BackgroundIn recent times, the use of health technologies in the diagnosis and treatment of diseases experienced considerable and accelerated growth. The goal of the present study was to describe the designated pilot MCDM (Multiple Criteria Decision Making) model for priority setting of health technology assessment in Iran.MethodsRelevant articles were sought and retrieved from the most appropriate medical databases, including the Cochrane Library, PubMed and Scopus via three separate search strategies, using MESH and free text until March, 2015. Retrieved criteria were questioned from health technology assessment experts in two rounds and the relative weight for valid criteria was finally obtained from paired wise comparison method. After extraction of relative weights based on the aforementioned procedure, TOPSIS (The Technique for Order of Preference by Similarity to Ideal Solution) priority setting model was designed. The stated model was applied for assessing three technologies (adenosine, tissue plasminogen activator and mechanical thrombectomy) which were available for projects call of Iranian health technology assessment department in order to determine applicability of the model for practical purpose.ResultsNine criteria, including efficiency/effectiveness, safety, population size, vulnerable population size, availability of alternative technologies, cost effectiveness in other countries, budget impact, financial protection, quality of evidence, were extracted by the Iranian health technology assessment experts. The relative weights of these criteria were as follows 0.12, 0.2, 0.06, 0.08, 0.08, 0.13, 0.08, 0.09, and 0.15, respectively. Finally TOPSIS pilot model was designed by three health technologies and nine criteria relative weights. Results showed that, the applicability of the stated model was suitable and as the pilot testing, tissue plasminogen activator was the first priority, adenosine was second and mechanical thrombectomy was third for performing health technology assessment by the Iranian ministry of health and medical education.ConclusionAccording to the results of this study, this model with nine effective criteria and their relative weights and in combination with TOPSIS approach could be used with suitable applicability by health technology assessment department in deputy of curative affairs and food and drug organization for determination of research priorities in health technology assessment.

The PSC of the investigated hospitals is not at an ideal level and is in need of serious improvement, particularly in the dimensions of feedback and communication regarding errors, communication openness, staffing, and nonpunitive response to error. The same conditions hold true for other Iranian hospitals (i.e., the Afshar and Sadoughi hospitals in the city of Yazd, Iran), and American hospitals were used for comparison purposes in this paper.

Background: Today, accreditation is considered as the most commonly used health assessment approach. Considering the importance and application of the process of this approach in the hospital, this study aimed to investigate the challenges of implementation of hospital accreditation in Iran using exploratory factor analysis. Methods: A cross-sectional study design was carried out from July to December 2017, consisting of 200 managers in the seven hospitals accredited by the MOH in Tehran, Iran. Samples were selected through the purposive sampling method, and data were collected using a structured questionnaire in which validity and reliability were confirmed. Likert's five-choice range was used for the rating of items. Exploratory factor analysis was used to categorize the identified challenges and extract the mathematical model on them. Results: Exploratory factor analysis identified six dimensions (implementation, evaluation, content, structural, psychological, and managerial) with 40 items using a 5-point Likert scale. Each dimension accounted for greater than 63.20% of the total variance. The scale had strong content validity (indices = 0.84). Each dimension of Cronbach's alpha ranged from 0.74 to 0.94. Implementation, evaluation, content, structural, psychological, and managerial components also formed the final identified areas. Conclusion: The present study showed that there were major challenges in the path to successful deployment of Iranian hospital accreditation, requiring serious action by managers and policymakers in this field.

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Customer's trust is the most important and one of the key factors of success in e-commerce. However, trust is the essential aspects of e-banking adoption and the main element for building long-term relationships with the bank's customers. So the purpose of this research is to investigate the factors influencing on customer′s trust in e-banking services and prioritize them. Therefore, designed questionnaire was distributed among 177 electronic service customers in number of banks in the city of Karaj, Iran. Likert quintuplet scales were used to measure the variables. After collecting the questionnaires, the data were analyzed by structural equation modeling (by using LISREL 8.5). The results revealed that quality of electronic services such as ease of use, privacy and security, individual characteristics of customers such as disposition to trust and features of bank such as reputation, size and dependence on government, have had the greatest effect on customer′s trust in e-banking services.Growing Science Ltd. All rights reserved. 5

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The structural features of Iran's health system obligate the development of information technology in medical field and design of an effective e-health system. Due to the importance of this issue, the current study was performed to identify the effective elements on e-health deployment in order to codify a comprehensive plan for Iran. The practical, descriptive-comparative study was conducted using semiqualitative methods with mathematical analysis. The study populations included the following countries: Australia, Germany, Japan, Sweden, Britain, Turkey and Iran. Due to the comparative nature of the study, there were no samples and the selected countries were chosen as the sources of information. This study was performed in four stages including studying the current situation and the history of issue in Iran through documents and evidences, comprehensive study of e-health in selected countries by searching through books, materials and also the web, suggesting the primary proposal and eventually determining the proposal's credibility and presenting the final plan using the semi-Delphi technique. The findings of the study indicated that e-health deployment priorities included individual health care identifier (IHI), patient ID, e-health card, increasing investment in information technology, electronic appointment registration, electronic prescribing and finally, telemedicine service. Strategies commonly aimed to use the information technology to provide health care services based on patients centrality. E-health infrastructures included physical networks, legal infrastructures, education, preparation and performance of e-health operation. The necessary resources to establish ehealth included financial, data and other resources. The deployment of e-health included e-health record, e-health card, telemedicine service and health portals. The major obstacles to establish e-health in Iran included lack of a specific strategy, ambiguous and complicated information technology infrastructure, two cultural and educational problems in relation to training and practice in information technology and communication skills, rapid changes of managers especially in Ministry of Health and Welfare, not being able to attract skilled information technology technicians in e-health field, unclear mechanism to fund e-health system, lack of codified technical standards and weak health service implementation methods. Infrastructure of information and communication technology in Iran is complex and ambiguous and e-health strategies and priorities have not been determined yet.

Background: Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. Methods and Materials: The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included “Evidence-Based Practice”, “Evidence-Based Management”, “Healthcare”, “Care Management, Evidence-Based Healthcare Management”, “Health Care”, Health”, “Barrier”, “Facilitator”, policy and “Evidence-Based Healthcare”. Results: In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. Conclusion: Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP. [GMJ.2020;9:e1645]