Managing the security of nursing data in the electronic health record

Background: The Electronic Health Record (EHR) is a patient care information resource for clinicians and nursing documentation is an essential part of comprehensive patient care. Ensuring privacy and the security of health information is a key component to building the trust required to realize the potential benefits of electronic health information exchange. This study was aimed to manage nursing data security in the EHR and also discover the viewpoints of hospital information system vendors (computer companies) and hospital information technology specialists about nursing data security. Methods: This research is a cross sectional analytic-descriptive study. The study populations were IT experts at the academic hospitals and computer companies of Tehran city in Iran. Data was collected by a self-developed questionnaire whose validity and reliability were confirmed using the experts' opinions and Cronbach's alpha coefficient respectively. Data was analyzed through Spss Version 18 and by descriptive and analytic statistics. Results: The findings of the study revealed that user name and password were the most important methods to authenticate the nurses, with mean percent of 95 and 80, respectively, and also the most significant level of information security protection were assigned to administrative and logical controls. There was no significant difference between opinions of both groups studied about the levels of information security protection and security requirements (p>0.05). Moreover the access to servers by authorized people, periodic security update, and the application of authentication and authorization were defined as the most basic security requirements from the viewpoint of more than 88 percent of recently-mentioned participants. Conclusions: Computer companies as system designers and hospitals information technology specialists as systems users and stakeholders present many important views about security requirements for EHR systems and nursing electronic documentation systems. Prioritizing of these requirements helps policy makers to decide what to do when planning for EHR implementation. Therefore, to make appropriate security decisions and to achieve the expected level of protection of the electronic nursing information, it is suggested to consider the priorities of both groups of experts about security principles and also discuss the issues seem to be different between two groups of participants in the research. © 2015 Mahnaz Samadbeik, Zahra Gorzin, Masomeh Khoshkam, Masoud Roudbari

Functional Requirements of the Pharmacy Information Systems from the Pharmacists' Perspective: A Qualitative Approach

Introduction: In the field of studying information systems, qualitative approach is one of the ways to extract the system requirements from the perspective of the users. Therefore, this study was performed to identify the functional requirements of the pharmacy information system from the perspective of the pharmacists using a qualitative approach. Method: This qualitative study was performed using conventional content analysis approach. In this study, 15 pharmacists who worked at hospitals affiliated to Fars University of Medical Sciences, were selected using purposive sampling. The data were collected through semi-structured interviews (30-40 min) in 2016. Data were analyzed using Graneheim and Lundman's method by MAXQDA v.10 software. Lincoln and Guba's criteria were used to ensure the accuracy and trustworthiness of the study Results: After analysis of the data obtained from interviews, five main categories and 13 subcategories were obtained. The main categories include the ability to accurately reconcile medication lists (medication reconciliation), update and flexible reporting, systems interoperability, integration with the decision support system, and access to the clinical information. Conclusion: According to the results, evaluation of the systems before purchase and comparing them with the expected functional requirements of the users, are necessary. Also, in the case of intraorganizational design of these systems, skilled analysts who are familiar with health organizations should be employed to extract the users' needs

Personal Electronic Health Record for Patients with Diabetes; Health Technology Assessment Protocol

Introduction: In recent decades, diabetes has contributed significantly to the burden of disease in developed and developing countries, due to the considerable prevalence and involvement of various age groups in the communities.Today, a variety of ways to manage and control the disease are used, one of which is the use of personal electronic health records. Recently there has been a remarkable upsurge in activity surrounding the adoption of personal electronic health records systems for patients and consumers. personal electronic health records systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care.The present study was conducted with the goal of Health Technology Assessment the impact of personal electronic health records in Patients with Diabetes.Methods: Writing is based on PRISMA standards.  This was a Health Technology Assessment  study. It aimed to evaluate the technology of personal electronic health record . The scoping review was conducted to evaluate 8 dimensions (Health Problem and Current Use of the Technology, Description and technical characteristics of technology, Safety, Costs and economic evaluation, Ethical analysis, Organisational aspects, Patients and Social aspects, Legal aspects) of  Personal electronic health record . This study was based on answering questions which were developed based on Health Diagnostics Technology Assessment Documents Framework and HTA Core Model 3.0 . A systematic review was conducted to evaluate the Clinical Effectiveness dimension of personal electronic health record  in controlling diabetes. In order to gather evidences, Ovid databases, Cochrane Library, PubMed, CRD, Trip database and EMBASE, and Randomized Controlled Trial Registries, such as the Clinical Trial and Trial Registry, were searched using specific keywords and strategies. .Articles are evaluated on the basis of the quality criteria of JADAD.The data is analyzed by the STATA software.Dissemination:The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.Policy makers and healthcare decision-makers can use these results

Awareness of Patients' Rights Charter among Paramedical Intern Students in Lorestan University of Medical Science

Introduction: A Charter of Patients' Rights is one of the means to improve and strengthen the health system and patient satisfaction. Therefore, the purpose of the current study was to evaluate awareness of paramedical intern students about Patients' Rights Charter in Lorestan University of Medical Sciences. Method: This cross-sectional, descriptive, and analytical study was performed in 2014. The study population included all of the paramedical intern students in Lorestan University of Medical Sciences. Due to the limited number of population (69 people), they participated in the study with census method. The data-gathering tool was a valid and reliable questionnaire based on the elements of Iran patients' rights developed by the Ministry of Health and Medical Education (MOHME).The collected data were analyzed by descriptive and analytical statistics using SPSS 16 software. Results: The results show that in 1.45 percent of the cases, the total awareness of students was weak, in 81.16 percent was moderate, and in 17.39 percent of them was good. The highest level of awareness was about the patient's rights in receiving the optimal health services (%81.1), and the lowest was about the patient's right to choose and decide freely on health services (%1.45). There was a significant relationship between gender and the students’ awareness. Conclusion: Total awareness of the students from patients' bill of rights was medium. Therefore, greater emphasis should be placed on inclusion and support of patients' rights in course and curriculum planning for paramedical students

Health Literacy Instruments for Computer-Based Applications: A Review Article

Introduction: Health literacy has been defined as the cognitive and social skills which determine the individuals' motivation and ability to gain access to, understand, and use information in ways which promote and maintain good health. To address health literacy in today’s technology-rich health care environments, there is a strong need for validated computer-based tools to assess health literacy. Therefore, this study aimed to present an overview of specifications of current health literacy screening instruments to adapt for computer-based usages. Method: In this narrative review study, relevant English publications were examined. The selected resources resultedfrom Boolean search in the related databases using key words concerning the Health Literacy Instruments. Results: The results of the overview of the health literacy measurement tools showed that these instruments include the two gold standards TOFHLA (pilot testing of a computer-based version) and the Rapid Estimate of Adult Literacy in Medicine (REALM) as well as, Newest Vital Sign (NVS) and eHealth Literacy Scale (eHEALS). Additionally, the tool for Health Literacy Screening Question Methodologies (HLSQM) was applied to measure the health literacy. Conclusion: Current health literacy screening tools demonstrate different beneficial properties depending on the context of use. Therefore, it's recommended that a health literacy instrument be developedfrom the combination of validated and reliable HLSQM and eHEALS questions for the purpose of developing a computer-based instrument to screen individuals accessing eHealth applications

Tele ECG; Applications, Infrastructures and Necessity of Using it

Introduction: In recent decades because of the high mortality from cardiovascular disease, many technologies have been established in order to deal with it. One of these technologies is Tele ECG which is very practical in remote areas. Regarding the significant rural population in the country, the aim of this study was to identify and explan required applications and infrastructures of the Tele ECG and the necessity of using it. Method: This is a review was carried out by running a search in valid databases and evaluation of published articles between 2005 to 2015. Results: The results of this study show that use of Tele ECG’s application is very simple and doesn’t require a lot of resources and infrastructures. In rural areas is very useful and is very low cost. Conclusion: With respect to wide geographical distribution and considerable population in rural area of Iran, Tele ECG can be effective application to management of patients with cardiac disease in remote areas and reduction of death rate from cardiovascular disease

A systematic review of the attributes of electronic personal health Records for Patients with multiple sclerosis

The personal health record (PHR) is a novel information technology in the domain of health. In recent decades, PHR has been employed as an emerging tool for the improvement of healthcare services for patients with chronic diseases. The application of PHR plays a significant role in healthcare provision for multiple sclerosis (MS) as a chronic disease. The present study aimed to identify the attributes of PHR for patients with MS. This was a systematic review performed in 2019. Scopus, ProQuest, Embase, PubMed, IEEE, and Web of Science databases as well as the Google Scholar were searched using a combination of keywords. Data were collected using a data extraction form and analyzed using combined narrative and content analysis. Of the 1963 retrieved articles, 39 articles entered the study based on inclusion criteria. The attributes of PHR for patients with MS can be categorized into two groups of minimum data sets (MDS) and capabilities. MDS includes 13 categories and capabilities include eight. Identifying the PHR attributes, and use of them in designing and developing of PHR for MS, can be effective in better decision-making with regard to people�s health and improve the quality of care by accessing and using the data required for effective communication between people and the healthcare team. © 2019, IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature

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

Components that affect the Implementation of Health Services’ Strategic Purchasing: A Comprehensive Review of the Literature

Introduction: Strategic purchasing is one of the mechanisms that can increase access, equity, and efficiency as well as the correct management of health resources. The aim of this study was to extract important and influential factors as necessary infrastructures to implement this method. Methods: In this comprehensive literature review, 13 databases and search engines were searched from 2000 to 2015 by applying appropriate keywords. From a total of 1403 titles and after ensuring the validity of the study by the Clinical Appraisal Skills Program (CASP) tool, 18 articles that contained title, abstract, and associated text were used in the study, and their related information was analyzed and extracted using an extraction form and LitAssist software. Results: The findings showed six categories of intervention have been effective in the strategic purchasing of all health interventions in different countries. These six categories were "The target group of users of the service" (demand side), "purchased interventions," "providers and suppliers of interventions" (the supply side), "Methods and incentives" (payment method), "price," and "Structure and organization." Conclusion: Although the necessity of performing strategic purchasing in the health sector or developing countries is an indisputable fact, it is of great importance to use the experiences of developed countries while considering the factors extracted from the study for implementing this method. In this regard, it is suggested that studies be performed that can lead to assessing the feasibility of strategic purchasing for health services in developing countries and also in Iran to help health policy makers in these countrie

Developing a national formulary based on a unified payment system in Iran

Introduction: The national formulary plays an important role in increasing access to medicine and correct drug information based on national considerations. However, this study aimed to provide a model for development of national formulary based on a unified payment system in Iran. Methods: This study used a combination of descriptive, comparative, and qualitative methods. It was an applied developmental study in 2016. The data were collected using a form based on the World Health Organization’s (WHO) standard model for national formulary. Using census method, all national formulary of countries available on the WHO website (n=14) were selected for study. The similarities and differences of national formulary of these countries and Iran were compared with the WHO’s standard model. Then, Iran’s national formulary content was determined using comparative study results and opinions of an expert panel consisting of 12 faculty members and assistants of the medicine economy. Results: Results showed that the content of national formulary in studied countries is consistent with the WHO model. They consisted of four parts: introductory information, medicine information and monograph, appendices, and alphabetical index. In the introductory, which was out of elements of the WHO, the drug selection and advice to patients’ criteria in the preliminary information part of used dose and its side effects in drug monograph and information had the highest frequency. The lowest frequency was for medicine pharmacology and pharmacokinetics in the medicine monograph section. The most common data element in the appendix was related to drug interactions, and the lowest frequency was related to hepatic impairment and renal impairment. All data elements were confirmed by an expert panel. They stated that, after the component of common brand name, the drug cost effectiveness and drug code are necessary for each drug in the drug monograph section. Conclusion: This study provided an updated model and structure for developing national formulary of Iran based on a unified reimbursement system, WHO model, comparative study of national formulary of selected countries, and the opinion of an expert panel in the field of medicine economy. This model may provide reliable information for health employees and managers and improve the effective and safe use of medicines. Also, the creation of drug formulary based on this model and using it may facilitate the selection of standard and high- quality medicines from among different companies and brands, comparing them with each other, prescribing high-quality medicine with lower price, and avoiding the impact from advertisement