Development and Usability Evaluation of a Telemedicine System for Management and Monitoring of Patients with Diabetic Foot / 대한의료정보학회지

Objectives@#The aim of the present study was to develop and evaluate the usability of a telemedicine system for management and monitoring of patients with diabetic foot. @*Methods@#This study was conducted in four phases. In the first phase, the information needs and characteristics required to design the telemedicine system were identified based on a literature review. Then, in a two-stage Delphi survey, 15 experts approved the identified information needs and characteristics. The prototype telemedicine system was then designed. In the third phase, system usability was evaluated through a semi-structured interview. In the fourth phase, users’ satisfaction with the designed system was analyzed. @*Results@#Out of 115 information needs and required characteristics, 95 were considered in the system design. Eight main pages for enabling patient-physician interactions and physician-physician interactions, monitoring the patient and controlling the disease process, providing medical consultation, and prescribing medications were considered. In the third phase, 26 distinct problems were identified. However, 75% of the participants were very satisfied with the system. @*Conclusions@#This study presents an attempt to design and evaluate a telemedicine system for the management and monitoring of patients with diabetic foot. In this system, patients receiving medical services or physicians who encounter rare cases can send the complete medical history, clinical test results, and videos and images related to the foot to specialist physicians. After examining the medical history or images and videos, the physician can provide the necessary medication prescriptions and laboratory tests or other recommendations.

Documenting nursing reports using speech recognition technology: benefits, barriers, challenges and facilitators

Introduction: Documenting nursing reports and recording data are among the first and most important tasks of nurses. Speech recognition technology has been introduced as one of the most effective technologies in nursing documentation, which supports the nursing and patient interaction as well as the training of nurses through saving nurses' time. This study aimed to identify the benefits, barriers and facilitators of using this technology in documenting nursing reports

Methods: In this review study, various studies on the use of speech recognition technology in the field of nursing documentation published from 1990 to 2017 were reviewed at Pubmed, Science Direct, Google Scholar, Magiran, SID databases and, finally, ten papers were included in the review. The inclusion criteria were studies published in Persian or English language and the implementation of the speech recognition system in the field of nursing documentation and reporting

Results: Improvement of workflow, with the highest frequency, was the most important benefit. Reduction of the accuracy of speech recognition software was the first mentioned barrier of using this technology followed by the impact of environmental noises. Sufficient training and use of appropriate tools were found as the most important facilitators of using this technology

Conclusion: This study helps hospital managers, nursing managers and IT managers of hospitals to better manage selection and implementation of speech recognition system for documenting nursing reports. As a result, reducing productivity due to inaccuracy in voice recognition, lack of improvement in the quality of documentation of nursing reports, increasing the workload of nurses and their involvement in indirect care activities can be prevented

Factors related to the acceptance of radio frequency identification technology in health information management departments of hospitals affiliated to Iran University of medical ýsciences

Introduction: Radio Frequency Identification [RFID] technology has been implemented in a wide variety of industries including healthcare field. Due to the introducing RFID technology in the healthcare industry, it is necessary to determine the factors influencing acceptance of this technology. Therefore, in the present study, the factors associated with the acceptance of RFID technology in Health Information Management hospitals affiliated to Iran University of Medical Sciences were studied

Methods: The current applied research was descriptive-analytic. A questionnaire was distributed among all health information management staff of the hospitals affiliated to Iran University of Medical Sciences [n=138] and finally, 135 questionnaires were completed. The results of the study were analyzed through SPSS16 and using descriptive statistics, inferential statistics, and regression

Results: The mean scores of factors were as follow: social effects [4.24 out of 5], management support [4.34 out of 5], expected performance [4.20 out of 5], expected effort [4.09 out of 5], facilitating conditions [3.47 out of 5], security [3.83 out of 5] and intention [4.3 out of 5]. The coefficients of influence of social effects [0.125], management support [0.210], expected performance [0.244], expected effort [0.148] and facilitating conditions [0.135] showed positive significant relationships with intention to use RFID. However, security was not an influential factor on use of RFID

Conclusion: Based on the findings, providing general education, facilitating the use of this technology by vendors and developing adequate infrastructure may increase the willingness to accept RFID

[Knowledge of physicians, nurses and medical record personnel about legal aspects of medical records in teaching hospitals affiliated to Kashan university of medical sciences]

Obeying patient rights is dependent upon the knowledge of healthcare providers about ethical and legal aspects of healthcare. This study aimed to determine the knowledge of physicians, nurses and medical record personnel about legal aspects of medical records in teaching hospitals affiliated to Kashan University of Medical Sciences. In this cross-sectional study, 325 healthcare personnel including physicians, nurses and medical record personnel were surveyed by a valid questionnaire designed based on Iranian laws and referenced materials. The questions were related to legal aspects of informed consent, confidentiality, and issuing certificates. We analyzed the data through the mean score [ +/- SD] of correct responses. The knowledge level of participants was moderate about legal aspect of informed consent [3.78 +/- 1.36 from 8 points], confidentiality [1.45 +/- 0.97 from 4 points] and issuing certificates [3.27 +/- 1.79 from 9 points]. Totally, the knowledge level was moderate [8.51 +/- 2.83 from 21 points]. Physicians had more knowledge and nurses less. Educating legal aspects related to medical records including confidentiality, informed consent, and issuing certificates for all of healthcare providers especially for nurses seems necessary

[Informed consent process: inpatients competency and admission clerks' performance in teaching hospitals in Kashan, Iran]

Patients' decision-making and legal capacity are major factors of informed consent considered as a basis of medical ethics. This study aimed to determine the undergoing surgery inpatients capacity to sign the consent form and admission clerks' performance in taking the form in teaching hospitals in Kashan. In this cross sectional study, 300 random inpatients and admission clerks in 3 hospitals were observed through a checklist to determine the patients' legal capacity to sign the consent form and admission clerks' performance. We analyzed the data through SPSS software with lambda[2] test. Only 55% patients singed themselves the consent form, however, 80% patients could sign it legally. In addition, 3.6% patients who signed the consent were not allowed to sign it. In addition, 59.3% surrogates were not allowed to sign the consent form. Admission clerks did not encourage 98.7% patients [surrogates] to read the consent form; also staffs did not give any opportunity to 75.3% patients [surrogates] for reading the form. Admission staffs did not control the legal relationship of surrogates who signed the consent form. Explaining the consent form to patients [surrogates] and more attention to legal capacity of consenter, also, documenting the policy to taking the consent form seems to be necessary

[Information managers: the powerful strategists of health care organizations in future]

Nowadays, importance of health information and managing health information resources is growing. Managing information resources requires a variety of knowledge and skills. So, information managers find themselves as a valuable person in health care organizations. This article aimed to overview the importance, roles, duties, and organizational position of information managers in health care organizations. Information managers would be as future powerful strategists in health care organizations; to this end, they must furnish themselves to a variety of knowledge and skills such as information management, information technology, and related technical issues, management capabilities and understanding clinical processes

Patient safety; necessity for attention to information technology

Patient safety is one of the most important aspects of health care, but the medical errors and specifically medication errors make health care environment dangerous. Untimely access to the information at the time of decision- making and weak communication among the health care providers are the main causes of medication errors. According to expert's opinions, using the information technology is suitable approach to having access to timely information and to improving the relationships among specialists, and therefore; to decrease the medication errors. A variety of IT products such as computerized physician order entry [CPOE], decision support systems [DSS], computerized medication administration record, point of care barcode-based medication administration systems [BCMA] were designed to support health care providers in medication administration processes. This study shows that these IT products have the potentials to affect health care provider's behavior in drugs administration and to reduce medication errors