, journal editorial boards, and reviewers. The review process starts after authors submit their manuscripts. The aim of this study is to examine the online article submission and peer review systems in terms of the capability in medical journals of Iranian Ministry of Health, and Medical Education. Materials and Methods: In this descriptive survey study, 199 approved Iranian medical journals were examined so that the characteristics of online submission and peer review systems could be investigated. To study author role features, a checklist was developed by the researcher. The data were analyzed by SPSS 18 and Microsoft Excel 2007. Results: The online submission and peer review systems considered in this study had most (84%) of the features of the author role. Among the systems reviewed, Kowsar system had the highest number of features. Conclusion: The results show that the studied systems consider some, but not all, of the required features. To meet the maximum required features of the author role, it seems necessary to take all standard research criteria into account

Background and Aim: Pathology Information Systems provide opportunities for pathologists and clinical laboratory professionals to influence clinical care and modern research programs. The objective of this study was to determine the minimum data set of Anatomical Pathology Information System from the experts’ point of view.

Materials and Methods: This study is considered an applied research conducted through a descriptive cross-sectional research method. The research instrument was a questionnaire containing data elements related to sample and those related to the patient. This questionnaire was completed by three groups of participants including 22 experts in the field of Pathology and Laboratory Medicine, 23 experts in Health Informatics and Health Information Management, and 6 Insurance experts. The collected data were analyzed using descriptive statistics and SPSS software.

Results: The results indicated that all information elements contained in the questionnaire except the address of the pathologist, resident or the person who performs the act of gross examination were considered as informational elements essential to the system and the high average of five was allocated to them.

Conclusion: Based on the results of this study, the Minimum Data Set of Anatomical Pathology Information System can be presented in two main categories: Clinical and non-clinical information, which include identity information, management information, insurance information, clinical information and the data related to the study of  anatomiaca pathology samples.

Background and Aim: Given the increasing growth of new technologies in health care and their rising cost, the necessity of concentration on assessing new technologies and their potential role in quality of health care is more crucial. The aim of this study was to investigate the role of health technology assessment (HTA) in improving healthcare quality and offer the best evidence for decision makers.

Materials and Methods: The study was based on systematic review of papers in health technology assessment via searching in databases such as Pubmed, Cochrane and other HTA related databases. The search has covered the period between years 2000 to 2013. Studies analyzed by narrative synthesis method.

Results: Related studies show that assessing new technologies has potential role in quality improvement of healthcare. HTA can boost the competition among companies which this in turn increases the quality of technologies and ultimately enhances the quality of health services and stakeholders satisfaction.

Conclusion: HTA may increase quality of healthcare services through facilitating a move towards evidence-based decision-making, providing safe health care and increasing patients’ trust and satisfaction to clinical procedures and team members.

Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of the health system in Iran. Therefore, the necessity to reform organizational structure based on new goals and strategies is felt more than before. The aim of this study is to review and summarize all cases about Iran’s organizational structure and its challenges in primary healthcare system.

Materials and Methods: This study is a systematic review. All relevant databases, bibliography of related papers, and laws were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts, and their choices were discussed to reach a final decision.

Results: Fourteen final cases were categorized in two groups: papers and upstream policies and laws. The results revealed the ineffectiveness of current organizational structure at different levels. The majority of the findings suggested proper reforms in the system. Centralization and delegation processes were the main dimensions studied.

Conclusion: Due to fundamental changes in goals and strategies, certain reforms in the organizational structure of health system in Iran are indispensable, especially at peripheral levels.

Key words: Primary Health Care System, Organizational Structure, Iran

Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of the health system in Iran. Therefore, the necessity to reform organizational structure based on new goals and strategies is felt more than before. The aim of this study is to review and summarize all cases about Iran’s organizational structure and its challenges in primary healthcare system.

Materials and Methods: This study is a systematic review. All relevant databases, bibliography of related papers, and laws were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts, and their choices were discussed to reach a final decision.

Results: Fourteen final cases were categorized in two groups: papers and upstream policies and laws. The results revealed the ineffectiveness of current organizational structure at different levels. The majority of the findings suggested proper reforms in the system. Centralization and delegation processes were the main dimensions studied.

Conclusion: Due to fundamental changes in goals and strategies, certain reforms in the organizational structure of health system in Iran are indispensable, especially at peripheral levels.

Background and Aim: Diagnosis of preeclampsia has an essential role in applying appropriate treatment plan for the patients. The aim of this study was to design an expert system in order to diagnos preeclampsia in order to assist the clinicians.

Materials and Methods: This was a cross-sectional study which resulted in developing a new system. The study population consisted of all patients admitted to three Maternity hospitals affliated to Tehran University of Medical Sciences (TUMS). Sample size included 215 medical records which were randomly selected. The results obtained were compared with the diagnosis from experts by kappa test using SPSS software.

Results: First of all, input parameters fuzzificated and entered into inference engine. Outputs were categorized in two groups as patients and healthy, with the final diagnosis and clinical explanation. The results obtained from system evaluation showed that accuracy, specificity and sensitivity of the system were 98.2 percent, 100 percent and 96.4 percent respectively.

Conclusion: Based on evaluation results, it could be concluded that fuzzy logic is an efficient method for designing of expert systems in the field of obstetrics and gynecology. Also, due to the similarity of the logic used in the proposed system with workflow and medical decision making, it will be accepted by the physicians.

Background and Aim: Today, customer perception assessment as a way to measure satisfaction and expectations has an important role in improving the quality of services and organizational excellence. This study aims to measure customers’ perception at the Health Deputy of Iran’s Ministry of Health and Medical Education (MOHME).

Materials and Methods: This cross-sectional study was performed in 2012-2013. The population comprised the health deputies of medical universities, among which 13 of the universities were randomly selected. As the main customers of MOHME health deputy, these universities’ managers and experts were asked questions like a census. The data collection device was the national award standard questionnaire consisting of 2 sections and 26 questions. The data were analyzed by SPSS 18 with level.

Results: Of the 267 managers and experts, 147 (56.1%) were male. Many of them (57.3%) had a bachelor's degree. Most of them (91.6%) were employed in technical units. The average perceived level of managers and experts regarding their reputation and image was 3.3±0.7, production and service 3.1±0.7, support while and after providing services 3.0±0.7, and loyalty and honesty 3.3±0.8 out of a maximum 5 points, respectively. There was no significant relationship between administrators and experts’ perception level on the one hand, and individual and organizational factors on the other (P>0.05).

Conclusion: The study showed that customers’ perception of indices related to the quality of relationships, services and measures was at a moderate level. Therefore, it is recommended that the department of health should design and implement an appropriate intervention program for organizational excellence.

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: 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: 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.