نوع مقاله : مقاله پژوهشی
نویسندگان
1 استادیار، مدیریت اطلاعات سلامت، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی علوم، تهران، ایران
2 دانشیار، مدیریت اطلاعات بهداشتی، دانشگاه علوم پزشکی شهید بهشتی، تهران
3 دانشجوی کارشناسی ارشد، آموزش مدارک پزشکی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی علوم، تهران، ایران
چکیده
مقدمه: عدم یکپارچگی اطلاعات موجب رویکرد بخش بهداشت به کاربری تکنولوژی اطلاعات و ارتباطات شده است. زیرساخت ملی اطلاعات سلامت، اطلاعات بالینی و بهداشتی را یکپارچه کرده و باعث کاهش خطاها، هزینه‌ی درمان و افزایش امنیت بیمار می‌شود. هدف از این مطالعه، امکان‌سنجی پیاده‌سازی زیرساخت ملی اطلاعات سلامت در ایران از دیدگاه مدیران و متخصصین تکنولوژی اطلاعات و ارتباطات در وزارت بهداشت و سایر سازمان‌های مرتبط با سلامت در سال 1388 بود.
روش بررسی: تحقیق حاضر از نوع توصیفی- کاربردی و در سال 1388 انجام گرفت. پس از شناسایی زیرساخت ملی اطلاعات سلامت، نظرسنجی انجام شد. حجم جامعه شامل مدیران و متخصصین تکنولوژی اطلاعات و ارتباطات سازمان‌ها و حجم نمونه برابر با حجم جامعه بود. داده‌ها از طریق مصاحبه و به وسیله‌ی پرسش‌نامه جمع‌آوری شد. روایی پرسش‌نامه از طریق تعیین اعتبار محتوا و پایایی آن به روش آزمون مجدد (84/0 = r) سنجیده شد. داده‌ها با استفاده از آمار توصیفی تحلیل گردید.
یافته‌ها: با وجود ارتباط وزارت بهداشت با سایر سازمان‌ها، تنها 28/14 درصد سایر سازمان‌ها دارای سیستم اطلاعات به طور کامل مکانیزه و آماده‌ی شبکه‌سازی کامپیوتری با وزارت بهداشت بودند. مشکلات فرهنگی، اقتصادی و نامناسب بودن زیرساخت‌ها به میزان 30/92 درصد و نبود استانداردها و مشکلات قانونی به میزان 61/84 درصد مهم‌ترین موانع فراروی پیاده‌سازی زیرساخت ملی اطلاعات سلامت در ایران است.
نتیجه‌گیری: به علت فقدان زیرساخت‌های لازم، پیاده‌سازی زیرساخت ملی اطلاعات سلامت در ایران ممکن نیست. باید فرهنگ‌سازی، تدوین قوانین حریم شخصی و حوزه‌ی تکنولوژی اطلاعات و ارتباطات و نظارت دولت بر زیرساخت‌ها انجام شود.
کلیدواژه‌ها
عنوان مقاله [English]
Feasibility of Implementing National Health Information Infrastructure in Iran, 2009*
نویسندگان [English]
- Farkhonde Asadi 1
- Hamid Moghaddasi 2
- Aazamossadat Hosseini 1
- Susan Azizi Gondozlu 3
1 Assistant Professor, Health Information Management, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Associated Professor, Health Information Management, Shahidbeheshti University of Medical Sciences, Tehran
3 MSc Student, Medical Records Education, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]
Introduction: Non-integrated health information has forced health sector to utilize information and
communication technology (ICT). National health information infrastructure (NHII) integrates
clinical and health information, decreases medical errors as well as costs, and increases patient’s
safety. Thus, this article aimed to review the feasibility of NHII implementation in Iran from
perspective of ICT experts in Ministry of Health and other health-related organizations in 2009.
Methods: This survey was conducted after identifying the NHII. The study population consisted
of ICT managers and experts, and sample size was equal to the sample population. The data were
collected through interviewing and by means of questionnaire. The questionnaire was confirmed
by health information management and ICT experts. The validity of the questionnaire was
confirmed by content validity and its reliability by test-retest method (r = 0.84). Data were
analyzed by descriptive statistics.
Results: Despite a relationship between Ministry of Health and other health-related
organizations, only 14.28% of the organizations had fully integrated computerized information
system and were ready to connect to the Ministry of Health. Cultural, economic, and
infrastructural problems were 92.30% and lack of standards and legal issues with 84.61% were
the most important barriers for implementing NHII in Iran.
Conclusion: Due to the lack of required infrastructures, implementing NHII in Iran is impossible.
Developing culture, privacy laws enactment and ICT in addition to governmental supervision for
establishing required infrastructures should be implemented.
کلیدواژه‌ها [English]
- National Health Information Infrastructure
- National Health Information Network
- Health Information Technology
2. Yasnoff WA, Humphreys BL, Overhage JM, Detmer DE, Brennan PF, Morris RW, et al. A consensus action
agenda for achieving the national health information infrastructure. J Am Med Inform Assoc 2004; 11(4): 332-8.
3. NEHI. Computerized Physician Order Entry (CPOE) A Statewide Initiative [Online]. 2009 [cited 2009 Jan 15];
Available from: URL: www.nehi.net/uploads/one_pager/9_cpoe_one_pager.pdf/
4. HIMSS. National Health Information Infrastructure Act of 2003 Introduced in Congress [Online]. 2003 [cited
2003 Jul 30]; Available from: URL: http://www.himss.org/asp/ContentRedirector.asp?ContentId=37181/
5. Ross Will. Proceedings of the National Health Information Infrastructure (NHII) Cornerstones for Electronic
Healthcare Conference; 2004 Jul 21-23; Washington, DC; 2004.
6. Roberts D. A call to arms: why the NHII is critical to our nation's security. J Healthc Inf Manag 2003; 17(3): 22-4.
7. Detmer DE. Building the national health information infrastructure for personal health, health care services,
public health, and research. BMC Med Inform Decis Mak 2003; 3: 1.
8. Garson, Jr, A, Levin SA. Ten 10-Year Trends for the Future of Healthcare: Implications for Academic Health
Centers. Ochsner J 2001; 3(1): 10-5.
9. Rippen HE, Yasnoff WA. Building the National Health Information Infrastructure. J AHIMA 2004; 75(5): 20-6.
10.Wager KA, Lee FW, Glaser JP. ManagingHealth Care Information Systems: A Practical Approach for Health
Care Executives. New Jersey, NJ: John Wiley & Sons p. 247-8; 2005.
11. Furlong A. What will NHII mean for you? [Online]. 2007; Available from: URL:
www.isds.org/newsroom/articles/whatwillnhmean.pdf/
12.Health Policy Ohio. The National Health Information Infrastructure and Population Health, 2007 [cited 2007
Sep 7]; Available from: URL: http://www.healthpolicyohio.org/
13.Rishel W, Riehl V, Blanton C. Summary of the NHIN Prototype Architecture Contracts. Washington DC: Office
of the National Coordinator for Health IT [Online]. 2007 [cited 2011 Oct 17]; Available from: URL:
http://www.hhs.gov/healthit/healthnetwork/resources/summary_report_on_nhin_Prototype_architectures.pdf/ 14.Cohn SP, Blair JS, Houston JP, Tang P. Workgroup on national health information infrastructure [Online]. 2000;
Available from: URL: http://www.ncvhs.hhs.gov/wg-nhii.htm/
15.Brown GD, Brown GD, Stone TT, Patrick TB. Strategic Management of Information Systems in Healthcare.
Chicago, IL: Health Administration Press; 2005. p. 77, 78, 676.
16. Schleyer TK. Should dentistry be part of the National Health Information Infrastructure? J Am Dent Assoc 2004;
135(12): 1687-95.
17.Mon DT. An update on the NHIN and RHIOs. Journal of AHIM 2005; 76(6): 56-7.
18.National Committee on Vital and Health Statistics. Assuring a health dimension for the national information
infrastructure [Online]. 1998; Available from: URL: http://www.ncvhs.hhs.gov/hii-nii.htm/
19.Virtual Medical Worlds. U.S. National Health Information Network (NHIN) and Open Source Health
Information Exchange (HIE) Solutions [Online]. 2007; Available from: URL:
www.hoise.com/vmw/07/articles/vmw/LV-VM-01-07-29.html/
20.Healthcare Information and Management Systems Society. HIMSS National Health Information Infrastructure
Survey [Online]. 2004 [cited 2007 Nov 5]; Available from: URL: http://www.himss.org/
21.Nationwide Health Information Network (NHIN): Trial Implementations [Online]. 2008 [cited 2008 Oct 5];
Available from: URL:
www.http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&cached=true&objID=1191/
22.Moghaddasi H, Sheikhtaheri A, Hashemi N. Reducing medication errors: Role of computerized physician order
entry system. J Health Adm 2007; 10(27): 57-67. [In Persian].
23. Jamejamonline. Health Advances in nanotechnology and biotechnology were described [Online]. 2007; Available
from: URL: www.jamejamonline.ir/newstext.aspx? /[In Persian].
24.Wikipedia. Nanotechnology [Online]. 2007 [cited 2007 Jul 3]; Available from: URL:
www.en.wikipedia.org/wiki/Nanotechnology/
25.Wikipedia. Biotechnology [Online]. 2007 [cited 2007 Jul 3]; Available from: URL:
www.en.wikipedia.org/wiki/Biotechnology/
26. Loonsk JW. ONC Update on Standards Harmonization and NHIN Trial Implementations [Online]. 2007 [cited
2007 Nov 28]; Available from: URL: http://www.ncvhs.hhs.gov/071128p1.pdf/
27. Sankaran V. The Role of SOA in Improving Health Quality [Online]. 2007 [cited 2007 Apr 15]; Available from:
URL: http://www.omg.org/news/meetings/workshops/HC-2008/15-02_Sankaran.pdf/
28.Brewin B. National health records network to expand [Online]. 2008 [cited 2008 Mar 27]; Available from: URL:
http://www.govexec.com/oversight/2008/03/national-health-records-network-to-expand/26569/
29.Nationwide Health Information Network Proposed Functional Requirements Version 3 [Online]. 2006 [cited
2006 Apr 16]; Available from: URL:
http://www.providersedge.com/ehdocs/ehr_articles/Nationwide_Health_Information_Network_Proposed_Functio
nal_Requires.pdf/
30. Shah SN. An overview of NHIN and NHIN Direct for software developers [Online]. 2010 [cited 2010 Jul 27];
Available from: URL: http://www.ibm.com/developerworks/web/library/wa-nhindirect/index.html?ca=drs/
31.Nordic Council of Ministers. Health Innovation in the Nordic countries [Online], 2010; Available from: URL;
http://www.norden.org/en/publications/publikationer/2010-765/
32.Reid PP, Compton WD, Grossman JH, Fanjiang G. Building a Better Delivery System: A New
Engineering/Health Care Partnership. Washington, DC: National Academies Press; 2005. p. 63-78.
33. Faghihi M, Memarzadeh-Tehran G. Identifying Priorities of Policymaking
)