The Status of Hospital Information Systems in Iranian Hospitals

Abstract

Background:The area of e-Health is broad and has an excellent growth potential. An increasing number of experts believe that e-Health will fuel the next breakthroughs in health system improvements throughout the world, but there is frequent evidence of unsustainable use of e-Health systems in medical centres, particularly hospitals, for different reasons in different countries. Iran is also a developing country which is presently adopting this promising technology for its traditional healthcare delivery but there is not much information about the use of e-Health systems in its hospitals, and the weakness and opportunities of utilization of such Hospital Information Systems (HIS).Methods:For this research, a number of Hospitals from Isfahan, Iran, are selected using convenient sampling. E-health research professionals went there to observe their HIS and collect required data as a qualitative survey. The design of interview questions was based on the researchers’ experiences and knowledge in this area along with elementary interviews with experts on HIS utilization in hospitals.Results:Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, makes healthcare resources available to rural areas, etc. However, there are numerous issues affecting the successful utilization of e-health in Hospitals, such as a lack of a perfect HIS implementation plan and well-defined strategy, inadequate IT-security for the protection of e-health-related data, improper training and educational issues, legal challenges, privacy concerns, improper documentation of lessons learned, resistance to the application of new technologies, and finally a lack of recovery plan and disaster management. These results along with some informative stories are extracted from interview sessions to uncover associated challenges of HIS utilization in Iranian hospitals.Conclusion:The utilization of e-health in Iranian hospitals, particularly those in Isfahan, is subject to several challenges and there is no proper long-term strategy plans for HIS initiation, development, and improvement in Iranian hospitals. In order to address these problems, six recommendations are provided. Hence, human resource and e-health professionals from third party consultancy companies along with medical university scholars have to assist such hospitals to undertake the proposed solutions in order to provide proper plans to overcome future challenges and have a mature HIS in accordance with expected HIS utilization from hospitals and medical universities.

An evaluation model for the implementation of hospital information system in public hospitals using multi-criteria-decision-making (MCDM) approaches

“…Hence, the organizational innovation theories can be potentially useful to this research development of a new model of HIS adoption. Generally, studies on technology adoption and diffusion in the area on IS are conducted in two levels, user level and organizational level [22], [62], [63]. Furthermore, the stage of adoption and the context of study should be carefully paid attention to, especially in the technology and innovation adoption studies [62], [64].…”

“…The TOE framework as presented by Tornatzky and Fleischer [22], gives a proper analytical framework that is applied for examining the organizational adoption of diverse types of innovations [72], [81]. This framework has focused on analysis of organizational level that is as a lens to predict an adoption decision of technology.…”

“…Jahanbakhsh et al [22], [78] emphasized that HIS importance becomes clear when the great complexity of health system and the huge number of interventions that each patient faces, the high errors in healthcare organizations. Today, technological complexity and managing more patients with lesser resources are come from recent environment of medical involving with its IT base, and hence, causing medical staffs and professionals with higher demands [111].…”

“…Even though the HIS has brought the immense change to process of care delivery, it has attempted to increase the quality and safety of care [1], [9], [18][19][20]. However, compared to other technologies in the healthcare domain, the acceptance level of HIS is low [5], [17], [21][22][23][24]. HIS can support patient care planning and enhance decision making of clinical or administrative functions.…”

“…Iran is a developing country that introduces national plans, including SEPAS and TAKFAB as well as organizational e-Health projects, for instance, HISs in hospitals that are under development. According to several authors in Iran [22], [35], [40][41][42][43][44], the challenges of HIS implementation in Iran related to some fundamental issues of Human, Technology and Organization. Hence, this study is aimed to propose a strategic integrated theoretical model to serve in guiding a proper and successful HIS implementation within public hospitals.…”