Recent advances in digital health and increasing access to mobile health (mHealth) tools have led to more effective self-care. This study aimed to identify the minimum data set (MDS) and the requirements of a smartphone application (app) to support caregivers of children with severe burns. The study was carried out in three phases in a burn center in the north of Iran in 2022. In the first phase, a literature review was performed. In the second phase, interviews were conducted with 18 caregivers. The third phase was performed in two stages; first, an initial questionnaire was prepared in which the content validity ratio (CVR) and content validity index (CVI) were calculated. The final questionnaire included 71 data elements about the MDS and requirements and open-ended elements. Then, the data elements were surveyed by 25 burn experts using the Delphi technique. The minimum acceptable mean score for each item was 3.75. Out of the 71 elements in the first Delphi round, 51 were accepted. In the second Delphi round, 14 data elements were assessed. The most important elements for the MDS were a family relationship, total body surface area (TBSA), the primary cause of the burn, anatomical location, itch, pain, and infection. User registration, educational materials, caregiver-clinician communication, chat box, and appointment booking were the most highlighted functional requirements. Safe login was the most important element for the non-functional requirements. It is recommended that health managers and software designers use these functionalities in designing smartphone apps for caregivers of children with burns.
Background Telehealth services were used by healthcare centers during the COVID-19 pandemic in order to identify and manage patients at the forefront of the healthcare system. As one of these technologies, tele-triage refers to the assessment of a patient's health status through telephone or another means of communication and recommending treatment or providing appropriate referrals in emergency rooms and primary care offices. This study aimed to perform a systematic review of the evidence on the effectiveness of tele-triage, as one of these technologies, during the COVID-19 pandemic. Methods Medline (via PubMed), Scopus, and Web of Science databases were searched for relevant English articles published since the pandemic's onset until December 30, 2021. Studies investigating the tele-triage's effect on patient safety, clinical outcomes, and patient satisfaction were included. Data on study characteristics, intervention characteristics, and their effects on study outcomes were extracted separately by two authors. A narrative synthesis of the included studies was ultimately performed. Results Out of the 6312 retrieved studies, 14 met the inclusion criteria. The tele-triage intervention was offered by an algorithm-based system in eight studies (57.14%) and by healthcare providers in six other studies (42.86%) to determine the patient's level of care. According to the results, tele-triage interventions during COVID-19 can reduce unnecessary emergency room visits (by 1.2–22.2%), improve clinical outcomes after intervention (such as would closure in diabetic feet), reduce mortality and injuries, and ensure patient satisfaction with tele-triage (53–98%). Conclusions This study found that tele-triage interventions reduced unnecessary visits, improved clinical outcomes, reduced mortality, and injuries, increased patient satisfaction, reduced healthcare provider workload, improved access to primary care consultation, and increased patient safety and satisfaction. Therefore, tele-triage systems are not only suitable for providing acute and emergency care remotely but they are also recommended as an alternative tool to monitor and diagnose COVID-19.
Given the lack of literature on the contributing factors to adopt mobile applications (apps) among physicians and the crucial role of the quality of the apps in their widespread use, the aim of this study is using the Mobile App Rating Scale (MARS) to evaluate the quality of the head CT scan appropriateness criteria app(HAC app). It was developed to assist medical interns and residents in ordering head CT scans. MARS is internationally recognized as an app rating tool and consists of four objective and subjective quality subscales quality subscale. Although the overall quality score of the HAC app was favorable (82 out of 100), it had low quality scores in the “information” (73.37 out of 100) and the “engagement” (73.48 out of 100) subscales. The HAC app appears to be functional to the physicians; however, it needs to improve its quality in terms of interactivity and effectiveness.
Background: Studies have revealed inappropriate laboratory testing as a source of waste. This review was aimed to evaluate the effects and features of CDSSs on physicians' appropriate laboratory test ordering in inpatient hospitals.Method: Medline through PubMed, SCOPUS, Web of Science, and Cochrane were queried without any time period restriction. The outcomes were categorized based on test-related, physician-related, and patient-related. The primary outcome measures were the number and cost of laboratory test ordered.Result: Sixteen studies met the inclusion criteria. Most studies were conducted based on a quasi-experimental design. The results showed improvement in laboratory test-related outcomes (e.g. proportion and cost of tests) and also physician-related outcomes (e.g. guideline adherence and orders cancellation). Patient-related outcomes (e.g. length of stay and mortality rate) were not well investigated in the included studies. Also, the evidence about applying CDSS as a decision aid for interpreting laboratory results was rare.Conclusion: CDSSs increase appropriate test ordering in hospitals through eliminating redundant test orders and enhancing evidence-based practice. Appropriate testing and cost saving were both affected by the CDSSs. However the evidence is limited about the effects of laboratory test CDSSs on patient-related outcomes.
Background Hospital Information System (HIS) implementation is complex and costly compared to other information systems. Therefore, the present study was conducted with the aim of designing and evaluating technical HIS requirements.Methods This study was conducted in 2016 in two parts: designing technical requirements and evaluating the HIS. The first part of the study was performed through the Delphi technique. In the second part of the study, evaluation of systems was done using a checklist based on the approved requirements.Results In the first part of the study, the final list of technical HIS requirements was designed with 73 items in four domains including ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’. In the second part, the results of the evaluation indicated that the approved requirements had been observed in 63.8%, 65.5%, 72.4%, and 76.3% of the HIS software programs in the dimensions of ‘communication service’, ‘system architecture’, ‘security service’, and ‘system response time’, respectively.Conclusions The technical HIS evaluation tool was designed to be used in the evaluation and selection of the system. The evaluation results also indicated that the studied HISs were weaker in ‘communication service’ and ‘system architecture’ domains compared to the other two domains under study.
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