Investigating the quality control of laboratory information

      Clinical laboratory results play an important role in helping physicians in diagnosis and treatment. In view of the direct effect of the working methods on the quality of data in the laboratory, quality control of data and results in the Biochemistry Ward of Laboratory includes taking into account all the factors and variables relating to all the pre-analytical, analytical and post-analytical steps at this ward. The objective of this study was to examine the quality control of data and results in the biochemistry departments of hospital laboratories in universities of medical sciences in Tehran.Current study was a descriptive research, and 40 biochemistry laboratories in universities of medical sciences in Tehran constituted the settings of the study. Data were collected by a checklist and a questionnaire using observation and interview. Using the checklist, 33 effective factors in the pre-analytical step; 18 effective factors in the analytical step and 8 effective factors in post-analytical step were examined. The questionnaire included questions relating to biochemical factors in the laboratories, while the factors affecting the quality of the results were examined by using checklist. Data from questions and observations were analyzed by using descriptive statistics and by determining the absolute and relative frequencies.Results showed that in all settings of the study, 58%, 68% and 87% of the factors affecting the pre-analytical, analytical and post-analytical data and results were taken into consideration respectively. However, the biochemistry directors remarked that they considered 77% and 89% of the first two groups of factors respectively, and the third groups of factors were considered only by observation.according to the findings by the checklists, sufficient attention  was paid to 58% of the factors effective on pre-analytical data quality (Identifying the patient; Labeling the sample while collecting the sample; etc.), 68% of the factors effective on analytical data quality (Analyzing the samples during the 1 to 4 hours following the collection of the samples; Using control samples for evaluating the operation of instruments once in every 8 hours; etc.) and 87% of the factors effective on the post-analytical data quality (Legibility of the hand-written reports; Similarity of the hand-written reports to the typewritten report, in terms of patient ID data record; etc.) while there is no enough attention paid to other factors in pre-analytical step (Preparing the patient; Paying attention to the physiological changes of the patient’s body; etc.), analytical step (availability of written guidelines for performing certain work where the samples are analyzed; Calibrating the instruments according to the standard program; etc.) and post-analytical step (precision in recording distinguishing features in real values). Also, by comparing the findings obtained using the two tools, it can be found out that the findings do not match each other in certain factors and that the amount of findings obtained from the questionnaire is more than the findings obtained from the checklists

Error Detection in Patients’ Pharmaceutical Data: Application of Ontology-Based Text Miner

 Introduction: Medication errors in patients’ medical records can influence the healthcare quality and cause risks for them. It is, therefore, crucial to apply appropriate procedures to reduce these errors. This study sought to develop a software for detecting medication errors through qualitative analysis of patients’ medical records. Materials and Methods: The software was developed using object-oriented analysis and Java. The text was first pre-analyzed using a framework known as Stanford Core NLP. In the next stage, the text was turned into a semi-structured passage to be connected to Dr Onontology using Apache Jena framework. The name and dosage of available drugs were then extracted in the physician order forms and the patient progress notes. The areas of mismatch were identified through comparing the data obtained from these two forms. Results: Software assessment was conducted in two stages. In the first stage, the capability of the software in proper recognition of medicine’s name was measured, as100 completed forms containing physician order forms with a total number of 1014 drugs were used for text mining and error detection. After running the analysis in the error detection software, 93% of the drugs were properly recognized. In the next stage, comparisons were made between the physician order forms and the patient progress notes to find possible mismatches. Out of 1000 recorded drugs in the analyzed forms, the software was able to properly detect mismatches in 91.8% of the cases. The medication data available in i2b2 were used for conducting the assessment. Conclusion: Given that medical records are of paramount importance and their human analysis is a complicated and time-consuming process, deployment of a text miner with the capability of quality analysis could facilitate error detection efficiently and effectively

The Role of Systems Biology and Synthetic Biology in Appearing and Managing COVID-19

Introduction: Studies reveal that viruses play important roles in the origins of cellular life and the evolution of all mammals for example. COVID-19 as a modified brutal virus has affected daily life and is slowing down the global economy.  The main purpose of the current study stems from the question that how COVID-19 was created and how it will be solved. Method: In order to conduct the present research, 26 English articles were chosen from among 57 articles published from 2000 to 2020 based on their relation to viral diseases and the availability of the full text at the PubMed, Science Direct, ProQuest, and Google Scholar databases. Findings: To study the new coronavirus, its genetic sequence should be accessible for us. As understood, synthetic biology takes advantage of the knowledge obtained from systems biology analysis and the conceptual tools made for such purposes. These approaches develop systems toxicology as well as stand out in predicting and evaluating the immunogenicity of vaccines as well as improving vaccine formulations through a definite immunological marker. Conclusion and Suggestion:Dealing with viral diseases such as COVID-19 demands vast knowledge of biotechnology, cell and molecular biology expertise, and competent approaches based on bioinformatics technology that contains systems biology and synthetic biology. Therefore, such scientific fields need to be highly developed in developing countries to keep their immunity and national security under warranty encountering any biological invasion, most specifically of viral types

eHealth Equity: Current Perspectives

Health justice is something that every country in the world needs. However, the existence of health disparities among different social groups and geographical regions in various countries of the world is inevitable. These health inequalities are a major obstacle in achieving health justice. There are a number of factors affecting health equity such as socio-economic status, education level, age, religion, geographical position, racial and ethnical differences, gender minorities, environmental factors, accessibility level to healthcare services and resources, and also the quality of healthcare. Although eHealth has the potential of eliminating health inequalities leading to the establishment of health justice, it is essential that governments and health policy makers provide some measures to diminish major barriers facing the society members especially the elderly, poor, uneducated, and disabled people when implementing it. This can result in attaining the advantages of eHealth for establishing health equity

National Health Information Network: Lessons Learned From the USA and the UK

National Health Information Network (NHIN) is a network in which all health care organizations, government agencies and other health-related organizations are connected to each other to exchange information about health. Due to the necessity of a framework for NHIN development, in this paper, according to the literature review, a definition for NHIN framework was provided, and then the NHIN related projects were reviewed in the United States of America (USA) and the United Kingdom (UK), NHIN and National Programme for Information Technology in the NHS (NPfIT), respectively. The Review of NHIN framework in the countries studied show some similarities and differences in each dimension that are discussed in this framework. NHIN guiding principles in the NHS NPfIT were not regarded or were considered incomplete, compared to the US. NHIN architecture in the US is decentralized while it is centralized in the UK. Based on the review of NHIN framework, these two countries represent important points that can be used in many other countries. However, it can be said that the development of NHIN does not only mean the implementation of national system or systems, or the binding of local health information systems, but It also needs to build on a framework in which many of the issues related to the formation of NHIN would be considered; including the cooperation between government, private sector and stakeholders with regard to local, national and international needs

A Survey on Intensive Care Unit Information Systems in Hospitals Affiliated with Shahid Beheshti University of Medical Sciences

Introduction: The information system of the intensive care unit has been designed and established in order to manage patients’ data and quickly retrieve patients’ information in this unit. This research was carried out to study the information system of the ICU and reporting capabilities in the hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU). Methods: In this descriptive cross-sectional study, the study population included ICU information systems in seven hospitals that had the system in place. Data gathering tools were a questionnaire and a checklist. The content validity was performed to ensure the validity of the checklist and questionnaire. The test-retest method was used to determine the questionnaire reliability (r = 0.89). Data were analyzed using descriptive statistics. Results: Data collection in the ICU information system in all hospitals understudy is done both in the form of paper forms and electronically. Regarding reporting capability,  patients’ demographic information reports, admission reports, discharge reports, transfers, diagnoses, mortality, and management reports, none of the studied hospitals, the automatic reporting capability scores (GCS), reporting patient safety indicators through alerts and reminders, reporting the cost of medications, reporting disease severity, including Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE), were not observed. Conclusion: Implementing comprehensive and integrated ICU information systems can be an effective step towards organizing patient information and improving the quality of service provided to them. Therefore, the deployment of an ICU information system is necessary to improve care delivery in ICUs

Comparing Type 2 Diabetes Logbooks in Selected Countries

Context: According to the wide range of patients with type 2 diabetes and their unique characteristics, the process of treatment should be personalized for them. The most important step towards treatment and care of them is preparing daily reports by patients in logbooks. Diabetes organizations and associations have provided various logbooks for diabetic patients, with different structures. Evidence Acquisition: In this review study, articles and documents relating to type 2 diabetes logbooks were collected from relevant databases. From 60 articles, 28 titles including 23 articles related to type 2 diabetes and five logbooks from various diabetes organization were selected. The criterion for the selection was the validity of the organization offering the logbooks. Then, their data elements were compared. Results: The findings showed that the data elements of blood glucose, physical activity, meal and medication are fundamental data to record in type 2 diabetes logbooks. However, different organizations have considered different data elements for their logbooks and the number of their data elements is different from each other. In addition, few logbooks included all data elements. Conclusion: To achieve the best results from personalization of care in type 2 diabetes patients, it is necessary to record measurable self-care behaviors so that the process of the disease is completely controllable. Therefore, it is necessary for diabetes logbooks to have all these necessary elements so that the physician would make decisions based on sufficient data and the process of treatment would come in effective

Electronic Health Record Architecture: A Systematic Review

Numerous advantages are derived from the electronic health record (EHR).Though achieving such advantages depends on its architecture, at present no unique understanding of the architecture dimensions and specifications is available. Therefore, the aim of the present study is a systematic review of architecture perception of the electronic health record. The authors searched the literature in Science Direct, Scopus, PubMed and Proudest Databases (2000 to Jun 2015).  Data extraction was done by 2 reviewers on content, structure, content/structure relationship, confidentiality and security of the EHR. Subsequent to refining the 87 retrieved studies, 25 studies were finally included in the study. In the studies and paradigms so far proposed for the EHR, a unique comprehensive architecture model from the viewpoint of research criteria has not been investigated and it has been considered only from some dimensions. Hence, we provide a new definition of the EHR architecture

Infrastructures of the System for Developing Electronic Health Record

The overall objective of a health system is to improve health through reducing disease, disability and death. Accomplishment of this goal depends on the worldwide integrated and coordinated care continuity. Information transmission is a prerequisite to ensure the continuity of care. Widespread acceptance of health information and communication technology (HICT) and developing systems such as Electronic Health Record (EHR), have changed the health care industry. Electronic Health Record is the main part of information management in an integrated health care system. Electronic health record provides access to all health information at organizational, regional, national and international  levels and allows for the patient's health data [usually with geographical distribution in several health information systems] to become integrated. Since Electronic health record integrates all  care events data, it can make data sharing possible between all care providers to consequently minimize the repeated diagnostic tests, and drug and treatment interactions. Furthermore, Also health care professionals can easily access to patient information at any time and this could lead to improving the quality of care and reduce costs. Accordingly, a productive system is required to provide the electronic health record. Given the significance of the electronic health record and its generating system in improvement of care quality and reducing the health care costs, authors decided to study the needs for developing the national EHR system (NHIN)  The main focus of this paper was on selecting material related to the system developing an EHR and it prerequisites. Electronic health record system is a new source of valuable intelligence of real world for the whole health care industry. Electronic health record system includes people, rules, standards, storage and processing equipments, communication and support facilities. To shape this, existence of components and their coordination is necessary. Electronic health record system are established to enhance patient care and its outcome, increase efficiency, improving the availability of information and minimizing the medical errors. With the Europe union formation that in fact was an important step toward globalization, the electronic health record passed the national borders and turned into a global concept to make possible the worldwide integration and sharing of the health data. Therefore international standards are needed to share patient health information between national health systems and across borders. Infrastructure or national information network  existence of proper hardware and software and finally participation  of  all stakeholders are necessary to develop the system. So it is necessary to prepare the infrastructures needed for development of the system in our country. Since EHR has a universal concept, it is needed to create a lifelong health information record for every individual accessible in  every point in the world