Effects of Hospital Information System on the Performance of Management Units in Public Hospitals Analysis in Southwestern Iran

: The current study examines the effects of a hospital information system (HIS) on the performance of management units in Ahvaz public hospitals, Iran. The HIS supports hospital activities at practical, tactical, and strategic levels. In other words, this system establishes a connection between patient care and administrative information in all hospital activities. This descriptive-analytic research was an applied study with a correlational method. The hypotheses were tested by correlation model, structural equation modeling, one-sample t-test, one-way analysis of variance, and one-sample Kolmogorov-Smirnov test using the SPSS software version 20 and LISREL. The findings of this study indicated that an automated HIS can be a powerful tool helping managers with the process of hospital management and decision-making, leading to significantly improved hospital performance. Therefore, continuous training courses are beneficial in enhancing information quality and modern technology usage, which in turn improve the quality of services offered to patients and clients and make them less time-consuming. As a result, an effective step is taken in improving health services. The present study showed that the characteristics of HIS, including user-friendliness, speed, quality, being up-to-date, conformity with working conditions, and proficiency, have positive and significant impacts on the performance of management units.

Online patológiai vizsgálatkérő felület létrehozása a Semmelweis Egyetemen

Összefoglaló. Bevezetés: Az I. Patológiai és Kísérleti Rákkutató Intézet – a Semmelweis Egyetemen belüli diagnosztikai szolgáltatásnyújtás mellett – kiterjedt külső partneri hálózattal (vizsgálatmegrendelővel) bír. Az Intézet a napi működése során párhuzamosan használja az egyetem központi informatikai rendszerét, valamint belső, folyamattámogató alkalmazását (workflow management). A külsős partnerek hozzáférése vizsgálatfeladásra az egyetemi központi informatikai rendszerhez nincs biztosítva. A vizsgálatok rendelése papíralapú, a minta érkeztetésekor a klinikai adatok rögzítése manuális, kifejezetten humánerőforrás-igényes. Célkitűzés: Célunk volt a patológiai minták regisztrációjának egyszerűsítése és felgyorsítása, az adminisztratív folyamatok hatékonyságának javítása. Módszer: A kitűzött célt a minőségfejlesztésből ismert Plan-Do-Check-Act (Tervezés-Cselekvés-Ellenőrzés-Beavatkozás) ciklus módszereit alkalmazva kívántuk elérni, online, a mintavétel helyén elérhető, a meglévő belső folyamattámogató alkalmazáshoz kapcsolódó, szakterület-specifikus vizsgálatkérő felület kifejlesztésével. Eredmények: A vizsgálati minták regisztrációjának átlagos ideje 65%-kal csökkent az online vizsgálatkérő rendszerhez csatlakozott klinikai partnerek körében. Megbeszélés: Az elmúlt években tapasztalható volt, hogy kisebb, nem hatékonyan működtethető patológiai osztályok megszűntek, részben vagy egészben beolvadtak nagyobb diagnosztikai egységekbe. A humánerőforrás-problémák (elöregedő szakma a patológia) a fenti folyamatot minden bizonnyal tovább erősítik. Várható, hogy a nagyobb patológiai osztályokon a következő években a mintaszám tovább növekszik, a vizsgálatkérések egyre nagyobb hányada érkezik majd intézményen kívülről. Következtetés: A patológiai informatika fejlesztésekor figyelembe kell venni, hogy szükséges már a mintavétel helyén biztosítani az informatikai támogatást a minta nyomon követéséhez, nem elégséges csak a laboron belüli folyamatok kiszolgálása. Orv Hetil. 2021; 162(49): 1962–1967. Summary. Introduction: The 1st Department of Pathology and Experimental Cancer Research, Semmelweis University (Budapest, Hungary) has a broad network of clinical partners, many of which are non-university hospitals. A separate hospital information system and a local laboratory workflow management system is used at the Department. University clinics use the hospital information system for electronic requesting of tests. Non-university partners have no access to the systems, requesting tests is paper-based, registration of the requests at the pathology lab is manual and laborious. Objective: Our main objective was to improve the efficiency of the sample registration step of the pathology workflow. Method: Applying the Plan-Do-Check-Act procedure, a quality improvement project has been carried out and an online, subspecialty-based requesting application tool, interfaced with the current laboratory information system, was developed. Results: The average sample registration time improved with 65% among the early user partners. Discussion: The past years have shown smaller, inefficient pathology labs decreasing in number and integrated into larger regional diagnostic centers. Both issues of efficiency and quality assurance and problems rooted in human resources are drivers of further centralisation. The numbers of test requests and samples from non in-house partners are expected to be increased in the pathology labs in the future. Conclusion: Efficient and safe sample tracking has to start at the site of sample acquisition. State of the art laboratory information systems should support this expansion of competence. Orv Hetil. 2021; 162(49): 1962–1967.

Chios Hospital Information System Assessment

A very important aspect for organizations that provide healthcare services is to have fully functional and successful information systems. A successful hospital information system can contribute to high quality healthcare services provided to the patients of the hospital. In this paper, is presented the evaluation of the information system of Chios Hospital, “Skylitsio”. The survey was conducted using a questionnaire which consists demographic questions and questions that measure the factors of the DeLone & McLean success model. The participants of the survey were 71 users of the clinical information system. Cronbach’s alpha reliability test, descriptive statistics, and further data analyses to investigate the relations between the factors of the DeLone & McLean success model were performed. Based on the results, the users of the information system are satisfied with it, as well as they find the system useful and easy to use. The average value of the “information quality” is 3.78 out of 5, the “system quality” is 3.61, the “service quality” is 3.45, the “use” is 3.83, the “user satisfaction” is 3.46, and the “user benefit” is 3.76. The research concludes with a validation of the DeLone & McLean success model and it seems that the information system of the General Hospital of Chios is successful based on the users’ opinions.

Information system support for medical secretaries’ work in patient administration tasks in different phases of the care process

Medical secretaries may have several separate electronic nursing information systems in use, but regardless of the systems, their task is to make sure that the patient information is correct and usable. The purpose of this study is to describe the support provided by the hospital information systems for the work of medical secretaries in patient administration tasks in different phases of the care process. The data were collected in a central hospital where medical secretaries had long been using partly electronic information systems. The data were collected using an abridged version of the Hospital Information System Monitor (HIS-monitor). The majority of the secretaries (N=60) gave a positive assessment for the support provided by the information system for their work at patient admission, when ordering diagnostic or therapeutic examinations or procedures, and at patient discharge. In the planning and organization of care, most thought that the systems provided poor support for informing all those involved in patient care. At patient admission, nearly half considered that the support for ensuring data protection (46%) and the systems’ compliance with legal obligations (44%) was poor. In connection with ordering diagnostic and therapeutic examinations and procedures, nearly half (43%) thought that information on the availability in ancillary units was not readily and easily available. At patient discharge, 40% considered that the systems did not support the identification of missing or incorrect information. The hospital information system provides partial support for medical secretaries’ work. The implementation of fully electronic systems and their functions may improve the support.

Mining Clinical Process from Hospital Information System: A Granular Computing Approach

Data mining methods in medicine is a very important tool for developing automated decision support systems. However, since information granularity of disease codes used in hospital information system is coarser than that of real clinical definitions of diseases and their treatment, automated data curation is needed to extract knowledge useful for clinical decision making. This paper proposes automated construction of clinical process plan from nursing order histories and discharge summaries stored in hospital information system with curation of disease codes as follows. First, the system applies EM clustering to estimate subgrouping of a given disease code from clinical cases. Second, it decomposes the original datasets into datasets of subgroups by using granular homogenization. Thirdly, clinical pathway generation method is applied to the datasets. Fourthly, classification models of subgroups are constructed by using the analysis of discharge summaries to capture the meaning of each subgroup. Finally, the clinical pathway of a given disease code is output as the combination of the classifiers of subgroups and the the pathways of the corresponding subgroups. The proposed method was evaluated on the datasets extracted hospital information system in Shimane University Hosptial. The obtained results show that more plausible clinical pathways were obtained, compared with previously introduced methods.

Variable clinical characteristics and laboratory results in five patients with Chinese Good's syndrome (thymoma and hypogammaglobulinemia): an 8-year retrospective analysis in a university hospital in China

Background Good's syndrome (GS) is a rare secondary immunodeficiency disease presenting as thymoma and hypogammaglobulinemia. Due to its rarity, the diagnosis of GS is often missed. Methods We used the hospital information system to retrospectively screen thymoma and hypogammaglobulinemia patients at the First Affiliated Hospital of Wenzhou Medical University from Apr 2012 to Apr 2020. The clinical, laboratory, treatment, and outcome data for these patients were collected and analyzed. Results Among the 181 screened thymoma patients, 5 thymoma patients with hypogammaglobulinemia were identified; 3 patients had confirmed diagnoses of GS, and the other 2 did not have a diagnosis of GS recorded in the hospital information system. A retrospective review of the clinical characteristics, laboratory results, and follow-up data for these 2 undiagnosed patients confirmed the diagnosis of GS. All 5 GS patients presented with pneumonia, 2 patients presented with recurrent skin abscesses, 2 patients presented with recurrent cough and expectoration, 1 patient presented with recurrent oral lichen planus and diarrhea, and 1 patient presented with tuberculosis and granulomatous epididymitis. In the years after the diagnosis of hypogammaglobulinemia with mild symptoms, all 5 patients had received irregular intravenous immunoglobulin (IVIG) treatment. As the course of the disease progressed, the clinical symptoms of all patients worsened, but the symptoms were partly resolved with IVIG in these patients. However, 4 patients died due to comorbidities. Conclusion GS should be investigated as a possible diagnosis in thymoma patients who present with hypogammaglobulinemia, especially those with recurrent opportunistic infections, recurrent skin abscesses, chronic diarrhea, or recurrent lichen planus.

Evaluation of favipiravir treatment before intensive care in COVID-19 patients

The purpose of this study is to investigate the healing effect of Favipiravir used in pre-intensive care treatment of patients diagnosed with COVID-19 in order to elucidate the pathogenesis and complications of coronavirus. The data regarding the clinical findings of the patients in the hospital information system and the biochemical parameters made standard in the treatment/follow-up of COVID 19 were taken from the system and evaluated retrospectively. In addition, it was examined as a whole with mild, moderate and severe pulmonary involvement compared to CT findings. Hemogram, coagulation and biochemistry parameters used in the diagnosis and follow-up of COVID-19 were evaluated. SPSS 22.0 statistics program for Windows was used in statistical analysis to evaluate the data obtained from patient files and hospital information system. There is no definitive treatment protocol within the scope of treatment. Drug studies are currently ongoing. In this study, the first clinical findings, treatment types and recovery times of patients diagnosed with COVID-19, the healing effect of favipiravir used before intensive care were determined. Between group 1 (those who started treatment within 0-5 days) and group 2 (those who started treatment within 6-10 days), after 5 days of favipravir treatment, when serum parameters were compared, favipravir treatment was statistically significantly lower in the first group that was started early, WBC, Neutrophil, Creatine, CK, CRP, D-Dimer, PCT, LDH. By collecting the data obtained as a result of the research, early deaths can be prevented worldwide. Our study recommending alternative treatment approaches is important for the protection of patients' quality of life. In this study, when all biochemical markers were evaluated together, it was evaluated that starting Favipiravir treatment early was beneficial in treating COVID-19 disease.