Journal of

Background and Aim: Personal Health Record (PHR) systems play a key role in employing patient-centered care. Besides, the inclination to use Internet services has increased in recent years. The goal of this study is to describe the needed requirements for developing the proposed hybrid PHR model in a social network. 
Materials and Methods: Using a descriptive study, a hybrid PHR model was designed in this paper to be implemented in the social health network. Then, by using observation, introspection and questionnaire methods, the requirements of the proposed social network were listed. The elicited requirements were then analyzed by SPSS 16 using descriptive statistics (absolute frequency). Finally, the proposed system was described in the Software Requirement Specification (SRS) standard format. 
Results: The proposed hybrid PHR model has benefits of all existing PHR models and is most consistent with PHR definition (individuals control and manage their PHR). It is also applicable and reliable both for individuals and physicians. The results indicated that the proposed system had PHR capabilities as well as social network functionalities. So, the possibility of creating relations between individuals provided more benefits in comparison to other PHR models.    
Conclusion: By providing reliable information, the social health network can improve patient-physician relationships. As a result, the proposed social health network can make possible the utilization of web 2.0 and social network capabilities in the healthcare field as well as the benefits of PHR records and patient-centered care.

Background and Aim: Nowadays, e-procurement systems have provided many opportunities to improve supply and procurement activities in healthcare industry through Internet-based electronic communications for supplier-buyer interactions. Considering the fact that the implementation of these systems is not successful in many cases, extensive preparation in relevant areas is necessary before implementation. This paper aims to present a framework of key readiness factors of hospitals for the adoption of e-procurement system.
Materials and Methods: This study was an applied descriptive survey. The framework of readiness factors was developed based on an extensive review of literature and e-readiness models as well as opinions of experts in the field of information technology, procurement, and healthcare systems. The proposed framework was applied in a case study of a specialty hospital located in Tehran in 2016. The data were collected using a questionnaire, and Fuzzy Cognitive Map (FCM) method was used for modeling and analysis of the identified factors.
Results: In this research, a comprehensive framework of critical readiness factors of hospitals for e-procurement adoption was developed comprising five main components: management, technology, process, human resource, and environment. Environmental and managerial factors were identified as the most important readiness determinants of the case hospital, and among various factors, managers' expertise in IT, IT infrastructures of hospital, and continuous monitoring of system's performance are of higher priority.
Conclusion: This paper provides guidance for more accurate planning to improve readiness and successful adoption of e-procurement systems in hospitals by identifying the most important influential readiness factors.

Background and Aim: Glaucoma, with an increasing pressure inside the eye, is one of the causes of blindness worldwide. The only glaucoma treatment is regular eye examination and control of intraocular pressure (IOP). The centralized information obtained from these examinations is an essential prerequisite for providing optimal healthcare which is possible by creating electronic records. Minimum Data Set (MDS) is a standard tool for getting access to accurate data, which is among the basic needs for the design of electronic records.
Materials and Methods: This is descriptive-analytical study. The population of this study consisted of glaucoma patients’ medical records at Farabi Eye Hospital, reference books, and glaucoma specialists. The data collection tool was a questionnaire -- containing patients' records, and demographic and clinical data -- which was distributed between 22 available glaucoma specialists. The validity of the questionnaire was assessed by an expert team and its reliability was determined by test-retest method. Data analysis was performed by calculating the frequency percentage and Delphi test.
Results: After reviewing the rate of experts’ agreement with the components of the survey, all of the cases with over 75% approval rate were considered as minimum data set for glaucoma. Minimum data set was divided into three general categories: patient's records, demographic data, and clinical data.
Conclusion: Determination of minimum data set for glaucoma will be an effective step to integrate and improve the management of patients’ records. Moreover, it will be feasible to store and retrieve such records. 

Background and Aim: Nowadays, one of the most important areas of application of information technology in the health sector is monitoring patients' condition. Recently utilization of body area sensor networks in healthcare had significant advances. The purpose of this article is to examine the applications of wireless health sensor networks in the field of health. 
Materials and Methods: This study was a review study which was done by searching in reliable scientific sources such as Pubmed, IEEE, Science Direct, Springer and other Persian information sources like Magiran and Sid. In order to search English sources, keywords such as “Wearable and implantable body sensors” “Body area sensor network”, and in order to search in Persian sources, keywords such as “implantable and wearable network nodes”, were used.
Results: The tasks of the body sensor networks are to monitor the important parameters of the body, which are vital signs of ill health and illness. Additionally, various types of sensor networks can control various illnesses, for example, heart disease, neoplasms, diabetes, kidney disease, Parkinson's disease, infectious diseases, and so on. Also a variety of wireless body sensor networks in the medical field are divided into two main categories: the wearable wireless body area networks and the implantable wireless body area network.
Conclusion: The use of body sensor networks has a tremendous impact on health and leads to improvements in the life quality and comfort of patients. These technologies are improving, and their development aims to help patients, doctors and the treatment team.

Background and Aim: Medication errors are preventable event, which may result inappropriate medication intake or damage to patients and, Medication management is a complicated process including multiple activities in order to improve patient safety. There are many documentations that indicate the considerable potential of information technology, especially mhealth in this area. The aim of this study was to review the mobile based medication management systems in order to extract the requirements for these systems development.
Materials and Methods: Four electronic databases (PubMed, Embase, Web of Science and Science Direct) were searched for papers regarding mhealth based medication management systems. After screening the abstracts and publications information a descriptive study was performed on 15 papers.
Results: In this study, 13 functional requirements were extracted and the user requirements was divided into six main groups. Also the technologies which was used in order to implement the functional requirements were extracted.
Conclusion: According to the current study, medication management systems using mhealth technologies are feasible for people with chronic diseases, elderly people and etc. but there is not any medication management system for visually impaired people. Although due to their disabilities they are at higher risk of medication errors and it is a research gap that should be considered in future works.

Background and Aim: Successful implementation and optimum use of telemedicine technology depends on providing the necessary infrastructure and the success factors of this technology, such as high-speed broadband. The present study is aimed at feasibility study on the implementation of telemedicine in selected hospitals of Iran.
Materials and Methods: This descriptive-analytic study was conducted in selected hospitals in 2016. The data gathering tool was a researcher-made questionnaire that its content validity and structure were measured by four professors of health information management. Reliability of the questionnaire was determined using internal correlation test (Cronbach's alpha=0.83). The results were analyzed using descriptive statistics (average and standard deviation) and inferential statistics.
Results: According to the findings, 82.2% of the hospitals had no access to 
high-speed broadband and only 5.5% had optics fiber. Insurance and repayment obstacles and shortages of technical staff were identified as the main barriers and medical personnel's resistance and licensing issues were identified as the low importance barriers to the implementation of this technology. Organizational and cultural factors (p-value=0.001), technical infrastructure (p-value=0.005) and financial requirements (p-value=0.021) of telemedicine technology had a significant difference of 5% error rate with education level and orientation.
Conclusion: Due to barriers such as lack of video conferencing tools, the lack of high-speed broadband, and inadequate funding for the purchase and implementation of the necessary equipment, the studied hospitals currently were not able to provide telemedicine services.

Background and Aim: The Ovarian epithelial cancer is one of the most deadly types of cancers in women.Thus, the purpose of this study was to investigate the most effective factors in predicting and detecting Ovarian cancer in the form of a decision tree to facilitate the Ovarian cancer diagnosis.
Materials and Methods: The present study was a descriptive-developmental study. The main research tool applied in this study was a checklist which was designed based on the medical records, published studies, scientific references, and expert consultation.To determine the content validity of the checklist, the CVR method was applied. Next, survey research was done with aid of Likert-based checklist based on expert opinions in gynecology. Finally, to develop the decision tree, the results of the expert survey were analyzed and the final model was implemented based on the survey results.
Results: The data elements of final decision tree were derived from the result of expert surveys, guidelines, clinical pathways and strategies in context of diagnosis and screening of Ovarian cancer. The leaf nodes in the tree include different types of tumor markers, following up, therapeutic measures, and referrals. The accuracy of the decision tree was approved by the experts. The most important tumor markers that obtained from the decision model in this study were CA19-9, ROMA (CA125 + HE4) and CEA.
Conclusion: Clinical decision models can provide specific diagnosis and therapeutic suggestions by creating patient information integration framework. The model developed in this study can improve the diagnosis of epithelial Ovarian cancer considerably by facilitating decision making.

Background and Aim: The emergence of Web interactive technologies has enabled interactive social networking services. The purpose of this research is to choose a model and present an architectural design for the social network of health at Shariati Hospital in Tehran.
Materials and Methods: At first, valid enterprise architecture frameworks were reviewed. Then, dimensions of the architecture frameworks needed for the social network of health were reviewed and six dimensions including of input, output, goals, views, abstraction, and system life cycle were selected. Architecture frameworks were prioritized on the basis of these six dimensions and the Zachman framework was selected. The extracted elements for these dimensions were evaluated by using a researcher-made questionnaire and experts’ opinion in the t-test. The questionnaire was distributed among 40 health-care information technology experts. After analyzing and verifying the dimensions and sub-indicators of each dimension, probable risks for the implementation of the health social network were identified based on interviews with experts and were approved by a panel of five experts.
Results: The Zachman framework was selected based on six dimensions as a suitable framework and potential implementation risks were identified.
Conclusion: The results showed that the proposed architecture model could be the basis for the implementation of this network in the country. Attention to extracted risks can minimize the failure of the implementation of the health social network.

Background and Aim: The quality of Electronic Health Records (EHRs) depends on the quality of its content and proper documentation. Determining the Minimum Data Set (MDS) to enhance the quality of electronic health records’ content and helping to improve the quality of health care provision to uveitis patients are essential matters. The aim of this study is to determine the essential MDS for uveitis patients’ electronic health records.
Materials and Methods: In this descriptive-analytical study, data collection tools for collecting the Minimum Data Set were library resources and internet-based database. The MDS was obtained through Likert scale questionnaire and was surveyed by 22 ophthalmologists and retina subspecialists.
Results: Among the elements of the survey, all cases with over 90% approval were considered as main elements. Regarding the importance of presented data elements, no significant difference was found between the responses of ophthalmologists who participated in this study. 
Conclusion: The Minimum Data Set of uveitis patients’ electronic health records can be represented by five groups of demographic information: patients’ clinical records, laboratory information, type of uveitis, treatment guidelines, and the information of ophthalmic pictures. A suggested model for manual systems and electronic medical records is available. 

Background and Aim: Since safety, performance and outcome indicators can improve the quality of care, patient safety indicators are required to monitor and provide safety in care. The aim of this study was to compile a set of patient safety indicators for monitoring in patient safety dashboard.
Materials and Methods: A set of patient safety indicators was collected by reviewing such indicators presented in Australia, England and OECD, ESQH, and AHRQ organizations. Then, the indicators were validated during Delphi process in two stages by the staff of patient safety and quality improvement unit of governmental hospitals and patient safety experts at Tehran University of Medical Sciences treatment deputy office. Data analysis was performed by SPSS version 13 and descriptive statistics.
Results: The present study was conducted on 62 patient safety indicators and eight main categories were classified as follows: safe hospital indicators, childbirth indicators, surgery-related indicators, mortality indicators, infection-control indicators, drug and prescription error indicators, falling indicator, and other special indicators.
Conclusion: Considering the identification of patient safety indicators in different dimensions, measuring the importance of these indicators and using them in the form of dashboard software in health centers will have a significant role in improving patient safety and the quality of health care.

Background and Aim: In recent years, tuberculosis is a major cause of illness and mortality due to infectious diseases. In fact, one of the reasons for increasing the incidence of tuberculosis is that it is often associated with HIV infection. The present study aimed to design and establish a mobile-based self-care system for controlling tuberculosis.
Materials and Methods: The data required in this research for evaluating the information and designing the application were collected in two main steps: first, the data required in this research for information needs assessment and application design were collected by searching in library resources. A questionnaire was applied by physicians to validate and determine the significance of these elements.  Afterwards, based on information elements and the self-care, application was designed in the Android Studio environment.
Results: Information elements and functional capabilities required by the program were determined. Web-based services as a system interface, not only provided the communication between the patient and the care provider, also allowed for patient monitoring and disease control. Then evaluation of the performance and performance of the program was done by doctors and software experts. The findings showed user satisfaction with the application.
Conclusion: Monitoring of treatment electronically allows for less costly monitoring of the patient. In this study, we present a prototype of the relationship between self-care application and portal and its potential benefits, which will allow future studies to improve and add new capabilities.

Background and Aim: To provide effective care, health care providers need timely and appropriate information. Electronic records provide quick access and easy management of data. The aim of this study was to develop electronic health records for patients with hydatidiform mole and evaluation of completeness of medical records
Materials and Methods: This applied study was conducted in 2017. After verifying the minimum data set required for the system, data were extracted from patient records using a checklist and entered into SQL server. SQL server 2012 and Visual Studio 2013 to design electronic records and SPSS 20 for data analysis was used. Extent of data completion in patient records was also assesed.
Results: Data on the completion of paper records indicated that in 100% of cases, “address” item was filled in. The less completed data was related to carotene deficiency (%1.1). Our findings also showed that the eight most important items like age of first menstruation, first gestational age, interval between pregnancies, number of sexual partners, menstruation between pregnancies, contraceptive methods, social habits and radiotherapy, were not completed in all records.
Conclusion: Many of the important minimum data set for hydatidiform mole disease were either not completed or completed in limited numbers in paper records. By developing such health records, we can ensure better prevention and treatment, and regular follow-up for the patients and help them to save their time and costs.

Background and Aim: Infertility is a chronic disease with a long-term treatment and self-care leads to an increase in the level of knowledge and awareness about the disease. Moreover, smartphones provide access to information at any time and place; therefore, by using the mobile-based assisted reproductive technology, a self-care application program can be a good choice to help people gain awareness and improve the treatment. 
Materials and Methods: Library resources and related and similar applications were studied. Then, data items and the sections required for applied program were identified. To study their importance, a survey was performed on the working members of Iran Helal Infertility Specialty Center. Out of the 35 members of the research community, 20 were randomly selected. The survey questionnaire was made with 32 questions in three sections. In this survey, the data model framework was confirmed; however, the basis of the tools framework didn't need the confirmation of validity and reliability since the data model was designed based on the reference. With summarization of responses, data items and sections specified in designing the program were applied.
Results: The mean of the scores showed that the respondents had identified most of the items as essential. This survey had three main axes. The mean scores of axes of patient information, patient education, and disease management tools are 4.205, 4.402 and 4.275, respectively. The mean scores above 4 show that their effectiveness is very high.
Conclusion: Considering the results, the designed application program can be helpful for patients.