Relationship between serum irisin, glycemic indices, and renal function in type 2 diabetic patients.

Introduction: Irisin is a novel peptide that plays notable role in human and animal biology and physiology. It has been reported that irisin may improve insulin resistance and related disturbances. Objectives: The aim of this investigation was to assess the relationship between serum irisin, glycemic indices, and renal function in diabetic subjects. Patients and Methods: In this cross-sectional study, a total of 102 type 2 diabetes mellitus (T2DM) patients were recruited. Blood biochemical parameters, including fasting plasma sugar (FBS), glycosylated hemoglobin (HbA1C), serum uric acid (sUA), creatinine concentration and glomerular filtration rate (GFR) were measured. All statistical analysis was performed with SPSS 16.0. Results: There was a positive correlation between irisin and age (P=0.05, r=0.19) and a negative correlation between irisin and body mass index (BMI) (P=0.01, r=-0.25) was detected. There was a significant difference of serum irisin level between patients with normal and abnormal FBS too. Conclusion: In this study we found, irisin concentration was increased with age, decreased with BMI, and it was higher in subject with abnormal FBS. Thus further research is needed to provide inclusive understanding of irisin associated physiological effects and possible implications in clinical conditions

The Current State of IT Governance in Education and Training Centers in Iran University of Medical Sciences: A Qualitative Study

Introduction: IT Governance includes IT management and the way to make IT decisions in line with the related IT processes, resources, and responsibilities. This study aimed to determine the current state of IT governance in education and training centers in Iran University of Medical Sciences. Method: This is a practical qualitative study. In the first step of the study the population centers including the related documentation, and in the second step the units responsible for information technology, computing, informatics and hospital administrators who work in the center were included. Data collection tools in the first step was the data collection forms, and in the second step was interview guide. Content analysis of the documents and all the propositions were extracted. The final step is data processing and interpretations of the results. After interviews were collected, the data were identified, coded and classified. Finally, the sub-topics were combined, the topics were selected, and the thematic analysis was performed. Results: 40% of centers' information technology administrators studied computer software at university and 40% of the managers were graduated from medical centers. The results showed that the president, the director, the IT department administrators, and the director of the Department of Statistics and Information Technology in many areas have made their decision in technology-related fields . In some centers also the IT department administrator provided the staff with job description after being approved by the hospital manager. Conclusion: The structure of the studied centers' IT departments was vague and complex, so that the trustees, policy makers, administrators and IT operators in hospitals were not exactly clear. Keywords: Information Technology Governance, Information Technology, Information Technology Governance Domain

Minimum Data Set for Elderly Health: A comparison of Selected Countries

Introduction: The progressive increase in the elderly population in many developed countries leading to focus on health in this age group. Recording adequate data for the elderly people is considered as the basis for future planning for this part of society. Therefore, this study was aimed to compare the minimum data about elderly health in selected countries. Method: This is a review article was carried out through internet and library studies. The Keywords were extracted from search engines and databases including Google, Yahoo, Google Scholar, PubMed and Proquest, and the Iranian National Medical Digital Library using inclusion criteria included English language and no time limit. All papers, research projects, theses, guidelines and progress reports were retrieved from America, Sweden, Japan and Iran. Also, Web sites of organizations responsible for elderly health in each country were visited and their documents were reviewed. The results of this search were presented narratively and within comparative tables. Results: The results of this study showed that in selected countries, elder’s data collected in four axis. Most of demographic data is completed in America. In Sweden, Iran and Japan some data from medical histories and health assessment are considered as well as some financial data in Iran. Conclusion: Given the importance of the health minimum data set for future planning, using the experiences of the pioneer countries in health is necessary, but localization of it according to the country’s needs is inevitable

Modeling of outpatient prescribing process in Iran: a gateway toward electronic prescribing system

Implementation of electronic prescribing system can overcome many problems of the paper prescribing system, and provide numerous opportunities of more effective and advantageous prescribing. Successful implementation of such a system requires complete and deep understanding of work content, human force, and workflow of paper prescribing. The current study was designed in order to model the current business process of outpatient prescribing in Iran and clarify different actions during this process. In order to describe the prescribing process and the system features in Iran, the methodology of business process modeling and analysis was used in the present study. The results of the process documentation were analyzed using a conceptual model of workflow elements and the technique of modeling "As-Is" business processes. Analysis of the current (as-is) prescribing process demonstrated that Iran stood at the first levels of sophistication in graduated levels of electronic prescribing, namely electronic prescription reference, and that there were problematic areas including bottlenecks, redundant and duplicated work, concentration of decision nodes, and communicative weaknesses among stakeholders of the process. Using information technology in some activities of medication prescription in Iran has not eliminated the dependence of the stakeholders on paper-based documents and prescriptions. Therefore, it is necessary to implement proper system programming in order to support change management and solve the problems in the existing prescribing process. To this end, a suitable basis should be provided for reorganization and improvement of the prescribing process for the future electronic systems

Health information system to improve elderly health: Study of health information system in us to setup standard for developing countries

In this paper the state of health information system in US investigated to reach an instance for developing countries. Our main concern was to obtain how HIS and HIT help to increase public and especially elderly health. We do this investigation to setup standard bound to use in developing countries. HIS and HIT transit a mismanaged paper structure of record keeping to an efficient electronic database for record keeping. It will transform the method of management of data to ensure better information results for overall quality improvement. Health information System professionals also play pivotal role information interoperability. Information interoperability helps in easy transfer of data wherever it is needed. Information interoperability is essentially a function of hospitals, but the role played by HIS professionals makes them a good choice for interoperability developers in healthcare

Towards the Application of Open Source Software in Developing National Electronic Health Record-Narrative Review Article.

Electronic Health Record (EHR) is a repository of patient health information shared among multiple authorized users. As a modern method of storing and processing health information, it is a solution for improving quality, safety and efficiency of patient care and health system. However, establishment of EHR requires a significant investment of time and money. While many of healthcare providers have very limited capital, application of open source software would be considered as a solution in developing national electronic health record especially in countries with low income. The evidence showed that financial limitation is one of the obstacles to implement electronic health records in developing countries. Therefore, establishment of an open source EHR system capable of modifications according to the national requirements seems to be inevitable in Iran. The present study identifies the impact of application of open source software in developing national electronic health record in Iran

Utilization of open source electronic health record around the world: A systematic review

Many projects on developing Electronic Health Record (EHR) systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems

A copmarative review of electronic prescription systems: Lessons learned from developed countries

This review study aimed to compare the electronic prescription systems in five selected countries (Denmark, Finland, Sweden, England, and the United States). Compared developed countries were selected by the identified selection process from the countries that have electronic prescription systems. Required data were collected by searching the valid databases, most widely used search engines, and visiting websites related to the national electronic prescription system of each country and also sending E-mails to the related organizations using specifically designed data collection forms. The findings showed that the electronic prescription system was used at the national, state, local, and area levels in the studied countries and covered the whole prescription process or part of it. There were capabilities of creating electronic prescription, decision support, electronically transmitting prescriptions from prescriber systems to the pharmacies, retrieving the electronic prescription at the pharmacy, electronic refilling prescriptions in all studied countries. The patient, prescriber, and dispenser were main human actors, as well as the prescribing and dispensing providers were main system actors of the Electronic Prescription Service. The selected countries have accurate, regular, and systematic plans to use electronic prescription system, and health ministry of these countries was responsible for coordinating and leading the electronic health. It is suggested to use experiences and programs of the leading countries to design and develop the electronic prescription systems

An Assessment of Readiness for Pre-Implementation of Electronic Health Record in Iran: a Practical Approach to Implementation in General and Teaching Hospitals

Readiness assessment provides a proper image of the existing conditions and an explanation of facilitated operational plans and functional approaches to successful implementation of electronic health record. Readiness assessment requires indices adjusted to particular conditions in each country. Therefore, the present study attempts to provide an acceptable model in Iran and to provide an assessment of public and teaching hospitals in medical education university. After reviewing related papers and descriptive study of five selected countries, the initial model was designed in the form of a questionnaire for analysis through Delphi and distributed among 30 experts nationwide. Along identification of components in the proposed method, a 7-point Likert scale was used to determine priority of each component. Then, all general -education hospitals at Tehran University of Medical Education were examined based on this model in terms of total, relative, or no readiness. The final model was designed in five dimensions: cultural, leadership and management, technical infrastructure, governance and operational dimensions; Educational Hospitals were evaluated in this dimension. 28.6 % of general--teaching hospitals are ready for pre-implementation. It seems to establish uniform strategic and executive team in Health center is essential for the preparation them in abovementioned area in the least possible time