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Background Lack of proper and timely patients' access to speech pathologists can affect the treatment and follow-up process; therefore, patients do not achieve the expected therapeutic goals. The aim of this study was to determine the effect of tele-rehabilitation on the stuttering patients using the goal attainment scaling (GAS). Methods This interventional study was carried out on patients who visited the rehabilitation centers affiliated to the Jahrom Welfare Office. They underwent remote speech therapy using Skype. To evaluate the treatment outcomes of the stuttering patients, GAS was used. Results The participants' speech and lingual skills improved using videoconferencing. The mean score of total GAS for patients was 53.08. Of 112 health goals, patients reached the expected or higher than expected levels in 78 goals. Conclusions Rehabilitation through video conferencing was effective for patients with stuttering, improved their speech, and decreased their stuttering. Since, application of remote rehabilitation services can provide regular access to healthcare services, it can lead to improving patient treatment provide more frequent and faster treatment follow-up.

Background The purpose of this study was to evaluate HIV/AIDS mobile applications using the Mobile App Rating Scale (MARS) and rate the features of these applications using the new tool called the Feature-based Application Rating Method (FARM). Methods In this study, all available HIV/AIDS apps in Iran from Cafe Bazaar and Google Play Store due to inclusion criteria were studied. The evaluation of the quality of applications was done using the MARS tool and the FARM tool. The FARM, which was developed in this study, was applied to rank the features of the applications. Results In this study, 79 applications were included. The mean score of all apps using both tools was 3.58 (SD = 0.95) out of 5. The overall mean quality score based on the MARS was 3.14 (SD = 0.84), and the mean score of features based on FARM was 3.81 (SD = 1.23). This study showed a higher than moderate correlation between the scores assigned to apps based on the MARS and FARM tools (r > 0.4). Conclusions The HIV/AIDS mobile applications available in Iran had the "acceptable" ranking. Also, our study results showed that to evaluate mobile apps, using a single tool may not provide good insight to evaluators about the assessed apps. However, using more than one tool may provide more details about the evaluated apps. To improve the quality of mobile health apps and help users select the most desirable app, we suggested using tools like FARM for ranking apps based on the features of each app in the app stores.

Background Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this regard. This can be achieved by classifying the collected data using the international classification systems. This study aimed at investigating the content coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in a hospital. Methods This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of a hospital which is the biggest truma center in the southeast of Iran. The required data were collected via a designed questionnaire by the researcher visiting the Emergency ward. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The content coverage of the classification system and the degree of completeness of the required data for encoding in the patients’ records were measured. Data were analyzed by the SPSS software, ver 19. Results The findings showed that 70% of the external causes of injury were covered by ICECI. Among the 322 cases, 138 (43%) had been referred due to a car crash. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car crash. The least mechanism for injury was bite injury with 5 (2%). ICECI was capable of classifying 92% of the data related to the external causes of the injuries. The most un-covered data has belonged to the "activity when injured" axis (n = 18). Lack of precise data recording in the medical records resulted in missing data about at least one of the axis of the external causes in most records. Conclusion The findings of the present study showed that ICECI has good content coverage for encoding the external causes of injuries. Before implementing ICECI for encoding the external causes of injuries, it is required to train clinicians regarding how to document all aspects of an injury incidence.

Background Despite the increasing number of mobile health applications, the validity of their content is understudied. The objective of this study was to rate the content of HIV/AIDS-related mobile applications and to determine the extent to which evidence-based medicine is being incorporated into their content using a new tool called the Evidence-based content rating tool of mobile health applications (EBCRT-mHealth). Methods All available HIV/AIDS-related applications in Iran from Cafe Bazaar and Google Play Store were evaluated. This study was first conducted in 2018, then after almost two years in 2021 was done again. In this study, researchers developed the EBCRT-mHealth tool to rate the content of applications based on the evidence-based medicine pyramid. Its reliability was calculated (α = 0.78), and five specialists confirmed its validity. Two reviewers independently reviewed all HIV/AIDS applications directly downloaded and installed from the Google Play Store and Cafe Bazaar. Results Out of 980 retrieved applications, in 2018, 85, and in 2021, 78 applications were included in the study. Only in 17 (28%) out of the 60 in 2018, and 25 (51%) in 2021 Google Play store applications the source of content information was mentioned. All Cafe Bazaar mobile applications mentioned the source of information. The mean rating of all application content in 2018 was 2.38 (SD = 0.74), and in 2021 was 2.90 (SD = 1.35) out of 5. The mean rating of the content of Cafe Bazaar applications in 2018 was 2.10 (SD = 0.49), and in 2021 was 1.94 (SD = 0.29). The mean content rating of Google Play store applications in 2018 was 2.50 (SD = 0.80) and in 2021 was 3.86 (SD = 1.18). Conclusion After two years, the rating of the content of HIV/AIDS-related applications available in Iran that existed in Cafe Bazaar decreased from "poor" to "inappropriate". Also, the content score of the Google Play Store applications increased from "poor" to "good". It is critical to ensure the credibility of the sources used in developing their content and removing applications with inappropriate and unreliable content from the App Stores. Also, mobile health application developers should use the highest quality information in their applications.

Background Despite the rapid expansion of electronic health records, the use of computer mouse and keyboard, challenges the data entry into these systems. Speech recognition software is one of the substitutes for the mouse and keyboard. The objective of this study was to evaluate the use of online and offline speech recognition software on spelling errors in nursing reports and to compare them with errors in handwritten reports. Methods For this study, online and offline speech recognition software were selected and customized based on unrecognized terms by these softwares. Two groups of 35 nurses provided the admission notes of hospitalized patients upon their arrival using three data entry methods (using the handwritten method or two types of speech recognition software). After at least a month, they created the same reports using the other methods. The number of spelling errors in each method was determined. These errors were compared between the paper method and the two electronic methods before and after the correction of errors. Results The lowest accuracy was related to online software with 96.4% and accuracy. On the average per report, the online method 6.76, and the offline method 4.56 generated more errors than the paper method. After correcting the errors by the participants, the number of errors in the online reports decreased by 94.75% and the number of errors in the offline reports decreased by 97.20%. The highest number of reports with errors was related to reports created by online software. Conclusion Although two software had relatively high accuracy, they created more errors than the paper method that can be lowered by optimizing and upgrading these softwares. The results showed that error correction by users significantly reduced the documentation errors caused by the software.

The timely and accurate diagnosis of ENT (Ear, Nose, and throat) diseases in deprived areas is very important due to the increased burden of the disease in high-risk populations. Therefore, the purpose of this study is to identify, validate and prioritize the information needs of stakeholders of a tele-otology system for diagnosing ear diseases and to provide a solution.In this study, to identify the information need of the stakeholders and prioritize them, the spiral-iterative model was used. Data were obtained through direct observation, interviews with 23 stakeholders (6 ENT specialist doctors, 3 health center managers, 2 patients, and 12 health facilitators), and a survey among all ENT specialists and residents (n = 49), working in Kerman province, Iran. Finally, based on the study findings, the important information needs of the stakeholders were considered as the input for developing the tele-otology software.In the observation phase, the workflow of the tele-otology system was developed. In the interview phase, 4 main themes including patient information; Technology and communication; Policy, guidelines, and requirements; Facilitator skills and knowledge were determined. In total, the four categories of the iterative-spiral model including strategic, patient information, commercial and technical with 8, 9, 3, and 9 sub-categories, respectively, were prioritized by specialists which were considered as input for system development.By applying the spiral-iterative model, the prototype included a mobile app and server system was developed. In the final solution, the possibility of capturing patient history and video images was provided for facilitators to help physicians in effective diagnosis. The results of this study, while identifying the workflow of service providers and determining their information needs can help telemedicine system developers to have an optimal design when designing systems for the diagnosis of ear disease.

Background Lack of attention to end-users' requirements and preferences may lead to the failure of health information technology (IT) interventions. Identifying users’ needs for designing a mobile application can lead to the development of an acceptable intervention. This study aimed to determine the requirements for designing a mobile application to educate and provide needed information to contact lens (CL) wearers. Methods A qualitative study was conducted on 24 CL wearers and nine eye care practitioners from the three CL clinics in Iran. Data were collected through semi-structured interviews and analyzed using the conventional content analysis proposed by Lundman and Graneheim. Lincoln and Guba's criteria were used to ensure the trustworthiness of the data. Results The three main categories that emerged from the interviews were mobile application content, mobile application functionalities, and mobile application features. Ten subcategories and 57 sub-subcategories were also identified. It was determined that mobile content should focus on advice and information for optimizing the CL wearing experience and training regarding the use of CLs. Entering information required for self-care, computational capability, interactivity, updates, and reminders were determined as needed functionalities. The participants recommended features for the structure and user interface of the mobile application and information presentation methods. Conclusion This study identified the information needed to develop a mobile application for CL wearers. This also provides insights regarding required functionalities when applying IT interventions. These findings can be used by CL clinics, developers of health information systems, policymakers, and health planners to design better CL-related care and compliance interventions.

Background To facilitate disease management, understanding the attitude of healthcare professionals regarding the use of this tool can help mobile health (mHealth) program developers develop appropriate interventions. Aims To assess the perspective of healthcare professionals regarding the contribution of mobile-based interventions in the prevention, diagnosis, self-care, and treatment (PDST) of COVID-19. Methods This is a survey study conducted in 2020 in Iran with 81 questions. In this study mHealth functionalities were categorized into four dimensions including innovative, monitoring and screening, remote services, and education and decision-making. The data were analyzed using descriptive statistics, ANOVA, and the Kruskal–Wallis test to compare the attitudes of the different job groups. Results In total, 123 providers participated, and 87.4% of them reported that mHealth technology is moderate to most helpful for the management of COVID-19. Healthcare professionals believed that mHealth technology could be most helpful in self-care and least helpful in the diagnosis of COVID-19. Regarding the functionalities of the mobile application, the results showed that the use of patient decision aids can be most helpful in self-care and the use of computer games can be least helpful in treatment. The participants believed that mHealth is more effective in monitoring and screening dimensions and less effective in providing remote services. Conclusions This study showed that healthcare professionals believed that mHealth technology could have a better contribution to self-care for patients with COVID-19. Therefore, it is better to plan and invest more in the field of self-care to help patients to combat COVID-19. The results of this study revealed which mhealth functionalities work better in four domains of prevention, treatment, self-care, and diagnosis of COVID-19. This can help healthcare authorities to implement appropriate IT-based interventions to combat COVID-19.

Background Despite the use of health information technology (HIT) for controlling and managing lupus, its effectiveness has not been well studied. The objective of this study was to investigate the role of HIT in controlling and managing lupus. Methods We searched Scopus, PubMed, Web of Science, and Embase, using "self-management", "self-care" and "Systemic Lupus Erythematosus" keywords. Two researchers selected relevant papers and extracted data using a data collection form. Disagreements were resolved in consultation with the third and fourth researchers. After extraction, the data were analyzed. Results Totally, 23 papers met the inclusion criteria. About 75% of the studies used web and telephone-based technologies. Most services provided with health technologies were ‘Training’ and ‘consulting’. The ‘lifestyle" and ‘Consultation and education’ axes were the most widely used HIT services to control and manage lupus. While, ‘Better management and control of the disease’, ‘Increasing knowledge and awareness of people about lupus’ and ‘Improving behaviors and attitudes toward self-management and self-care’ were also the most important outcomes. ‘Collectiing patient data and information’, 'Providing education and consultation services to patients', 'Measuring patient-reported outcomes', and 'Increasing patients' knowledge and awareness of their disease' were the most important advantages of various technologies. 'Slow internet speed' and 'Challenges and problems related to appearance and usability' and 'Patient concerns about privacy and misuse of their data' were three disadvantages of technologies. Conclusion The findings showed that HIT can improve the management and control of lupus and facilitate self-efficacy, self-care, and self-management in patients. The axes and data elements identified in this study can be the basis for developing and implementing efficient HIT-based systems to improve, control, and manage lupus.

Introduction Using information technology (IT) for purposes such as patient education and disease prevention and management is effective when patients are ready to use it. The objective of this study was to determine the readiness of patients with renal failure to use health IT. Methods This study was performed on all dialysis patients in South Khorasan province (n = 263) using a 28-item questionnaire. The questionnaire consisted of (1) demographic information of participants and (2) questions concerning eight main factors including the need for information, desire to receive information, ability to use computers and the Internet, computers and the Internet anxiety, communication with physicians, using mobile phones and concerns about security and confidentiality of information. Descriptive statistics and Mann–Whitney and Kruskal–Wallis statistical tests were used to analyze the data. Results About 15% of the participants stated that they do not want to receive information from the Internet. Anxiety and concern about Internet security and confidentiality were higher in women, married people, people over 60, villagers, and illiterate people (p p p Conclusion Despite the need of most patients to online health information, they do not use this information due to a lack of skills and experience to use IT. Therefore, the ability of users should be considered when developing IT-based interventions. Due to patients' concerns about Internet privacy, it is required to teach patients how to protect their privacy while using the Internet.

BACKGROUND The most important reason for vaccination delay is the unawareness of the parents of vaccination schedule. The use of reminders can result in better vaccination coverage. OBJECTIVES This study aimed to determine the preferred method of receiving vaccination reminders from the parents' perspective. STUDY DESIGN Cross-sectional study. METHODS We studied the parents of under 7-year-old children who visited one of the six urban health centres in Mashhad for vaccination of their children in 2017. Three hundred parents were participated based on the convenience sampling method. Data were collected using a questionnaire consisting of five sections. Five Medical Informatics specialists confirmed the validity of the questionnaire. The data were analysed by descriptive-inferential statistics and the significance level was set at p

Pregnant women get information about pregnancy andchild-birth from many sources, including the Internet. There is alack of evidence about the extent to which pregnant women usethis source. This study aimed to investigate the use of the Internetby pregnant women to search for information about pregnancyand childbirth. This study was conducted in Kerman, Iran. Threehundred eighty-five pregnant women waiting for their appointmentswith obstetricians/gynecologists participated in the survey byfilling out a questionnaire. The most common searched topicswere nutrition in pregnancy (81%), fetal development (67%), andcomplications of pregnancy (49%). The most popular sources ofinformation were physicians (61%), the Internet (51%), and printedsources (41%), respectively. More than half of the participantsdid not share the retrieved information from the Internet with theirhealth professionals. After being examined by a physician, 43% ofthe participants searched the Internet about the discussed topic.Beside physicians, the Internet is the second common source ofpregnancy and childbirth information for Iranian pregnant women.Future studies are needed to analyze the quality and accuracy ofonline pregnancy and childbirth information.

Background Information technology (IT) plays an important role in nursing practice. Hence, nurses’ experiences and viewpoints about IT integration into healthcare help improve nurses’ adoption of IT. This study aimed to explore the nurses’ experiences and viewpoints about the benefits of IT integration and adoption in healthcare. Methods This study was conducted with a qualitative research approach. Participants included 14 nurses from four hospitals affiliated to a large medical university in Iran, who were selected using a purposive sampling method. Data were collected through semi-structured interviews and analyzed using the conventional content analysis of Lundman and Graneheim. Results Six categories in the study reflected the nurses’ experiences and viewpoints about the benefits of integrating IT into health care. These categories included improving the quality and efficiency of medical services and care, facilitating the communication management in the technological environment, improving information documentation, management, and monitoring, improving resource management, improving management performance and policymaking, and facilitating pathways of organizational and professional growth. Conclusions Lessons learned in this study can help overcoming the barriers of IT adoption, and developing appropriate strategies to familiarize nurses with the benefits of IT in healthcare settings. Healthcare managers are recommended to investigate the experiences of nurses with IT in their hospitals and organize courses to orient hesitant nurses toward adopting IT.

Objective Investigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services. Methods This descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19. Results The mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p Conclusions The present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs.

ObjectiveTo define a core dataset for intensive care unit (ICU) patients outcome prediction in Iran. This core data set will lead us to design ICU outcome prediction models with the most effective parameters.MethodsA combination of literature review, national survey and expert consensus meetings were used. First, a literature review was performed by a general search in PubMed to find the most appropriate models for intensive care mortality prediction and their parameters. Second, in a national survey, experts from a couple of medical centres in all parts of Iran were asked to comment on a list of items retrieved from the earlier literature review study. In the next step, a multi-disciplinary committee of experts was installed. In four meetings, each data item was examined separately and included/excluded by committee consensus.ResultsThe combination of the literature review findings and experts’ consensus resulted in a draft dataset including 26 data items. Ninety-two percent of data items in the draft dataset were retrieved from the literature study and the others were suggested by the experts. The final dataset of 24 data items covers patient history and physical examination, chemistry, vital signs, oxygenations and some more specific parameters.ConclusionsThis dataset was designed to develop a nationwide prognostic model for predicting ICU mortality and length of stay. This dataset opens the door for creating standardised approaches in data collection in the Iranian intensive care unit estimation of resource utility.

Objective The objective of this study was to examine the effect of mobile phone applications (App) based cognitive behavioral therapy (CBT) on postpartum depression. Method A non-blinded parallel-group randomized controlled trial was conducted. The study population consisted of women attended to three health care centers in Kerman, Iran. Participants were recruited between September and November 2018, and randomized 1:1 to either the intervention group (mobile application access) or control group (no mobile application access). All participants completed the Edinburgh Postnatal Depression Scale (EPDS) at the baseline and 2 months after baseline. Data were analyzed using inferential statistics including chi-square, independent sample t-test, paired t-test and linear regression. Results A total of 75 women with an average age of 27 years participated in this study. Before the intervention, there was no statistically significant difference between the EPDS score between the two groups (p > 0.001). However, in the intervention group, the average EPDS score after intervention was 8.18 and in the control group was 15.05, which was statistically significant (p Conclusion These findings provide proof that providing a CBT program using a mobile application can lead to clinically important improvements in outcomes for mothers who suffer from postpartum depression.

Laboratory information systems are widely used health information systems that have the potential to improve health care quality. Despite their benefits, many studies have indicated problems with user interaction with these systems due to poor interface design.To evaluate the usability of a laboratory information system.In this descriptive, cross-sectional study, we used heuristic evaluation to examine the user interface design of a laboratory information system in an academic hospital affiliated with Kerman University of Medical Sciences in 2017. This system is also used in 59 other Iranian hospitals .We investigated the usability of different parts of the usability of a laboratory information system (outpatient admission, inpatient admission, sample collection, and test result reporting). Data were collected using a standard form based on the heuristic evaluation method, and categorized based on their severity and violated heuristics. The content validity was confirmed by 3 medical informatics specialists.We identified 162 usability problems. In terms of the heuristics, the highest number of problems concerned flexibility and efficiency of use (n = 32, 19.75%) and the lowest concerned help users recognize, diagnose, and recover from errors (n = 2, 1.23%). In terms of different modules of the system, the highest number of problems (n = 51, 31.48%) concerned outpatient admission and the lowest (n = 29, 17.9%) concerned sample collection. In terms of severity, 45.06% of the problems were rated as major.Despite widespread use of laboratory information systems, their user interface design has usability problems that diminish the quality of user interaction with these systems and may affect the quality of health care. Consideration of standards and principles for user interface design, such as the heuristics used in this study, could improve system usability.الامتثال لمبادئ التصميم: دراسة حالة لنظام معلومات مختبري مستخدَم على نطاق واسع.زهيلة أغارازاي، رضا خاجوي، ليلى أحمديان، لاليه أغارازي.نُظم المعلومات المختبرية هي نُظم المعلومات الصحية المستخدَمة على نطاقٍ واسع والتي لديها القدرة على تحسين جودة الرعاية الصحية. وعلى الرغم من فوائدها، أشارت العديد من الدراسات إلى وجود مشاكل في تفاعل المستخدمين مع هذه النُّظم بسبب سوء تصميم الواجهة.هدفت هذه الدراسة إلى تقييم قابلية استخدام نُظم المعلومات المختبرية في المستشفيات.استخدمنا في هذه الدراسة المقطعية الوصفية التقييم الاستدلالي لدراسة تصميم واجهة المستخدم لنظام المعلومات المختبرية في مستشفى أكاديمي تابعٍ لجامعة كرمان للعلوم الطبية في عام 2017. ويُستخدَم هذا النظام أيضاً في 59 مستشفى إيرانياً آخر. وبحثنا في قابلية استخدام مختلف أجزاء نظام المعلومات المختبرية (دخول المرضى الخارجيين، ودخول المرضى الداخليين، وجمع العينات، وإعداد تقارير نتائج الاختبارات). وجُعت البيانات باستخدام نموذج قياسي يستند إلى طريقة التقييم الاستدلالي وصُنفت البيانات على أساس وخامة المشكلة وانتهاك الاستدلالات. وأكَّد ثلاثة أخصائيين في المعلوماتية الطبية صحة المحتوى.حددنا 162 مشكلة في قابلية الاستخدام. وفيما يتعلق بالاستدلالات، كان أكبر عدد من المشاكل يتعلق بالمرونة وكفاءة الاستخدام (العدد = 32، ٪19.75)، وكان أقل عدد من المشاكل يتعلق بمساعدة المستخدمين على التعرُّف على الأخطاء وتشخيصها وحلها (العدد = 2، ٪1.23). وفيما يتعلق بمختلف وحدات النظام، كان أكبر عدد من المشاكل (العدد = 51، ٪31.48) يتعلق بدخول العيادات الخارجية، وكان أقل عدد (العدد = 29، ٪17.9) يتعلق بجمع العينات. ومن حيث الوخامة، صُنف ٪45.06 من المشاكل على أنها كبيرة.رغم انتشار استخدام نُظم المعلومات المختبرية، يكتنف تصميم واجهة المستخدم مشاكل في قابلية الاستخدام تُقلل من جودة تفاعل المستخدمين مع هذه النُّظم، ويمكن أن تؤثّر على جودة الرعاية الصحية. ويمكن أن يؤدي النظر في المعايير والمبادئ المتعلقة بتصميم واجهة المستخدم، مثل الاستدلالات المستخدَمة في هذه الدراسة، إلى تحسين قابلية استخدام هذه النُّظم.Respect des principes de conception : étude de cas d’un système d’information de laboratoire dont l ’ utilisation est largement répandue.Les systèmes d’information de laboratoire sont des systèmes d’information sanitaire largement utilisés qui ont le potentiel d’améliorer la qualité des soins de santé. Ces systèmes présentent des avantages, mais de nombreuses études ont mis en évidence des problèmes d’interaction avec les utilisateurs en raison d’une mauvaise conception de l’interface.La présente étude visait à évaluer l’utilisabilité des systèmes d’information de laboratoire en milieu hospitalier.Dans la présente étude transversale descriptive, réalisée en 2017, nous avons eu recours à l’évaluation heuristique pour examiner la conception de l’interface utilisateur d’un système d’information de laboratoire employé dans un hôpital universitaire affilié à l’Université des Sciences médicales de Kerman. Ce système est également utilisé dans 59 autres hôpitaux iraniens. Nous avons étudié l’utilisabilité de différents modules du système (admission en ambulatoire, admission en séjour hospitalier, collecte d’échantillons et notification des résultats de test). Les données ont été recueillies à l’aide d’un formulaire type basé sur la méthode d’évaluation heuristique. Elles ont ensuite été classées selon leur gravité et les heuristiques ayant été transgressées. La validité du contenu a été confirmée par trois spécialistes en informatique médicale.Nous avons recensé 162 problèmes d’utilisabilité. L’heuristique pour laquelle le plus grand nombre de problèmes ont été rapportés était la flexibilité et l’efficacité d’utilisation (n = 32, 19,75 %), tandis que l’aide à la reconnaissance, au diagnostic et à la réparation des erreurs était celle pour laquelle on rapportait le plus petit nombre de problèmes (n = 2, 1,23 %). L’admission ambulatoire était le module du système pour lequel le plus grand nombre de problèmes a été notifié (n = 51, 31,48 %), tandis que la collecte d’échantillons était celui pour lequel on rapportait le plus petit nombre de problèmes a été notifié (n = 29, 17,9 %). En ce qui concerne la gravité, 45,06 % des problèmes ont été jugés majeurs.Malgré l’utilisation répandue des systèmes d’information de laboratoire, les interfaces présentent souvent des problèmes d’utilisabilité qui diminuent la qualité de l’interaction avec les utilisateurs et peuvent affecter la qualité des soins de santé offerts. Ainsi, au moment de concevoir les interfaces utilisateurs, il pourrait être utile de s’appuyer sur des normes et des principes, à l’instar des heuristiques utilisées dans cette étude. Cela pourrait en effet permettre d’améliorer la convivialité des systèmes.

Background: Computerised decision support (CDS) based on trustworthy clinical guidelines is a key componentof a learning healthcare system. Research shows that the effectiveness of CDS is mixed.Multifaceted context, system, recommendation and implementation factors may potentially affect the success ofCDS interventions. This paper describes the development of a checklist that is intended to support professionals toimplement CDS successfully.Methods: We developed the checklist through an iterative process that involved a systematic review of evidenceand frameworks, a synthesis of the success factors identified in the review, feedback from an international expertpanel that evaluated the checklist in relation to a list of desirable framework attributes, consultations with patientsand healthcare consumers and pilot testing of the checklist.Results: We screened 5347 papers and selected 71 papers with relevant information on success factors forguideline-based CDS. From the selected papers, we developed a 16-factor checklist that is divided in four domains,i.e. the CDS context, content, system and implementation domains. The panel of experts evaluated the checklistpositively as an instrument that could support people implementing guideline-based CDS across a wide range ofsettings globally. Patients and healthcare consumers identified guideline-based CDS as an important qualityimprovement intervention and perceived the GUIDES checklist as a suitable and useful strategy.Conclusions: The GUIDES checklist can support professionals in considering the factors that affect the success ofCDS interventions. It may facilitate a deeper and more accurate understanding of the factors shaping CDSeffectiveness. Relying on a structured approach may prevent that important factors are missed.Keywords: Clinical computerised decision support systems, Practice Guidelines, Guideline adherence,Evidence-based medicine, Implementation

Background Improving maternal health is globally introduced as an important health priority. The purpose of this study is to identify the high priority areas which require more maternal health services in Kerman, Iran. Methods This is a descriptive cross-sectional study, performed in 2015. The literatures were first explored in order to extract geographic indicators and sub indicators relevant to the maternal health. Data were collected by the use of a questionnaire designed on the basis of AHP (Analytic Hierarchy Process) method. The validity and reliability of the questionnaire were confirmed by three medical informatics experts and test-retest method, respectively. Data were analyzed by Expert Choice software in order to specify the weight and importance of each indicator. The information were then added to Geographic Information System (GIS) to analyze and create the related maps. Results Women’s access to hospitals plays an important role in identifying high priority areas which need maternal care and services. More than half of the mothers in Kerman have a moderate level of access to maternal care services. There is an association between facilities that are provided for pregnant women and the existence of healthcare centers. Moreover, there is a negative correlation between maternal death and the number of facilities provided for medical care and services for pregnant women. Conclusions The application of GIS provides us with the capability to identify high priority areas which need maternal care. According to current population policies in Iran and the probable increase in the fertility rate, it is wise to plan proper schedules to improve health care services for pregnant women in Kerman. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2423-9) contains supplementary material, which is available to authorized users.

Background Pregnant women should be provided with relevant and useful information to manage this specific period of their lives. Assessing information needs of this group is a prerequisite for providing this information. Objective The aim of this study was to assess the information needs of pregnant women during their pregnancy and childbirth. Methods This descriptive study was conducted on the pregnant women who attended antenatal clinics and obstetricians/gynaecologists’ offices in Kerman, Iran, in 2015. Data were collected using a self-administered, valid and reliable questionnaire. A total of 400 women participated in the study. Findings Most pregnant women needed information about care of the foetus (n = 344, 86%), physical and psychological complications after delivery (n = 333, 83%), development and growth of the foetus (n = 330, 82.5%), pregnancy nutrition (n = 327, 82%) and special tests during pregnancy (n = 326, 81.5%). They mostly (n = 195, 49%) looked for information when they were suffering from a disease or pregnancy complications. Conclusions As pregnant women need extensive information to be able to take care of themselves and their babies, their information needs should be identified and taken into consideration when planning educational programmes for this group of women.

This study is a systematic literature review to identify data collected in the preoperative assessment. The PubMed and CINAHL databases were searched for articles published from 1997 to 2007. From the included articles, data items that were described as part of the preoperative assessment were extracted. Identified data items were categorized into 13 categories originating from SNOMED CT. Forty-one relevant articles were found. Preoperative assessment was equally performed in outpatient clinics and in-hospitals. The assessment was performed between the day of surgery and 30 days before surgery by anesthesiologists (51%) and/or nurses (39%) and/or other professionals (34%). The included articles described 541 data items. The two largest categories of data were "past history of clinical finding" and "physical examination procedure," with 212 and 75 data items. Only 6 data items "age," "diabetes," "ECG," "cardiovascular diseases," "hypertension," and "cigarette smoking and other use of tobacco" were stated in 50% or more of the articles. This study revealed a high diversity of data being collected during the preoperative assessment. Because of the diversity of patients, one undisputed preoperative assessment data set is hard to define. However, to solve the problem of data exchangeability, professionals should at least use a common core data set.

Background With the explosion of medical information, and emergence of evidence-based practice (EBP) in healthcare system, searching, retrieving and selecting information for clinical decision-making are becoming required skills for nurses. Aims The aims of this study were to examine the use of different medical information resources by nurses and their information searching and retrieving skills in the context of EBP. Method A descriptive, cross-sectional study was conducted in four teaching hospitals in Iran. Data were collected from 182 nurses using a questionnaire in 2014. Results The nurses indicated that they use more human and printed resources than electronic resources to seek information (mean = 2.83, SD = 1.5; mean = 2.77, SD = 1.07; and mean = 2.13, SD = 0.88, respectively). To search online resources, the nurses use quick/basic search features more frequently (mean = 2.45, SD = 1.15) than other search features such as advanced search, index browsing and MeSH term searching. (1.74 ≤ mean ≤ 2.30, SD = 1.01). At least 80% of the nurses were not aware of the purpose or function of search operators such as Boolean and proximity operators. In response to the question measuring skills of the nurses in developing an effective search statement by using Boolean operators, only 20% of them selected the more appropriate statement, using some synonyms of the concepts in a given subject. Conclusion The study showed that the information seeking and retrieval skills of the nurses were poor and there were clear deficits in the use of updated information resources. To compensate their EBP incompetency, nurses may resort to human resources. In order to use the latest up to date evidence independently, nurses need to improve their information literacy. To reach this goal, clinical librarians, health information specialists, nursing faculties, and clinical nurse educators and mentors can play key roles by providing educational programs. Providing access to online resources in clinical wards can also encourage nurses to learn and use these resources.

Hospital information systems (HIS) are often implemented to enhance the quality of care, as well as to improve the efficiency and safety of health care services. However, there are various barriers for their successful implementation. The aim of this paper is to prioritize these barriers. This research is a cross sectional analytic-descriptive study. The study populations were hospital managers, IT department administrators, and clinical supervisors at the academic and non-academic hospitals of two cities in Iran. The data was collected by a questionnaire that its content validity was confirmed by three specialists. Its reliability was confirmed using Cronbach's alpha (??=?0.78). Questionnaire contained five dimensions and 39 implementation barriers. The collected data was analyzed by descriptive and analytical statistics using the Kendall Rank Correlation Coefficient and Chi2 tests. The findings of the study revealed that lack of powerful information networks, error in data entry, technical problems related to system design, lack of organizational training, lack of users' knowledge about system and working with it, and negative attitudes of providers and patients toward systems are the most important barriers of HIS implementation. Prioritizing of these barriers helps policy makers to decide what to do when planning for HIS utilization.

Objectives The most important goal of a health information system (HIS) is improvement of quality, effectiveness and efficiency of health services. To achieve this goal, health care systems should be evaluated continuously. The aim of this paper was to study the impacts of HISs in Iran and the methods used for their evaluation. Methods We systematically searched all English and Persian papers evaluating health information systems in Iran that were indexed in SID, Magiran, Iran medex, PubMed and Embase databases until June 2013. A data collection form was designed to extract required data such as types of systems evaluated, evaluation methods and tools. Results In this study, 53 out of 1103 retrieved articles were selected as relevant and reviewed by the authors. This study indicated that 28 studies used questionnaires to evaluate the system and in 27 studies the study instruments were distributed within a research population. In 26 papers the researchers collected the information by means of interviews, observations, heuristic evaluation and the review of documents and records. The main effects of the evaluated systems in health care settings were improving quality of services, reducing time, increasing accessibility to information, reducing costs and decreasing medical errors. Conclusion Evaluation of health information systems is central to their development and enhancement, and to understanding their effect on health and health services. Despite numerous evaluation methods available, the reviewed studies used a limited number of methods to evaluate HIS. Additionally, the studies mainly discussed the positive effects of HIS on health care services.

Summary Objective: To provide a generic approach for developing a domain-specific interface terminology on SNOMED CT and to apply this approach to the domain of intensive care. Methods: The process of developing an interface terminology on SNOMED CT can be regarded as six sequential phases: domain analysis, mapping from the domain concepts to SNOMED CT concepts, creating the SNOMED CT subset guided by the mapping, extending the subset with non-covered concepts, constraining the subset by removing irrelevant content, and deploying the subset in a terminology server. Results: The APACHE IV classification, a standard in the intensive care with 445 diagnostic categories, served as the starting point for designing the interface terminology. The majority (89.2%) of the diagnostic categories from APACHE IV could be mapped to SNOMED CT concepts and for the remaining concepts a partial match was identified. The resulting initial set of mapped concepts consisted of 404 SNOMED CT concepts. This set could be extended to 83,125 concepts if all taxonomic children of these concepts were included. Also including all concepts that are referred to in the definition of other concepts lead to a subset of 233,782 concepts. An evaluation of the interface terminology should reveal what level of detail in the subset is suitable for the intensive care domain and whether parts need further constraining. In the final phase, the interface terminology is implemented in the intensive care in a locally developed terminology server to collect the reasons for intensive care admission. Conclusions: We provide a structure for the process of identifying a domain-specific interface terminology on SNOMED CT. We use this approach to design an interface terminology on SNOMED CT for the intensive care domain. This work is of value for other researchers who intend to build a domain-specific interface terminology on SNOMED CT.

Introduction: Clinical decision support systems (CDSSs) should be seamlessly integrated with existing clinical information systems to enable automatic provision of advice at the time and place where decisions are made. It has been suggested that a lack of agreed data standards frequently hampers this integration. We performed a literature review to investigate whether CDSSs used standardized (i.e. coded or numerical) data and which terminological systems have been used to code data. We also investigated whether a lack of standardized data was considered an impediment for CDSS implementation. Methods: Articles reporting an evaluation of a CDSS that provided a computerized advice based on patient-specific data items were identified based on a former literature review on CDSS and on CDSS studies identified in AMIA's 'Year in Review'. Authors of these articles were contacted to check and complete the extracted data. A questionnaire among the authors of included studies was used to determine the obstacles in CDSS implementation. Results: We identified 77 articles published between 1995 and 2008. Twenty-two percent of the evaluated CDSSs used only numerical data. Fifty one percent of the CDSSs that used coded data applied an international terminology. The most frequently used international terminology were the ICD (International Classification of Diseases), used in 68% of the cases and LOINC (Logical Observation Identifiers Names and Codes) in 12% of the cases. More than half of the authors experienced barriers in CDSS implementation. In most cases these barriers were related to the lack of electronically available standardized data required to invoke or activate the CDSS. Conclusion: Many CDSSs applied different terminological systems to code data. This diversity hampers the possibility of sharing and reasoning with data within different systems. The results of the survey confirm the hypothesis that data standardization is a critical success factor for CDSS development. (c) 2010 Elsevier Ireland Ltd. All rights reserved

Summary Objective: To define a core dataset for preoperative assessment to leverage uniform data collection in this domain. This uniformity is a prerequisite for data exchange between care providers and semantic interoperability between health record systems. Methods: To design this core dataset a combination of literature review and expert consensus meetings were used. In the first meeting a working definition for “core dataset” was specified. Subgroups were formed to address major headings of the core dataset. In the following eight meetings data items for each subheading were discussed. The items in the resulting draft of the dataset were compared to those retrieved from an earlier literature review study. In the last two expert meetings modifications of the dataset were performed based on the result of this literature study. Results: Based on expert consensus a draft dataset including 82 data items was designed. Seventy-six percent of data items in the draft dataset were covered by the literature study. Nine data items were modified in the draft and 14 data items were added to the dataset based on input from the literature review. The final dataset of 93 data items covers patient history, physical examination, supplementary examination and consultation, and final judgment. Conclusions: This preoperative-assessment dataset was defined based on expert consensus and literature review. Both methods proved to be valuable and complementary. This dataset opens the door for creating standardized approaches in data collection in the preoperative assessment field which will facilitate interoperability between different electronic health records and different users.

Karahoca et al. [1] addressed an important topic in their paperconcerning the use of usability evaluation methods to choose anappropriate software prototype for tablet personal computers.They applied a combination of usability evaluation methods toevaluate the usability of two software prototypes with differentgraphical user interfaces (GUIs); iconic and non-iconic. These GUIswere designed to replace the paper-based forms at an emergencydepartment of a Turkish hospital. The whole healthcare staff ofthe department, consisting of 6 physicians and 32 nurses, partici-patedas evaluatorsin the study.The findingsof the comprehensiveevaluation showed that the iconic GUI prototype had better usabil-ity thanthe non-iconicGUI prototype.This studycontributesto thebody of knowledge concerning the usability of GUIs. Such studiesare important from a practical perspective because in the compet-itive market of clinical software they help health care organiza-tions in selecting systems that best suits their users’ needs.Moreover, the results of these studies provide practical input tosoftware developers concerning the design of software that is easyto use and that fits the workflow of healthcare providers.Although Karahoca and his colleagues applied a comprehensivemethod and obtained interesting findings, we would like to drawattention to some methodological issues concerning the way theusability evaluation methods were employed in this study.The authors mention that Hom [2] identifies three types ofusability evaluation methods, which include testing, inspectionand inquiry and state that they applied heuristic evaluation andcognitive walkthrough (CW), both expert inspection methods, toevaluate the usability of the two prototypes.1. Recruitment of evaluators for heuristic evaluationThe authors recruited potential users of the prototypes as heu-ristic evaluators. Based on a computer literacy test, half of theseusers were classified as novice users. In a study identifying the fac-tors affecting heuristic expertise and levels of expertise permissi-ble to conduct a heuristic evaluation, according to Kirmani [3]three factors (usability experience, experience with the heuristicevaluation, and heuristic training) significantly affect the outcomesof heuristic evaluation. This study showed that domain expertisedoes not have a large impact on the outcomes. Nielsen [4] likewiseshowed that the performance of novice heuristic evaluators, hav-ing general computer knowledge but no special usability expertise,was fairly poor compared to the performance of evaluators withusability expertise. Novice evaluators must first become knowl-edgeable of and proficient in applying heuristics [5]. Therefore,the validity of the heuristic evaluation results of Karahoca et al.using ‘‘usability novices” of which half was computer illiteratecan be disputed.2. Recruitment of evaluators for cognitive walkthroughCW is a usability inspection method that evaluates the easewith which a typical new user can successfully learn to performa task using a given interface design. As also stressed by Hom, inCW either usability specialists or software developers shouldexamine the behavior of the interface [6]. In the study performedby the authors CW was again carried out by end users and notby usability experts. In usability inspection methods such as CW,experts evaluate a user interface without involving users. This isin contrast to usability testing where evaluators let users workwith the system while recording the user sessions for later analysisof usability problems.The approach that the authors followed to assess the learnabil-ity of the prototypes by real users is not in agreement with the CWmethod. In CW, inspectors should know the interface before apply-ing the method and then speculate about the ease with which anovice user can learn how to use the system taking user back-ground knowledge such as computer literacy into account.3. Usability problemsThis usability evaluation study lacks the detection of usabilityproblems,whichisthemaingoalofeveryusabilityevaluationstudy[4,7].Thislackcanaffecttheresultsofthestudyinseveralways.(A)Comparing the effectiveness of the prototypes based on scenariocompletion rates and completion time, without a careful reviewand analysis of the main usability problems that potentially canaffectuserinteractionandtaskoutcomes,doesnotseemvalid.Users,for example, could have completed a scenario in a shorter time byskipping some none mandatory steps hindering them during the