A comparative study of interagency communications and information exchange in disaster response among selected countries.

BACKGROUND: Effective communications and secure information exchange platforms during disasters and emergencies are among the significant factors in inclusive disaster management and can radically contribute to better preparedness, efficient and timely responsiveness, and, finally, maximal reduction of damages and fatalities. The present study was to compare communications and information exchange among disaster response organizations in selected countries. MATERIALS AND METHOD: This applied research, carried out in 2022, was a qualitative descriptive-comparative study pursuing a content analysis approach. Australia, Turkey, India, America, Japan, and Iran constituted the statistical population of the study. The sampling was based on the countries' disaster histories and response experiences. The note-taking tool was used to extract and collect data during the review of texts, documents, and articles, and the qualitative content analysis method was employed for data analysis. RESULTS: The outcomes of the descriptive-comparative analysis fell into four main comparative axes of the selected countries, including comparing reference, authority, and coordinator organizations in the response phase, comparing planning records and histories in disaster and emergency management comparing the contribution or non-contribution of government, military institutions, and non-governmental organizations to disaster and emergency management, the commonalities of the selected countries' disaster and emergency management and dependence on government. CONCLUSION: The results revealed that all selected countries depended on the government in managing disasters and emergencies, and the four communication platforms, i.e., landline telephone, mobile phone, radio communications systems, and couriers, were the common communication and information acquisition sources.

Extracting the Factors Affecting the Survival Rate of Trauma Patients Using Data Mining Techniques on a National Trauma Registry.

Introduction: Thousands of people die due to trauma all over the world every day, which leaves adverse effects on families and the society. The main objective of this study was to identify the factors affecting the mortality of trauma patients using data mining techniques. Methods: The present study includes six parts: data gathering, data preparation, target attributes specification, data balancing, evaluation criteria, and applied techniques. The techniques used in this research are all from the decision tree family. The output of these techniques are patterns extracted from the trauma patients dataset (National Trauma Registry of Iran). The dataset includes information on 25,986 trauma patients from all over the country. The techniques that were used include random forest, CHAID, and ID3. Results: Random forest performs better than the other two techniques in terms of accuracy. The ID3 technique performs better than the other two techniques in terms of the dead class. The random forest technique has performed better than other techniques in the living class. The rules with the most support, state that if the Injury Severity Score (ISS) is minor and vital signs are normal, 98% of people will survive. The second rule, in terms of support, states that if ISS is minor and vital signs are abnormal, 93% will survive. Also, by increasing the threshold of the patient's arrival time from 10 to 15 minutes, no noticeable difference was observed in the death rate of patients. Conclusion: Transfer time of less than ten minutes in patietns whose ISS is minor, can increase the chance of survival. Impaired vital signs can decrease the chance of survival in traffic accidents. Also, if the ISS is minor in non-penetrating trauma, regardless of vital signs and if the victim is transported in less than ten minutes, the patient will survive with 99% certainty.

Disaster planning approaches in Iran's health system: A mixed-methods study.

BACKGROUND: Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches. MATERIALS AND METHODS: This study was conducted using mixed methods in 2020-2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan. RESULTS: By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base. CONCLUSION: This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning.

Information challenges of COVID-19: A qualitative research.

BACKGROUND: At the beginning of the COVID-19 pandemic, the Iranian Ministry of Health and Medical Education set up a 24-h call center, i.e., Center 4030, to mitigate people's worries and anxieties, create composure, increase people's trust, and answer their questions. This qualitative study aimed to identify the challenges of COVID-19-related-information among people in point of experts' views. MATERIALS AND METHODS: This qualitative study was conducted to collect the opinions of experts on the identification of the Information challenges of COVID-19 during March-June 2020. The research population included all health professionals and experts. The sampling method was initially purposive and continued to saturate the data as snowball technique. In this study, 19 participants were interviewed. The data were collected using a semi-structured interview. After collecting the data, the audio files of the interviews were written down to extract their external and internal elements. MAXQDA version 12 software was used to organize qualitative analysis and coding data. RESULTS: The results of this study involved eight themes, i.e., lack of planning, lack of social trust in government, lack of COVID-19-integrated scientific authority in the country, conflicts of interest, lack of integrated information sources, distracting public attention, infodemic, and poor information quality, classified into 16 categories. CONCLUSIONS: The main information challenges that people in Iran faced included the lack of a scientific reference source to access accurate information, the existence of a large volume of information in virtual networks, and a huge volume of statistics from various information channels that caused confusion among people.

The role of virtual social networks in shaping people's attitudes toward COVID-19 in Iran.

BACKGROUND: The widespread occurrence of COVID-19 has caused people to seek information from various sources such as virtual social networks, which can positively or negatively affect one's mental status. In this article, we present the role of virtual social networks in shaping people's attitudes toward COVID-19 in Iran. MATERIALS AND METHODS: This is an applied descriptive study, in which 1010 users of virtual social networks were surveyed through an electronic questionnaire. Data were analyzed with SPSS, Excel, and Rapid Miner software. The FP-growth technique was used to investigate the concurrence of choices in multiple-choice questions, and the Mann-Whitney and the Kruskal-Wallis tests were used to determine the correlation of the mean of each dimension with demographic data. Moreover, the Wilcoxon signed-rank, the Shapiro-Wilk, and the Kolmogorov-Smirnov tests were used. RESULTS: Virtual social networks use increased significantly (40%) after the COVID-19 outbreak. According to users, the greatest psychological impact of virtual social networks was the induction of anxiety (46.43%) and the most common use was to learn about COVID-19 prevention and treatment (69.3%). Based on the findings, there were no significant differences between the "awareness," "behavior intention," and "attitude and trust" and the users' marital status, age group, educational degree, and gender. CONCLUSION: Although social networks have enriched the public knowledge, they increased the individuals' anxiety mostly because of controversial news and disperse of misinformation which in turn misled the users. The social networks play an important role in directing the behavioral inclinations. Accordingly, it is recommended that the authorities in healthcare system establish authentic and formal webpage in these social networks to manage controversial and voluminous information.

Assessing the educational services quality of health information technology students.

INTRODUCTION: Responsibility in the higher educational system requires the universities to be sensitive on students' needs and expectations. The purpose of the present study was to examine the educational service quality among health information technology (HIT) students in Isfahan University of Medical Science based on the SERVQUAL model. METHODS: This was a descriptive cross-sectional study and carried out at the Management and Medical Information Sciences faculty of IUMS in 2018. Sixty-eight undergraduate and postgraduate students of HIT participated in this study. For collecting data, the standard SERVQUAL questionnaire was used. The collected data were analyzed using SPSS version 20 software in descriptive level. RESULTS: Findings showed that there was a positive gap in overall dimensions of educational services quality (mean discrepancy of expectations and perceives). Most mean of service gap was contributed to responsiveness dimension 1.06 (0.98 standard deviation [SD]), following that empathy 1.04 (0.97 SD), assurance 1.00 (0.83 SD), reliability 0.83 (0.76 SD), and the least gap was seen intangibles 0.61 (1.02 SD). CONCLUSION: According to the current gaps in all quality dimensions, as well as high amount of expectations in comparison with students' perception, it is required to evaluate higher education quality through implementing students' knowledge skill and creative abilities. Therefore, to improve the quality of educational services at the Faculty of Management and Medical Information, all dimensions, especially the responsiveness dimension, should be considered.

Designing a model of patient tracking system for natural disaster in Iran.

CONTEXT: Disaster patient tracking consists of identifying and registering patients, recording data on their medical conditions, settings priorities for evacuation of scene, locating the patients from scene to health care centers and then till completion of treatment and discharge. AIM: The aim of this study was to design a model of patient tracking system for natural disaster in Iran. MATERIALS AND METHODS: This applied study was conducted in two steps in 2016. First, data on disaster patient tracking systems used in selected countries were collected from library-printed and electronic references and then compared. Next, a preliminary model of disaster patient tracking system was provided using these systems and validated by Delphi technique and focus group. The data of the first step were analyzed by content analysis and those of the second step by descriptive statistics. RESULTS: Analysis of the comments of key information persons in three Delphi rounds, consisting of national experts, yielded three themes, i.e., content, function, and technology, ten subthemes, and 127 components, with consensus rate of over 75%, to provide a disaster patient tracking system for Iran. CONCLUSION: In Iran, there is no comprehensive process to manage the data on disaster patients. Offering a patient tracking system can be considered a humanitarian and effective measure to promote the process of identifying, caring for, evacuating, and transferring patients as well as documenting and following up their medical and location conditions from scene till completion of the treatment.

Patient tracking in earthquake emergency response in Iran: A qualitative study.

BACKGROUND: After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS: A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA (version 10) for coding and content analysis. RESULTS: Three main themes and seven categories including content (recoding data), function (identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology (the state of using technology) were identified that showed the patient tracking status in past earthquakes in Iran. CONCLUSION: Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.

Overcrowding in emergency departments: A review of strategies to decrease future challenges.

Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track. Patients might be directed to different streaming channels depending on clinical status and required practitioners. The most comprehensive strategy is ideal ED patient journey models, in which ten interrelated substrategies are provided. ED leaders should apply strategies that provide a continuous care process without deeply depending on external services.

Patient tracking in earthquake emergency response in Iran: A qualitative study / 世界急诊医学杂志（英文）

@#BACKGROUND:After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS:A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA (version 10) for coding and content analysis. RESULTS:Three main themes and seven categories including content (recoding data), function (identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology (the state of using technology) were identified that showed the patient tracking status in past earthquakes in Iran. CONCLUSION:Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.

The study of inpatient medical records on hospital deductions: An interventional study.

BACKGROUND: The rate of hospital deductions is a commonly cited concern among teaching hospitals in Iran. The objective of the present study is to access the effect of the quantitative and qualitative analysis of inpatient medical records on deductions and identifying the major resources of deductions. There are currently no published interventional studies that have investigated this issue quantitatively. MATERIALS AND METHODS: In an interventional study, we reviewed all the 192 patient's medical records (PMRs) for any documentation errors, to determine the rate of deductions. We conducted a pilot of 30 cases prior to the actual survey. Nonprobability-based consecutive sampling was used. The main study was conducted in three phases: 1. Primary evaluation; 2. Training, performance of intervention and corrective actions; and 3. Final assessment. Comprehensive assessments of medical records and follow-upof error correction were carried out systematically and according to the pre-set schedule. Pre- and post-intervention assessments were compared in order to evaluate the effect of the intervention. Data were analyzed using the SPSS-20 statistical software. Paired-sample t-test was used to compare changes in deduction scores before and after the intervention. Differences at a P value less than 0.05 were considered statistically significant. RESULTS: In the initial survey of 800 PMRs, nearly one quarter (24%) (Or 192 cases) had at least one type of deduction. The three top types of deductions were Laboratory (47.9%), Medical radiation (45.3%), and Physician visit (35.9%). The results showed a 2.7- to about 36-fold lower rate of hospital deductions (average: 6.4-fold; reduction from21131 to 3285 US dollars). CONCLUSION: All in all, the results of the present study indicated that educational interventions and quantitative and qualitative analysis of inpatient medical records are very beneficial and effective in the reduction of medical record deductions.

Recognition of medical errors' reporting system dimensions in educational hospitals.

INTRODUCTION AND OBJECTIVE: Nowadays medical errors are one of the serious issues in the health-care system and carry to account of the patient's safety threat. The most important step for achieving safety promotion is identifying errors and their causes in order to recognize, correct and omit them. Concerning about repeating medical errors and harms, which were received via theses errors concluded to designing and establishing medical error reporting systems for hospitals and centers that are presenting therapeutic services. The aim of this study is the recognition of medical errors' reporting system dimensions in educational hospitals. MATERIALS AND METHODS: This research is a descriptive-analytical and qualities' study, which has been carried out in Shahid Beheshti educational therapeutic center in Isfahan during 2012. In this study, relevant information was collected through 15 face to face interviews. That each of interviews take place in about 1hr and creation of five focused discussion groups through 45 min for each section, they were composed of Metron, educational supervisor, health officer, health education, and all of the head nurses. Concluded data interviews and discussion sessions were coded, then achieved results were extracted in the presence of clear-sighted persons and after their feedback perception, they were categorized. In order to make sure of information correctness, tables were presented to the research's interviewers and final the corrections were confirmed based on their view. FINDING: The extracted information from interviews and discussion groups have been divided into nine main categories after content analyzing and subject coding and their subsets have been completely expressed. Achieved dimensions are composed of nine domains of medical error concept, error cases according to nurses' prospection, medical error reporting barriers, employees' motivational factors for error reporting, purposes of medical error reporting system, error reporting's challenges and opportunities, a desired system characteristics, and the quality of error experiences' transmission in the health-care system. CONCLUSION: Although, appropriate achievements have been assured in Shahid Beheshti Hospital, but it seems necessary that in order to immune promotion not only in this hospital, but in the other organizations, necessary infrastructures have been provided for an error reporting system performance. An appropriate medical error reporting system could be educated and prevent the occurrence of repeated errors.

Evaluation of organizational maturity based on people capacity maturity model in medical record wards of Iranian hospitals.

CONTEXT: People capacity maturity model (PCMM) is one of the models which focus on improving organizational human capabilities. AIMS: The aim of this model's application is to increase people ability to attract, develop, motivate, organize and retain the talents needed to organizational continuous improvement. SETTINGS AND DESIGN: In this study, we used the PCMM for investigation of organizational maturity level in medical record departments of governmental hospitals and determination strengths and weaknesses of their staff capabilities. MATERIALS AND METHODS: This is an applied research and cross sectional study in which data were collected by questionnaires to investigation of PCMM model needs in medical record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has been extracted from PCMM model and approved its reliability with Cronbach's Alpha 0.96. STATISTICAL ANALYSIS USED: Data collected by the questionnaire was analyzed based on the research objectives using SPSS software and in accordance with research questions descriptive statistics were used. RESULTS: Our findings showed that the mean score of medical record practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum 56 (100%). There is no significant relevance between organizational maturity and medical record practitioners, attributes. CONCLUSIONS: Applying PCMM model is caused increasing staff and manager attention in identifying the weaknesses in the current activities and practices, so it will result in improvement and developing processes.

Medical records department and balanced scorecard approach.

CONTEXT: The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. AIMS: The main goal of this study was to assess the MRD performance with BSC approach in a hospital. MATERIALS AND METHODS: This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. STATISTICAL ANALYSIS USED: To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. RESULTS: The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. CONCLUSIONS: The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

Investigation of retention and destruction process of medical records in the hospitals and codifying appropriate guidelines.

INTRODUCTION: One of the major issues in hospitals is the period for which the medical records are retained. Health information management professionals traditionally have performed retention and destruction functions using all media, including paper, images, optical disk, microfilm, DVD, and CD-ROM. Health information management departments must maintain a specific program to retain and destruct the records. The purpose of this paper is to investigate the retention and destruction process of medical records in the hospitals in Isfahan and codifying the appropriate guidelines. MATERIALS AND METHODS: The research was conducted as a cross-sectional descriptive study in 30 hospitals in Isfahan. The data was collected using a Check List. Also 30 medical records experts' viewpoints were obtained using the Delphi technique. Data entry and statistical analysis was performed using SPSS. RESULTS: The findings indicated that 53.8% of the study population maintained a written policy. A 34.6% maintained a written policy to destruct medical records. And 50% announced that no instructions had been given to the hospitals by qualified authorities to destruct the medical records. DISCUSSION: The majority of the hospitals are still unclear about the retention period of medical records, which could be due to not to mention the retention period for most medical records by the country's National Literature and lack of policy and procedure in hospitals. CONCLUSIONS: According to the legislations, hospitals are bound to retain the inpatients' records for full 15 years but based on the findings of this research, less than half of the study population retained the inpatients' records for the period mentioned.

External Evaluation of Four Hospitals According to Patient-centred Care Standards.

INTRODUCTION: Hospital accreditation is a multi-factorial issue. The aim of the current study was to accredit social security organization and university hospitals (that certificated by ISO 9001-2008) in Isfahan, the second largest city of Iran, based on Joint Commission International (JCI) accreditation standards. METHODS: Accreditation of four hospitals was evaluated and compared in a cross-sectional study. Seven checklists were driven from patient-centered JCI accreditation standards to cover indices of access of patients to care and continuity of care (ACC), patients and families rights (PFR), patients and families education (PFE), assessment of patients (AOP), care of patients (COP), analgesic and surgical care (ASC), and medication management and use (MMU). They were filled out by seven inspectors. The findings were analyzed by SPSS 14 (SPSS Inc., Chicago, IL). RESULTS: Beheshti and Zahra hospitals demonstrated the lowest and the highest mean levels preparation, respectively (60 vs. 68.5 percent, respectively). Also, Beheshti hospital revealed the lowest prepared levels in AOP, ASC, MMU and PFE among all evaluated hospitals; the corresponding mean amounts of preparation were 68, 82.5, 56 and 42 percent, respectively. Whereas Zahra hospital showed the highest prepared levels in AOP, COP, MMU and PFE among all evaluated hospitals; the mean amounts of preparation were 82, 61.5, 84 and 57 percent, respectively. No significant difference was found among the four hospitals in any of the seven indices. DISCUSSION: The four evaluated hospitals were not fully prepared to present the best possible patient-centered care system.

Patient access to electronic health record: a comparative study on laws, policies and procedures in selected countries.

INTRODUCTION: The e-health system must have the capability of patient access to electronic health record. The advantage of access to their record lets them have better understanding of their condition and treatment. It can also raise the reliability of consistency and correctness of data in health care system. Finally it will improve the maintenance quality of medical records and guarantee better results of medication. This study aimed to carry out a comparative study concerning laws, policies and procedures upon patients' access right to EHR in selected countries and to suggest appropriate solutions for Iran. METHOD: This was a comparative descriptive study. The study population was the laws, policies and procedures of patients' access right to EHR belong to countries like Canada, Australia, New Zealand and Iran. Data were collected by taking notes on index cards. In this study in order to collect data, at first, the researcher studied the websites related to Health Ministry of the countries and existing laws and policies through related links in the websites. In next step, the health information management association websites were studied and the related data were collected. The gathered data were analyzed through content analysis. RESULTS: The findings of research showed that in every four countries there are generally some laws, policies and procedures. Although Canada and New Zealand concerning the number of laws and policies related to the subject subsequently are ranked after Australia, they are ranked prior to Australia regarding benefiting the laws and specified policies. CONCLUSION: Given the necessity of EHR implementing and codifying the planning of SEPAS in Iran, as there is no specified laws or procedures regarding patients' access right to EHR, the obligation of paying attention to assigning a law or at least obvious policies and procedures and providing the details is absolutely apparent.

Electronic medical record in central polyclinic of isfahan oil industry: a case study based on technology acceptance model.

INTRODUCTION: Today, health information technologies are base of health services and Electronic Medical Record is one of them. The purpose of this paper is to investigate the Technology Acceptance Model (TAM) on EMR at Central Polyclinic Oil Industry that is a pioneer in implementation of EMR in Isfahan. METHODS: This study was an applied and analytical survey that it was done at the Central Polyclinic Oil Industry. Because statistical population were limited, sampling bas been done by conducting the census and the sample was according to the population. The data was collected by a researcher-made questionnaire that it was validated by experts and its reliability was confirmed by test retest. The questionnaire was developed in 5 scopes including external factors (data quality and user interface), perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use. The Results analyzed by SPSS. RESULTS: There was a significant relationship between data quality with PU(r=/295, p/005). DISCUSSION: The survey of the scopes in the polyclinic showed that there is relationship among user interface, perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use, but data quality has no relationship with attitude. It seems the system designers didn't consider to data quality characteristics. It is proposed that they consult with health information management professionals for improvement the existing system.

E-health implementation challenges in Iranian medical centers: a qualitative study in Iran.

BACKGROUND: E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery. MATERIALS AND METHODS: Two phases of research have been carried out for this study. In the first phase, a general Internet search was performed in different databases to extract e-health implementation activities in the world, particularly in Iran. MEDLINE and laboratory research were used for this purpose, using the key words "information technology," "e-health," "health IT," "health informatics," "health," and "Iran." In the second phase, a panel of experts from Isfahan, Iran, who specialized in e-health applications, was selected for a qualitative survey. RESULTS: Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, and enables transfer of healthcare resources to rural areas, among other benefits. However, there are numerous issues affecting the successful implementation of e-health such as lack of standardized e-health applications, deployment costs, training costs, legal challenges, privacy and security fears, implementation and acceptance time of such applications, technical difficulties, educational issues, resistance to change, and pilot projects or small implementations with limited numbers of patients in healthcare organizations. CONCLUSIONS: The implementation of e-health in Iran, particularly Isfahan, is subject to similar challenges as in other countries throughout the world. Hence, e-health implementers need to adhere to the proposed solutions in order to overcome the mentioned challenges in such complex projects.

Users' acceptance and attitude in regarding electronic medical record at central polyclinic of oil industry in Isfahan, Iran.

INTRODUCTION: Simultaneous with the rapid changes in the technology and information systems, hospitals interest in using them. One of the most common systems in hospitals is electronic medical record (EMR) whose one of uses is providing better health care quality via health information technology. Prior to its use, attempts should be put to identifying factors affecting the acceptance, attitude and utilizing of this technology. The current article aimed to study the effective factors of EMR acceptance by technology acceptance model (TAM) at central polyclinic of Oil Industry in Isfahan. MATERIALS AND METHODS: This was a practical, descriptive and regression study. The population research were all EMR users at polyclinic of Oil Industry in 2012 and its sampling was simple random with 62 users. The tool of data collection was a research-made questionnaire based on TAM. The validity of questionnaire has been assigned through the strategy of content validity and health information technology experts' views and its reliability by test-retest. FINDINGS: The system users have positive attitude toward using EMR (56.6%). Also, users are not very satisfied with effective external (38.14%) and behavioral factors (47.8%) upon using the system. Perceived ease-of-use (PEU) and perceived usefulness (PU) were at a good level. CONCLUSION: Lack of relative satisfaction with using of EMR derives from factors such as appearance, screen, data and information quality and terminology. In this study, it is suggested to improve the system and the efficiency of the users through software' external factors development. So that PEU and users' attitude to be changed and moved in positive manner.