Patient accounting systems: Are they fit with the users� requirements?

Objectives: A patient accounting system is a subsystem of a hospital information system. This system like other information systems should be carefully designed to be able to meet users� requirements. The main aim of this research was to investigate users� requirements and to determine whether current patient accounting systems meet users� needs or not. Methods: This was a survey study, and the participants were the users of six patient accounting systems used in 24 teaching hospitals. A stratified sampling method was used to select the participants (n = 216). The research instruments were a questionnaire and a checklist. The mean value of �3 showed the importance of each data element and the capability of the system. Results: Generally, the findings showed that the current patient accounting systems had some weaknesses and were able to meet between 70 and 80 of users� requirements. Conclusions: The current patient accounting systems need to be improved to be able to meet users� requirements. This approach can also help to provide hospitals with more usable and reliable financial information. © 2016 The Korean Society of Medical Informatics

Physicians' and Nurses' Opinions about the Impact of a Computerized Provider Order Entry System on Their Workflow

INTRODUCTION: In clinical practices, the use of information technology, especially computerized provider order entry (CPOE) systems, has been found to be an effective strategy to improve patient care. This study aimed to compare physicians' and nurses' views about the impact of CPOE on their workflow. METHODS: This case study was conducted in 2012. The potential participants included all physicians (n = 28) and nurses (n = 145) who worked in a teaching hospital. Data were collected using a five-point Likert-scale questionnaire and were analyzed using SPSS version 18.0. RESULTS: The results showed a significant difference between physicians' and nurses' views about the impact of the system on interorganizational workflow (p = .001) and working relationships between physicians and nurses (p = .017). CONCLUSION: Interorganizational workflow and working relationships between care providers are important issues that require more attention. Before a CPOE system is designed, it is necessary to identify workflow patterns and hidden structures to avoid compromising quality of care and patient safety

Clinicians' Knowledge and Perception of Telemedicine Technology

INTRODUCTION: Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. METHODS: This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). RESULTS: The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. CONCLUSION: The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions

Health information security in hospitals: The application of security safeguards

Introduction: A hospital information system has potentials to improve the accessibility of clinical information and the quality of health care. However, the use of this system has resulted in new challenges, such as concerns over health information security. This paper aims to assess the status of information security in terms of administrative, technical and physical safeguards in the university hospitals. Methods: This was a survey study in which the participants were information technology (IT) managers (n=36) who worked in the hospitals affiliated to the top ranked medical universities (university A and university B). Data were collected using a questionnaire. The content validity of the questionnaire was examined by the experts and the reliability of the questionnaire was determined using Cronbach's coefficient alpha (α=0.75). Results: The results showed that the administrative safeguards were arranged at a medium level. In terms of the technical safeguards and the physical safeguards, the IT managers rated them at a strong level. Conclusion: According to the results, among three types of security safeguards, the administrative safeguards were assessed at the medium level. To improve it, developing security policies, implementing access control models and training users are recommended. ©2016 Esmaeil Mehraeen, Haleh Ayatollahi, Maryam Ahmadi

Confirmation of expectations and satisfaction with hospital information systems: A nursing perspective

Objectives: This study aimed to compare nurses� satisfaction with, and expectations of, hospital information systems in two teaching hospitals. Methods: This was a survey study, which was completed in 2014. The potential participants were 267 nurses who worked in two teaching hospitals and used the same hospital information system. Data were collected using two questionnaires. Both questionnaires were examined in terms of content validity and reliability. Results: The results showed that, for a majority of nurses, their expectations of the system were not met in either hospital. Moreover, there was a significant association between the nurses� expectations and the perceived usefulness of the systems (p < 0.001), between the nurses� expectations and their satisfaction with the systems (p < 0.001), and between the perceived usefulness and nurses' satisfaction with the systems (p < 0.001). Conclusions: The results suggested that, apart from the technical issues of implementing clinical information systems, non-technical factors should be taken into account. Among them, the nature of clinical tasks and the organizational culture require more attention to allow a successful system to be designed and implemented. © 2016 The Korean Society of Medical Informatics

Predicting coronary artery disease: A comparison between two data mining algorithms

Background: Cardiovascular diseases (CADs) are the first leading cause of death across the world. World Health Organization has estimated that morality rate caused by heart diseases will mount to 23 million cases by 2030. Hence, the use of data mining algorithms could be useful in predicting coronary artery diseases. Therefore, the present study aimed to compare the positive predictive value (PPV) of CAD using artificial neural network (ANN) and SVM algorithms and their distinction in terms of predicting CAD in the selected hospitals. Methods: The present study was conducted by using data mining techniques. The research sample was the medical records of the patients with coronary artery disease who were hospitalized in three hospitals affiliated to AJA University of Medical Sciences between March 2016 and March 2017 (n = 1324). The dataset and the predicting variables used in this study was the same for both data mining techniques. Totally, 25 variables affecting CAD were selected and related data were extracted. After normalizing and cleaning the data, they were entered into SPSS (V23.0) and Excel 2013. Then, R 3.3.2 was used for statistical computing. Results: The SVM model had lower MAPE (112.03), higher Hosmer-Lemeshow test's result (16.71), and higher sensitivity (92.23). Moreover, variables affecting CAD (74.42) yielded better goodness of fit in SVM model and provided more accurate result than the ANN model. On the other hand, since the area under the receiver operating characteristic (ROC) curve in the SVM algorithm was more than this area in ANN model, it could be concluded that SVM model had higher accuracy than the ANN model. Conclusion: According to the results, the SVM algorithm presented higher accuracy and better performance than the ANN model and was characterized with higher power and sensitivity. Overall, it provided a better classification for the prediction of CAD. The use of other data mining algorithms are suggested to improve the positive predictive value of the disease prediction. © 2019 The Author(s)

Designing and building a teledermatology system

Background and purpose: Teledermatology means specialized skin care (diagnosis, treatment and follow-up) using information technology and telecommunications. This system facilitates communication between patients, doctors, nurses and primary care providers with dermatologists. The purpose of this study was to design and build a software for remote diagnosis of skin diseases. Materials and methods: In the first phase of study, based upon a literature review, a questionnaire was designed to determine the items needed for software design and was completed by dermatologists in Razi Hospital. Data was analyzed using descriptive statistics in SPSS V.19. In next phase, according to the results of first phase, the prototype was designed and Think Aloud usability test was applied. Then, the final version of the software was designed. Results: In the section of patient's identity, the respondents listed all data elements except the National Identification Number, address, and weight. They also suggested patient's job as an essential item. All items for clinical data and functionality of the software were found necessary. Considering the results obtained from the questionnaires and usability test, the final version of the web-based store and forward software was created. Conclusion: This kind of platform could help dermatologists in providing rapid diagnosis and treatment plan for each patient since it enables electronic transmission of patient images and clinical history. Also, this system requires limited technical equipment and is cheap to run which could be applied with little training to nurses or referral physicians. © 2015, Mazandaran University of Medical Sciences. All rights reserved

Injury surveillance information system: A review of the system requirements

Purpose: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system. Method: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively. Results: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination. Conclusion: ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings. © 2020 Chinese Medical Associatio

Data Quality Assessment in Emergency Medical Services: What Are the Stakeholders' Perspectives?

Introduction: Emergency care is usually conducted within limited time and with limited resources. During emergency care processes, data quality issues should be taken into account. The aim of this study was to assess the quality of emergency care data from the perspectives of different data stakeholders. Method: This survey study was conducted in 2017. In this research, the viewpoints of three groups of data stakeholders, including data producers, data collectors, and data consumers, were collected regarding data quality in emergency care services. Data were collected by using a standard information quality assessment questionnaire. Results: The mean values for each dimension of data quality were as follows: sound data (6.23), dependable data (6.28), useful data (6.30), and usable data (6.35), with 0 being the lowest possible score and 10 being the highest. The role gap analysis suggested a clear gap between data producers and data customers at the university level. Conclusion: Overall, data quality in emergency medical services was not at a high level. Although data quality was improving, the levels of data completeness, compatibility, and usability were low. To improve the usability of emergency medical service data, more attention should be paid to the dimensions of accuracy, completeness, and consistency of data sources

Web and mobile-based technologies for monitoring high-risk pregnancies?

Introduction High-risk pregnancy is an illness in which there are severe complications and problems that may cause fetal loss and requires continuous care. It seems that using telemedicine technology is helpful to provide wider access to prenatal care. The aim of this study was to compare the feasibility of using web-based and mobile-based technologies in caring for high-risk pregnancy. Materials and methods This was a cross-sectional study and the participants included midwives and gynaecologists who worked at teaching hospitals. The data were collected by using two five-point Likert scale questionnaires which were designed based on the literature review. The questionnaires included two main sections: demographic questions and questions related to five aspects of a feasibility study. Face and content validity of the questionnaires were confirmed by the experts and the reliability was checked by using the test-retest method. The data were analysed using descriptive and inferential statistics. Results In this study, 79 questionnaires were completed by 50 midwives (63.29) and 29 gynaecologists (36.71). Overall, midwives (p=0.001) and gynaecologists (p=0.003) believed that using mobile-based technologies was more feasible than using web-based technologies in caring for high-risk pregnancies. Conclusion It seems that planning for the future technological direction and providing mobile-based applications should be taken into account and prioritised to improve the quality of prenatal care and to increase access to healthcare services for high-risk pregnancies. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ