BACKGROUND:Admission, discharge and, transfer (ADT) process is one of the most important hospital workflows. ADT system is a part of a hospital information system (HIS).AIM:The objective of this study was to evaluate the usability of the ADT system.METHODS:The study performed at Mashhad University of Medical Sciences (MUMS) hospitals. Data collection instrument was a validated checklist of Pierotti heuristic evaluation. To determine the severity of usability problems, a hybrid of Nielson and Tampere unit for computer-human interaction (TAUCHI) severity scaling algorithm was used. Usability problems were divided into five categories (major, severe, minor, cosmetic, and technical). Six experts evaluated the ADT system independently. According to TAUCHI severity scale, if a feature has not yet been implemented in the ADT system, evaluators considered it a technical usability problem. Therefore, usability problems due to non-design feature in the ADT system were identified. Finally, the mean severity of each usability problems was calculated.RESULTS:A total of 186 usability problems were identified. The frequency of major, sever, minor and cosmetic usability problems were 2, 65, 69 and 50, respectively. A total of 55 usability problems by the evaluators were recognised as technical problems. The highest mismatch with usability principles was related to the “recognition rather than recall”. The range of the mean severity of usability problems was between 0-2.31.CONCLUSIONS:Our result showed that although implementation of IHIS on a large scale, it still suffered from unresolved usability problems. Identification of usability problems and evaluation of their level of severity, which was simultaneously performed in this study, can be used as a guide to evaluate the usability of other HISs.

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Background:Standardized data collection supports disease information management and leads to better quality of care. The Islamic Republic of Iran lacks a standard data set for data collection in hospitals. Aims: The aim of this study was to design a minimum data set for hospital information systems in the Islamic Republic of Iran. Methods: This study was conducted in 2015. Data sets of other countries, hospital records, hospital information systems and electronic health record systems in the Islamic Republic of Iran were reviewed for data elements for the minimum data set. Data elements were collected using a data extraction form and were categorized into similar classes, which were divided into administrative and clinical sections. The list of data elements was reviewed by experts in technical offices of the Iranian Ministry of Health and Medical Education, and a minimum data set was drawn up. Results: There were nine and 18 data classes in the administrative and clinical sections with a total of 166 and 684 data elements respectively. After review by the expert panel, 159 administrative and 621 clinical data elements were retained as the minimum data set for the Iranian hospital information system. Conclusion: Our dataset can be used by the Iranian health ministry, hospital information system companies and health surveillance centres for more efficient management of health data. Citation: Rampisheh Z; Kameli M; Zarei J; Vahedi Barzaki A; Meraji M; Mohammadi A. Developing a national minimum data set for hospital information systems in the Islamic Republic of Iran. East Mediterr Health J. 2020;26(4):400-409. https://doi.

Background:During the last three decades, ethics committees have been formed with a growing trend. These committees have a satisfactory and effective impact on the pattern of patient care and its performance. The medical ethics committee is considered one of the most active committees in hospitals, having the aim of providing necessary approaches for the optimal use of the findings in empirical science and diagnostic treatment and observance of Islamic noble values in performing medical affairs.Objectives:The aim of this study is to assess the performance of the ethics committees, in the teaching hospitals affiliated with Mashhad University of Medical Sciences, in Mashhad.Patients and Methods:Subjects of this study include teaching hospitals in Mashhad, affiliated with Mashhad University of Medical Sciences and the tool used in gathering the data was a questionnaire, completed based on the information provided by the proceedings of the meetings held by the ethics committees. Also, for the purpose of gathering the suggestions, specifically on the improvement of the performance, a meeting was held with the representatives from hospitals' ethics committees. During the meeting, work reports were presented and recommendations made, based on those presentations. .Results:Findings of the present study suggest that all hospitals under study, have an ethics committee, of which 85.7% operate in combination with other committees. The composition of the members of the committees, in 57.1% of the hospitals, was based on the guidelines for hospital evaluation.Conclusions:For the performance of the medical ethics committees to improve, it is recommended that the hospital administration and evaluation section, hold regular meetings and oblige members to participate more actively.

Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods: The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results:The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. Conclusion: The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety.

Introduction: Psychiatric emergencies are acute mental health disturbances, behaviors and social relationships that require immediate intervention. The major role of the psychiatric emergency services is to provide mental health care services for patients with acute mental health problems. Design in the emergency psychiatry core data set has improved the coordination and integration of services and improved the outcomes for patients with severe and persistent mental illness and with complex needs. So, the aim of this study was to design data elements in emergency psychiatry for Iran. Methods: This is an applied study. Emergency psychiatry data elements collected via literature review and then psychologist and psychiatrist (16 persons) according to the value of each data element, assign a score from 0 to 5 to them. Data elements selected as core Emergency psychiatry data elements were those which achieved a 4 or 5 score from 75% of the specialist. Results: From a total of 95 usability problems identified, three evaluators identified 82 problems (86.3%), 2 evaluators identified 6 problems (6.3%) and one evaluator identified 7 problems (7.3%). According to severity, problems were 23 minor, 19 severe, 16 cosmetic and 37 technical problems. Rate of problems in different areas were: visibility of system status 13.6%, match between system and the real world 12.6%, user control and freedom 14.7%, consistency and standards 11.5%, error prevention 6.3%, recognition rather than recall 12.6%, flexibility and efficiency of use 5.2 %, aesthetic and minimalist design 6.3%, help users recognize, diagnose, and recover from errors 7.3% and help and documentation 6.3%. Conclusion: Given the importance of psychiatric disorder and lack of a national system for gathering psychiatric information, performing a similar study about psychiatric data element is very important. The results of this study can be used for the design of psychiatric emergency forms and accurate and complete patient information gathering.

Background An electronic prescription system is a mechanism that has long been implemented in many countries around the world. In the present study, we reviewed the requirements, standards, and features of an electronic prescription system for its correct and accurate execution. Methods This scoping review was conducted according to the PRISMA-SCR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive literature search was performed with the related keywords in Web of Science, PubMed, Scopus, and ProQuest with no time limit. The selection of papers was based on inclusion criteria. After removing duplicates, reviewing titles, abstracts, and full-text, 13 articles were included in the analysis. Results Electronic prescription system requirements extracted from the studies: Patient data, Patient selection or identification and data access, Drug Selection, Security, Privacy and administration, Transparency and accountability, Interoperability and communication, Monitoring, report, reminder, and renewals, Feedback at the prescriber level, Infrastructure: Computer equipment, Awareness of physicians and System support, Patient education and information, Usability, Standards, History of Medications / Current Medications, Data transfer and storage, Alerts and other messages to prescribers, and filtering of user-selectable alerts for possible prescription problems and Decision support. Conclusions The results of this study showed that the electronic prescription systems have several functional and technical capabilities that can provide significant benefits to all system’s stakeholders, including service providers, drug distributors, patients, and insurance organizations if used correctly.

Aim: Nowadays, the concentration of information systems evaluation is changing from technical issues toward humanoid and organizational subjects. To evaluate the interrelationships between these three dimensions in health systems, the HOT-Fit Assessment Framework (HOT-Fit) was proposed in 2006. Therefore, this study was conducted to identify accurate criteria for evaluating systems based on this model. Information sources or data: In the field of health information evaluation using HOT-Fit criteria, articles in PubMed, Scopus, and Persian e-databases including Iran Public Information Database (Magiran), Iran University Jihad Scientific Information Database, and Irandoc were searched from 2006 to 2019. Selection methods for study: The extracted articles were reviewed by content analysis method. From 1062 articles, 18 articles were selected after eliminating duplicated articles and unrelated articles according to their title, abstract and full text. Combine content and Results: After reviewing evaluation criteria of health information systems using HOT-Fit framework, 130 benchmarks were obtained from databases in four different dimensions including technical (n=51), organizational (n=36), human (n=33) and net profit dimensions (n=10). Conclusion: In this comprehensive review, we tried to provide a practical and comprehensive view of the evaluation of hospital information systems using the HOT-Fit model. This model can be used for all health hospital information system. Generally, the results of this review can be useful for information technology policymakers in determining health information systems evaluation criteria.