Isfahan University of Medical SciencesHealth Information Management1735-785313720170219Health Information Technology and Its Effective Management, Basic Step to Promote HealthHealth Information Technology and Its Effective Management, Basic Step to Promote Health44511551FAPeymanRezaeiAssistant Professor, Health Information Management, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranElhamMaserratAssistant Professor, Health Information Management, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-1825-0097Journal Article20170228--https://him.mui.ac.ir/article_11551_34b9e872ae045712e436677940befcff.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219Fuzzy Expert System to Diagnose Neonatal Peripherally Inserted Central Catheters InfectionFuzzy Expert System to Diagnose Neonatal Peripherally Inserted Central Catheters Infection44645211552FARezaSafdariAssociate Professor, Health Information Management, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranMalihehKadivarAssociate Professor, Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, IranMahnazNazariMSc, Health Information Technology, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranMahbubehMohammadiResident, Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, IranJournal Article20161018Introduction: Peripherally inserted central catheters (PICC) are utilized in neonatal intensive care units (NICUs) as an instrument to vascular access. The PICCs significantly reduce side effects compared to central and peripheral venous catheters and can be the cause of catheter-related bloodstream infections (CRBSIs). The purpose of this study was to create a fuzzy expert system for the early diagnosis of PICC-related infections in newborns.Methods: This descriptive-applied study was conducted in 2016. The statistical population of this research consisted of the medical files of newborns in Children's Medical Center in Tehran, Iran, and sampling was carried out using convenient sampling method. The research tools were a checklist and questionnaires. Factors affecting infection diagnosis were determined based on pediatric specialists’ comments. The system was designed bilingually (Persian and English) using C# software and SQL Server database. The output of the system is the percentage of infection risk. The system evaluations were carried out using data from the medical files of newborns in a hospital in Tehran, Iran. Data was analyzed using Excel software.Results: Based on system assessment and comparison of the system output with the diagnosis of the specialists, the sensitivity, specificity, and accuracy of the system were 95%, 88%, and 91%, respectively.Conclusion: The non-specificity of clinical signs and laboratory findings of blood infection in newborns have made its diagnosis difficult and uncertain. Using a designed expert system can be effective in the diagnosis of CRBSIs.Introduction: Peripherally inserted central catheters (PICC) are utilized in neonatal intensive care units (NICUs) as an instrument to vascular access. The PICCs significantly reduce side effects compared to central and peripheral venous catheters and can be the cause of catheter-related bloodstream infections (CRBSIs). The purpose of this study was to create a fuzzy expert system for the early diagnosis of PICC-related infections in newborns.Methods: This descriptive-applied study was conducted in 2016. The statistical population of this research consisted of the medical files of newborns in Children's Medical Center in Tehran, Iran, and sampling was carried out using convenient sampling method. The research tools were a checklist and questionnaires. Factors affecting infection diagnosis were determined based on pediatric specialists’ comments. The system was designed bilingually (Persian and English) using C# software and SQL Server database. The output of the system is the percentage of infection risk. The system evaluations were carried out using data from the medical files of newborns in a hospital in Tehran, Iran. Data was analyzed using Excel software.Results: Based on system assessment and comparison of the system output with the diagnosis of the specialists, the sensitivity, specificity, and accuracy of the system were 95%, 88%, and 91%, respectively.Conclusion: The non-specificity of clinical signs and laboratory findings of blood infection in newborns have made its diagnosis difficult and uncertain. Using a designed expert system can be effective in the diagnosis of CRBSIs.https://him.mui.ac.ir/article_11552_31929d25d1c8e249e562153efe1dc65b.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219The Current and Future Occupational Opportunities for Health Information Technology Graduates: Problems and RequirementsThe Current and Future Occupational Opportunities for Health Information Technology Graduates: Problems and Requirements45345811553FAPeymanRezaiAssistant Professor, Health Information Management, Department of Health Information Technology, School of Management and Medical Informatics, Iranian Center of Excellence in Health Management, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, IranLeilaGhaderi-NansaMSc, Medical Records, Health Information Technology, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20161031Introduction: Health information technology (HIT) experts can work in any position that requires knowledge related to HIT. The aim of this study was to identify current and future occupational opportunities for HIT graduates and appropriate strategies to increase it.Methods: This was a descriptive and cross-sectional study. The study population consisted of graduates in medical records (109 people) and HIT (30 individuals) working in hospitals in Tabriz, Iran, and all managers of the related centers (40 individuals). Data were collected using two researcher-made questionnaires through interviews. The reliability of data was calculated using Cronbach’s alpha (α = 0.85(. Data were analyzed using descriptive statistics.Results: Most HIT experts were working in the medical records department of hospitals. The most preferred job positions among HIT graduates were in research centers (60.2%) and health insurance (66.6%). Non-hospital managers believed (40%) that the main reason for graduates’ lack of employment in organizations was the unfamiliarity of relevant organizations with graduates’ abilities.Conclusion: Introducing HIT graduates’ scientific and practical abilities to society seems to be an essential measure. Accountability to the information needs of health and non-health environments requires a suitable balance between theoretical and practical courses.Introduction: Health information technology (HIT) experts can work in any position that requires knowledge related to HIT. The aim of this study was to identify current and future occupational opportunities for HIT graduates and appropriate strategies to increase it.Methods: This was a descriptive and cross-sectional study. The study population consisted of graduates in medical records (109 people) and HIT (30 individuals) working in hospitals in Tabriz, Iran, and all managers of the related centers (40 individuals). Data were collected using two researcher-made questionnaires through interviews. The reliability of data was calculated using Cronbach’s alpha (α = 0.85(. Data were analyzed using descriptive statistics.Results: Most HIT experts were working in the medical records department of hospitals. The most preferred job positions among HIT graduates were in research centers (60.2%) and health insurance (66.6%). Non-hospital managers believed (40%) that the main reason for graduates’ lack of employment in organizations was the unfamiliarity of relevant organizations with graduates’ abilities.Conclusion: Introducing HIT graduates’ scientific and practical abilities to society seems to be an essential measure. Accountability to the information needs of health and non-health environments requires a suitable balance between theoretical and practical courses.https://him.mui.ac.ir/article_11553_0678ce3f8562ed9841f71ef92f6cb09a.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219The Effect of Mobile Educational Content Produced on Learning of Health Information Technology Students in the Medical Terminology CourseThe Effect of Mobile Educational Content Produced on Learning of Health Information Technology Students in the Medical Terminology Course45946411554FAShahlaDamanabiAssistant Professor, Health Information Management, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-1825-0097RezaFerdousiPhD, Medical Informatics, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranAfsoonAsadzadehBSc Student, Health Information Technology, Department of Health Information Technology, School of Management and Medical Informatics AND Talent Students Office, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-1825-0097MahsaMirzaei-SaeidabadBSc Student, Health Information Technology, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20161105Introduction: Medical Terminology is one of the specialized courses of the Health Information Technology (HIT) educational program, requires the recollection of numerous words, and educational tools could improve learning in this course. Mobile applications have been used as educational software and have recently received much attention. This study was conducted with the purpose of determining the effect of mobile educational content on study frequency, motivation, and educational improvement among HIT students.Methods: This quasi-experimental study was performed on 12 HIT students (in their second semester) of Tabriz University of Medical Sciences, Iran. Educational improvement of students was examined using pretest and posttest scores and the effect of the software on students’ motivation and study frequency was determined using a researcher-made questionnaire. The validity of the questionnaire was confirmed by professors and its reliability was confirmed using Cronbach’s alpha. Data were analyzed using descriptive and analytical statistics (paired t-test and McNemar’s test).Results: The use of educational software had a meaningful relationship with educational improvement (P < 0.001) and students’ motivation (P = 0.013); however, it did not have a significant relationship with study frequency.Conclusion: The use of mobile educational software along with traditional methods of study can lead to academic improvement and motivation among students in the medical terminology course.Introduction: Medical Terminology is one of the specialized courses of the Health Information Technology (HIT) educational program, requires the recollection of numerous words, and educational tools could improve learning in this course. Mobile applications have been used as educational software and have recently received much attention. This study was conducted with the purpose of determining the effect of mobile educational content on study frequency, motivation, and educational improvement among HIT students.Methods: This quasi-experimental study was performed on 12 HIT students (in their second semester) of Tabriz University of Medical Sciences, Iran. Educational improvement of students was examined using pretest and posttest scores and the effect of the software on students’ motivation and study frequency was determined using a researcher-made questionnaire. The validity of the questionnaire was confirmed by professors and its reliability was confirmed using Cronbach’s alpha. Data were analyzed using descriptive and analytical statistics (paired t-test and McNemar’s test).Results: The use of educational software had a meaningful relationship with educational improvement (P < 0.001) and students’ motivation (P = 0.013); however, it did not have a significant relationship with study frequency.Conclusion: The use of mobile educational software along with traditional methods of study can lead to academic improvement and motivation among students in the medical terminology course.https://him.mui.ac.ir/article_11554_364196813f3b746270a9b27bd76149c9.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219Risk Management in the Medical Records Department of Alavi Hospital of Tabriz, Iran, Using Failure Mode and Effects Analysis TechniqueRisk Management in the Medical Records Department of Alavi Hospital of Tabriz, Iran, Using Failure Mode and Effects Analysis Technique46547111555FAShahlaShahbaziAssistant Professor, Nursing, Department of Internal-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IranAdelMazaheriBSc, Medical Records, Alavi Hospital, Tabriz University of Medical Sciences, Tabriz, IranMaryamKashefBSc, Medical Records, Alavi Hospital, Tabriz University of Medical Sciences, Tabriz, IranLeilaGhaderi NansaMSc, Medical Records, Department of Health Information Technology, School of Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20161129Introduction: Health information is one of the key pillars of effective management of health care services, and has been recognized as the main factor in the operation and integrity of health systems. As most health information is provided by the medical records department, the use of risk management is necessary to protect information assets. The aim of the present study was to investigate risk management in the medical records department of Alavi Hospital of Tabriz, Iran, using failure mode and effects analysis (FMEA) technique.Methods: This study was an action research. The study population consisted of the medical records department staff of Alavi Hospital. Data gathering tools was a FMEA checklist. The validity and reliability of the checklist were approved. Data were gathered through the observation of the medical records process and focus group discussion with medical records department staff.Results: There were 31 possible failure modes; 10 failures were related to inpatient admission process, 8 failures to medical filing, 8 failures to releasing medical record information, and 8 failures to quantitative and qualitative analysis of records.Conclusion: FMEA technique is an effective method for risk management in the medical records department. In this approach, risks are identified and assessed. Then, a series of intervention measures are planned to control risk levels. These procedures lead to reduced risk level.Introduction: Health information is one of the key pillars of effective management of health care services, and has been recognized as the main factor in the operation and integrity of health systems. As most health information is provided by the medical records department, the use of risk management is necessary to protect information assets. The aim of the present study was to investigate risk management in the medical records department of Alavi Hospital of Tabriz, Iran, using failure mode and effects analysis (FMEA) technique.Methods: This study was an action research. The study population consisted of the medical records department staff of Alavi Hospital. Data gathering tools was a FMEA checklist. The validity and reliability of the checklist were approved. Data were gathered through the observation of the medical records process and focus group discussion with medical records department staff.Results: There were 31 possible failure modes; 10 failures were related to inpatient admission process, 8 failures to medical filing, 8 failures to releasing medical record information, and 8 failures to quantitative and qualitative analysis of records.Conclusion: FMEA technique is an effective method for risk management in the medical records department. In this approach, risks are identified and assessed. Then, a series of intervention measures are planned to control risk levels. These procedures lead to reduced risk level.https://him.mui.ac.ir/article_11555_ad6fff7b7be06acff1c63ced9f0da4ea.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219Development of an Interoperable Object-Oriented Design for Gynecology Data Management Compatible with the Iranian Electronic Health RecordDevelopment of an Interoperable Object-Oriented Design for Gynecology Data Management Compatible with the Iranian Electronic Health Record47247911556FAPeymanRezaei-HachesuAssistant Professor, Health Information Management, Center of Excellence in Management, Road Traffic Injury Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranTahaSamad-SoltaniAssistant Professor, Medical Informatics, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranNazilaMoftianMSc Student, Health Information Technology, Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20161017Introduction: In order to design and develop an efficient electronic health record (EHR) in Iran, the assimilation of health information systems based on a common language for the interpretation and sharing of information with HER is essential. The current research provides an object-oriented design for gynecology data management based on unified modeling language (UML). By applying this model, it is possible to improve interoperability capabilities of Iranian EHR.Methods: This applied, developmental, and cross-sectional study was carried out in 2015. First, published minimum data sets on gynecology and prenatal care in Iran were evaluated. Then, experts assessed and verified the most comprehensive minimum data set for Iran. In the next step, an object-oriented model was designed based on specific data patterns which were extracted from international standards matched with Iranian EHR to satisfy the interoperability requirements of healthcare information. Finally, the object-oriented design was created by applying UML in visual paradigm software package and the prototype of the system was developed.Results: The designed system was directly used by 3 people as main users (clinical secretor, physician, and system administrator). Moreover, this system can interact with the Iranian EHR as an external actor. Use case, activity, sequence, and class diagrams were drawn. Data elements were coded based on national coding standards.Conclusion: Coordination of standardization of different components using software analysis and design is necessary for the successful implementation and pervasive acceptance of EHRs. Object-oriented analysis and design provide a suitable tool for the modeling complexity in software systems. Applying content and technical standards in the design and implementation of EHRs render it useful and applicable in terms of information integration and interoperability.Introduction: In order to design and develop an efficient electronic health record (EHR) in Iran, the assimilation of health information systems based on a common language for the interpretation and sharing of information with HER is essential. The current research provides an object-oriented design for gynecology data management based on unified modeling language (UML). By applying this model, it is possible to improve interoperability capabilities of Iranian EHR.Methods: This applied, developmental, and cross-sectional study was carried out in 2015. First, published minimum data sets on gynecology and prenatal care in Iran were evaluated. Then, experts assessed and verified the most comprehensive minimum data set for Iran. In the next step, an object-oriented model was designed based on specific data patterns which were extracted from international standards matched with Iranian EHR to satisfy the interoperability requirements of healthcare information. Finally, the object-oriented design was created by applying UML in visual paradigm software package and the prototype of the system was developed.Results: The designed system was directly used by 3 people as main users (clinical secretor, physician, and system administrator). Moreover, this system can interact with the Iranian EHR as an external actor. Use case, activity, sequence, and class diagrams were drawn. Data elements were coded based on national coding standards.Conclusion: Coordination of standardization of different components using software analysis and design is necessary for the successful implementation and pervasive acceptance of EHRs. Object-oriented analysis and design provide a suitable tool for the modeling complexity in software systems. Applying content and technical standards in the design and implementation of EHRs render it useful and applicable in terms of information integration and interoperability.https://him.mui.ac.ir/article_11556_c7b711619071c92bef604c7ad68380dd.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219Registration of Symptoms and Signs in Death Certificates Issued In Hospitals Affiliated with Mazandaran University of Medical Sciences, IranRegistration of Symptoms and Signs in Death Certificates Issued In Hospitals Affiliated with Mazandaran University of Medical Sciences, Iran48048411557FABenyaminMohseni-SaraviMSc, Health Information Management, Treatment Deputy, Mazandaran University of Medical Sciences, Sari, IranMohammadFallah-KharyekiMSc, Health Care Management, Treatment Deputy, Mazandaran University of Medical Sciences, Sari, IranZoleykhaAsghariBSc, Health Information Management, Treatment Deputy, Mazandaran University of Medical Sciences, Sari, IranSeyede FatemehHoseyni-DamiriBSc, Nursing, Booalisina Hospital, Mazandaran University of Medical Sciences, Sari, Iran0000-0003-2850-5097Journal Article20161108Introduction: Data in death certificates are a basis of epidemiological studies. Since registering causes such as signs and symptoms is not informative in data processing, this research aims to determine their rate of registration in death certificates.Methods: This study was a descriptive, cross-sectional research. The study population included all death certificates with R00-R99 codes for cause of death. Data were collected using a checklist. Chi-square test was used to calculate the significance of relationships.Results: The findings show that, in 11.3% of death certificates, symptoms and sign were reported as the cause of death. The use of symptoms and sign as causes of death was higher in private hospitals (33.7%) than other hospitals. The use of symptoms and signs as causes of death was 51% in the age group of over 60 years of age which was higher than any other age groups. Based on the findings, reduction in the length of hospitalization resulted in increased rate of recording of symptoms and signs as causes. Most reported symptoms and signs (50.9%) were in ill-defined and unknown causes of mortality (R95-R99).Conclusion: The results of this study show that symptoms and signs are often recorded as cause of death. Therefore, it is necessary to take steps in order to improve the data of health records.Introduction: Data in death certificates are a basis of epidemiological studies. Since registering causes such as signs and symptoms is not informative in data processing, this research aims to determine their rate of registration in death certificates.Methods: This study was a descriptive, cross-sectional research. The study population included all death certificates with R00-R99 codes for cause of death. Data were collected using a checklist. Chi-square test was used to calculate the significance of relationships.Results: The findings show that, in 11.3% of death certificates, symptoms and sign were reported as the cause of death. The use of symptoms and sign as causes of death was higher in private hospitals (33.7%) than other hospitals. The use of symptoms and signs as causes of death was 51% in the age group of over 60 years of age which was higher than any other age groups. Based on the findings, reduction in the length of hospitalization resulted in increased rate of recording of symptoms and signs as causes. Most reported symptoms and signs (50.9%) were in ill-defined and unknown causes of mortality (R95-R99).Conclusion: The results of this study show that symptoms and signs are often recorded as cause of death. Therefore, it is necessary to take steps in order to improve the data of health records.https://him.mui.ac.ir/article_11557_58ebafabd92e2e3a80d86b7bb7e88eda.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219A Framework for Resource-Based Relative Value Scale Reimbursement System in the Iranian Health Care SystemA Framework for Resource-Based Relative Value Scale Reimbursement System in the Iranian Health Care System48549011558FAPeymanRezaeiAssistant Professor, Health Information Management, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranMahsaMirzaeiBSc student, Health Information Technology, Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, IranAfsoonAsadzadehBSc Student, Health Information Technology, Department of Health Information Technology, School of Management and Medical Informatics AND Talent Students Office, Tabriz University of Medical Sciences, Tabriz, Iran0000-0002-1825-0097Journal Article20161124The resource-based relative value scale (RBRVS) system is used to reimburse physician services in health care systems. The aim of the present study was to study the features of RBRVS system in order to provide a framework to estimate reimbursement of physician services based on the resources used. This narrative study was carried out by surveying 90 articles and other documents. The adoption of the RBRVS system required the use of the Current Procedure Terminology (CPT) code to determine Relative value units (RVUs) of physicians’ work and practice expenses as major components. Geographic practice cost index (GPCI) and conversation factor were the modifier factors. With the employment of this system, the actual costs assigned to each medical service, even in offices, are determined and patient’s out-of-pocket payment is conducted fairly.The resource-based relative value scale (RBRVS) system is used to reimburse physician services in health care systems. The aim of the present study was to study the features of RBRVS system in order to provide a framework to estimate reimbursement of physician services based on the resources used. This narrative study was carried out by surveying 90 articles and other documents. The adoption of the RBRVS system required the use of the Current Procedure Terminology (CPT) code to determine Relative value units (RVUs) of physicians’ work and practice expenses as major components. Geographic practice cost index (GPCI) and conversation factor were the modifier factors. With the employment of this system, the actual costs assigned to each medical service, even in offices, are determined and patient’s out-of-pocket payment is conducted fairly.https://him.mui.ac.ir/article_11558_1275f65e9bb3ef27470c3c3b817233ef.pdfIsfahan University of Medical SciencesHealth Information Management1735-785313720170219Designing of Elementary School Students’ Health Measurement Electronic RecordsDesigning of Elementary School Students’ Health Measurement Electronic Records4914971155910.22122/him.v13i7.3079FARezaSafdariProfessor, Health Information Management, Health Information Technology Research Center AND Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranNiloofarMohammadzadehAssistant Professor, Health Information Management, Health Information Technology Research Center AND Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranNegarGheibiMSc, Health Information Technology, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, IranJournal Article20161103Introduction: Today, increasing development of technology in communication sciences has facilitated access to basic information in the area of individual health. One of the most important decisions in the field of health is measuring the health level of students; thus, designing electronic records is a step toward addressing the requirements of healthcare providers in the assessment of various health indexes in children.Methods: First, a comparative study was carried out on the content and structure of paper-based and electronic systems for children's health in leading countries in this field (Australia, England, and USA). Then, the required information was collected using health measuring database and elementary school students' health measurement sheets. Subsequently, a checklist with three axes of demographic and social information, screening tests, and physician's assessment was compiled and distributed among professionalsResults: Among 62 surveyed elements were approved as main elements and 2 as suggested elements. Based on the results of the survey, data elements were approved by the study population and the software was designed in SQL server database management system by C# language.Conclusion: This application provides the registration and reporting of students' health indexes. Therefore, it helps healthcare providers recognize troubled children and make decisions and targeted plans.Introduction: Today, increasing development of technology in communication sciences has facilitated access to basic information in the area of individual health. One of the most important decisions in the field of health is measuring the health level of students; thus, designing electronic records is a step toward addressing the requirements of healthcare providers in the assessment of various health indexes in children.Methods: First, a comparative study was carried out on the content and structure of paper-based and electronic systems for children's health in leading countries in this field (Australia, England, and USA). Then, the required information was collected using health measuring database and elementary school students' health measurement sheets. Subsequently, a checklist with three axes of demographic and social information, screening tests, and physician's assessment was compiled and distributed among professionalsResults: Among 62 surveyed elements were approved as main elements and 2 as suggested elements. Based on the results of the survey, data elements were approved by the study population and the software was designed in SQL server database management system by C# language.Conclusion: This application provides the registration and reporting of students' health indexes. Therefore, it helps healthcare providers recognize troubled children and make decisions and targeted plans.https://him.mui.ac.ir/article_11559_658953f1f681915f543a40eef9acb562.pdf