Within this paper we describe the background context and discussions that lead to the selection of the theme for the NI2006 Post Congress Conference. The rationale for the choice of the overall theme is introduced, together with the selection of the five main sub-themes, on which the group discussions were based, and that lead to the production of the group papers that form the core of these Proceedings.

Studies in Health Technology and Informatics

Objectives

The intent of this paper is in the examination of health IT implementation processes – the barriers to and facilitators of successful implementation, identification of a beginning set of implementation best practices, the identification of gaps in the health IT implementation body of knowledge, and recommendations for future study and application.

Methods

A literature review resulted in the identification of six health IT related implementation best practices which were subsequently debated and clarified by participants attending the NI2012 Research Post Conference held in Montreal in the summer of 2012. Using the framework for implementation research (CFIR) to guide their application, the six best practices were applied to two distinct health IT implementation studies to assess their applicability.

Results

Assessing the implementation processes from two markedly diverse settings illustrated both the challenges and potentials of using standardized implementation processes. In support of what was discovered in the review of the literature, “one size fits all” in health IT implementation is a fallacy, particularly when global diversity is added into the mix. At the same time, several frameworks show promise for use as “scaffolding” to begin to assess best practices, their distinct dimensions, and their applicability for use.

Conclusions

Health IT innovations, regardless of the implementation setting, requires a close assessment of many dimensions. While there is no “one size fits all”, there are commonalities and best practices that can be blended, adapted, and utilized to improve the process of implementation. This paper examines health IT implementation processes and identifies a beginning set of implementation best practices, which could begin to address gaps in the health IT implementation body of knowledge.

Complexity and the science of implementation in health IT — knowledge gaps and future visions

This study was conducted to evaluate the usability of widely used laboratory and radiology information systems. Three usability experts independently evaluated the user interfaces of Laboratory and Radiology Information Systems using heuristic evaluation method. They applied Nielsen's heuristics to identify and classify usability problems and Nielsen's severity rating to judge their severity. Overall, 116 unique heuristic violations were identified as usability problems. In terms of severity, 67 % of problems were rated as major and catastrophic. Among 10 heuristics, "consistency and standards" was violated most frequently. Moreover, mean severity of problems concerning "error prevention" and "help and documentation" heuristics was higher than of the others. Despite widespread use of specific healthcare information systems, they suffer from usability problems. Improving the usability of systems by following existing design standards and principles from the early phased of system development life cycle is recommended. Especially, it is recommended that the designers design systems that inhibit the initiation of erroneous actions and provide sufficient guidance to users.

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Usability Evaluation of Laboratory and Radiology Information Systems Integrated into a Hospital Information System

Questionnaires are commonly used tools in telemedicine services that can help to evaluate different aspects Selecting the ideal questionnaire for this purpose may be challenging for researchers This study aims to review which questionnaires are used to evaluate telemedicine services in the studies, which are most common, and what aspects of telemedicine evaluation do they capture The PubMed database was searched in August 2020 to retrieve articles Data extracted from the final list of articles included author/year of publication, journal of publication, type of evaluation, and evaluation questionnaire Data were analyzed using descriptive statistics Fifty-three articles were included in this study The questionnaire was used for evaluating the satisfaction (49%), usability (34%), acceptance (115%), and implementation (2%) of telemedicine services Among telemedicine specific questionnaires, Telehealth Usability Questionnaire (TUQ) (19%), Telemedicine Satisfaction Questionnaire (TSQ) (13%), and Service User Technology Acceptability Questionnaire (SUTAQ) (55%), were respectively most frequently used in the collected articles Other most used questionnaires generally used for evaluating the users’ satisfaction, usability, and acceptance of technology were Client Satisfaction Questionnaire (CSQ) (55%), Questionnaire for User Interaction Satisfaction (QUIS) (55%), System Usability Scale (SUS) (55%), Patient Satisfaction Questionnaire (PSQ) (55%), and Technology Acceptance Model (TAM) (35%) respectively Employing specifically designed questionnaires or designing a new questionnaire with fewer questions and more comprehensiveness in terms of the issues studied provides a better evaluation Attention to user needs, end-user acceptance, and implementation processes, along with users' satisfaction and usability evaluation, may optimize telemedicine efforts in the future

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The most used questionnaires for evaluating telemedicine services.

This paper analyzes the workflow and implementation of electronic health record (EHR) systems across different functions in small physician offices. We characterize the differences in the offices based on the levels of computerization in terms of workflow, sources of time delay, and barriers to using EHR systems to support the entire workflow. The study was based on a combination of questionnaires, interviews, in situ observations, and data collection efforts. This study was not intended to be a full-scale time-and-motion study with precise measurements but was intended to provide an overview of the potential sources of delays while performing office tasks. The study follows an interpretive model of case studies rather than a large-sample statistical survey of practices. To identify time-consuming tasks, workflow maps were created based on the aggregated data from the offices. The results from the study show that specialty physicians are more favorable toward adopting EHR systems than primary care physicians are. The barriers to adoption of EHR systems by primary care physicians can be attributed to the complex workflows that exist in primary care physician offices, leading to nonstandardized workflow structures and practices. Also, primary care physicians would benefit more from EHR systems if the systems could interact with external entities.

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Workflow and Electronic Health Records in Small Medical Practices | NIST

Electronic Health Record (EHR) is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats) analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS). The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians' and other clinical staff's resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

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Electronic Health Record Implementation: A SWOT Analysis

Evaluation of Iran's HIS (hospital Information System) ergonomic quality using IsoMetric 9241 part 10 and compared results of that evaluation with results of ergonomic quality evaluation other softwares which evaluated by IsoMetric 9241 part 10. This research study was conducted in two stages. In the first stage, the researchers evaluated the HIS of 13 hospitals in Iran using ISO 9241 part 10, and in the second stage, they compared the evaluation results with the following softwares: a) IS-H*med (evaluated by Hamborg et al. 2004) b) SAP-HR (evaluated by Gruber 2000) c) Microsoft Word for Windows, Version 2 (evaluated by Gediga et al. 1999). For first stage used usability questionnaire called IsoMetrics which is based on the international standard ISO 9241 Part 10. This questionnaire is including 75 items based on the seven principles. Data analyzed using SPSS and Excel. The comparison between HIS and IS-H*med reveal that the former is significantly more usable than the latter in terms of all IsoMetrics sales. The HIS also proved to be significantly more applicable than SAP-HR in terms of such IsoMetrics scales as "suitability for task," "suitability for learning", "Error tolerance" and "learning ability". However, HIS was found to be significantly less usable than Microsoft Word. The results of the study show that compared with the mentioned three softwares, Iran's hospital information system enjoys an average ergonomic quality. Therefore, it is recommended that the users' comments and expectations be considered more when information systems are designed and developed.

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Comparing Four Softwares Based on ISO 9241 Part 10

Background Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. Aim to determine the minimum data set of echocardiography reporting system to exchange with Iran's electronic health record (EHR) system. Methods First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients' records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. Results The highest degree of consensus was found for the following MDSs: patient's name and family name (5), accepting doctor's name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. Conclusions To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran's electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider.

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Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran's Electronic Health Record (EHR) System.

Background Liver ultrasound images are so common and are applied so often to diagnose diffuse liver diseases like fatty liver. However, the low quality of such images makes it difficult to analyze them and diagnose diseases. The purpose of this study, therefore, is to improve the contrast and quality of liver ultrasound images. Methods In this study, a number of image contrast enhancement algorithms which are based on fuzzy logic were applied to liver ultrasound images - in which the view of kidney is observable - using Matlab2013b to improve the image contrast and quality which has a fuzzy definition; just like image contrast improvement algorithms using a fuzzy intensification operator, contrast improvement algorithms applying fuzzy image histogram hyperbolization, and contrast improvement algorithms by fuzzy IF-THEN rules. Results With the measurement of Mean Squared Error and Peak Signal to Noise Ratio obtained from different images, fuzzy methods provided better results, and their implementation - compared with histogram equalization method - led both to the improvement of contrast and visual quality of images and to the improvement of liver segmentation algorithms results in images. Conclusion Comparison of the four algorithms revealed the power of fuzzy logic in improving image contrast compared with traditional image processing algorithms. Moreover, contrast improvement algorithm based on a fuzzy intensification operator was selected as the strongest algorithm considering the measured indicators. This method can also be used in future studies on other ultrasound images for quality improvement and other image processing and analysis applications.

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Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques.

Objectives: In this study, a knowledge audit was conducted based on organizational intelligence quotient (OIQ) principles of Iran’s Ministry of Health and Medical Education (MOHME) to determine levers that can enhance OIQ in healthcare. Methods: The mixed method study was conducted within the MOHME. The study population consisted of 15 senior managers and policymakers. A tool based on literature review and panel expert opinions was developed to perform a knowledge audit. Results: The significant results of this auditing revealed the following: lack of defined standard processes for organizing knowledge management (KM), lack of a knowledge map, absence of a trustee to implement KM, absence of specialists to produce a knowledge map, individuals’ unwillingness to share knowledge, implicitness of knowledge format, occasional nature of knowledge documentation for repeated use, lack of a mechanism to determine repetitive tasks, lack of a reward system for the formation of communities, groups and networks, non-updatedness of the available knowledge, and absence of commercial knowledge. Conclusions: The analysis of the audit findings revealed that three levers for enhancing OIQ, including structure and process, organizational culture, and information technology must be created or modified.

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Ahmadreza Farzaneh Nejad

Papers

Electronic Health Record Implementation: A SWOT Analysis

Comparing Four Softwares Based on ISO 9241 Part 10

Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran's Electronic Health Record (EHR) System.

Quality Improvement of Liver Ultrasound Images Using Fuzzy Techniques.

Auditing Knowledge toward Leveraging Organizational IQ in Healthcare Organizations.