Investigating the Effective Factors on the Acceptance of Teleorthodontic Technology Based on the Technology Acceptance Model 3 (TAM3).

Statement of the Problem: Health information technology is used in dentistry worldwide. Despite the limited specialized resources for providing orthodontic treatment in Iran, the need to examine the technology acceptance model (TAM) seems necessary and is a significant step in the successful acceptance of teleorthodontic technology. Purpose: The present study has identified and investigated the factors affecting the acceptance of teleorthodontic technology among orthodontists based on the TAM3 with the aim of successful implementation and deployment of this technology. Materials and Method: In this descriptive-analytical research, 300 Iranian orthodontists who were members of the Iranian Orthodontic Association were selected by census sampling. The data was gathered through a modified and accommodated questionnaire called the acceptance model 3. The validity was confirmed. Moreover, the reliability was calculated based on Cronbach's alpha, which was equal to 0.870. Multiple linear regression analysis was also utilized to investigate the relationships between dependent, independent, and mediator variables. Besides, the final model was designed by the Amos software. Results: The results of 251 orthodontic specialists proved that subjective norm, job relevance, output quality, results in demonstrability, and job relevance on output quality could significantly affect perceived usefulness. Similarly, the perception of external control was identified to have a significant influence on perceived ease of use. On the other hand, the perceived usefulness does not play a mediating role between perception and subjective norm. Furthermore, perceived usefulness was confirmed as a mediating factor in relationship to both perceived ease of use and behavioral intention. Conclusion: The findings of the present study revealed valuable scientific evidence to identify and apply the key factors affecting the acceptance and use of modern teleorthodontic technology in Iran. Besides, the structure of the TAM3 was recognized as fruitful and worthwhile for predicting the acceptance of this new technology and also in identifying key effective factors.

Developing a mobile health application for wound telemonitoring: a pilot study on abdominal surgeries post-discharge care.

BACKGROUND: Many early signs of Surgical Site Infection (SSI) developed during the first thirty days after discharge remain inadequately recognized by patients. Hence, it is important to use interactive technologies for patient support in these times. It helps to diminish unnecessary exposure and in-person outpatient visits. Therefore, this study aims to develop a follow-up system for remote monitoring of SSIs in abdominal surgeries. MATERIAL AND METHODS: This pilot study was carried out in two phases including development and pilot test of the system. First, the main requirements of the system were extracted through a literature review and exploration of the specific needs of abdominal surgery patients in the post-discharge period. Next extracted data was validated according to the agreement level of 30 clinical experts by the Delphi method. After confirming the conceptual model and the primary prototype, the system was designed. In the pilot test phase, the usability of the system was qualitatively and quantitatively evaluated by the participation of patients and clinicians. RESULTS: The general architecture of the system consists of a mobile application as a patient portal and a web-based platform for patient remote monitoring and 30-day follow-up by the healthcare provider. Application has a wide range of functionalities including collecting surgery-related documents, and regular assessment of self-reported symptoms via systematic tele-visits based on predetermined indexes and wound images. The risk-based models embedded in the database included a minimum set with 13 rules derived from the incidence, frequency, and severity of SSI-related symptoms. Accordingly, alerts were generated and displayed via notifications and flagged items on clinicians' dashboards. In the pilot test phase, out of five scheduled tele-visits, 11 (of 13) patients (85%), completed at least two visits. The nurse-centered support was very helpful in the recovery stage. Finally, the result of a pilot usability evaluation showed users' satisfaction and willingness to use the system. CONCLUSION: Implementing a telemonitoring system is potentially feasible and acceptable. Applying this system as part of routine postoperative care management can provide positive effects and outcomes, especially in the era of coronavirus disease when more willingness to telecare service is considered.

Clinical and Epidemiological Characteristics of Hospitalized COVID-19 Patients in Hormozgan, Iran: A Retrospective, Multicenter Study.

BACKGROUND: To better manage the COVID-19 pandemic, it is necessary to carefully study information about patients with COVID-19. Objective: To report clinical and epidemiological characteristics of COVID-19 patients in southern Iran. METHODS: This cross-sectional retrospective study was conducted based on data extracted from the COVID-19 registry of Hormozgan. Data from patients with confirmed COVID-19 based on CT-scan results or real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results until September 25, 2020, were analyzed for this study (2351 inpatients). We reported demographics, signs and symptoms on admission, comorbidities, and treatments, as well as clinical outcomes, hospital stay, and intensive care unit (ICU) admission. RESULTS: Most of patients were men (1235/2351; 52.5%) and the most common signs and symptoms included cough (1343/2351; 57.1%), shortness of breath (1224/2351; 52.1%) and fever. The most common comorbidities included hypertension (410/2351 (17.4%), diabetes (343/2351; 14.6%) and chronic cardiac disease (282/2351; 12%). Also, 228 patients (9.7%) were hospitalized in the ICU. The mortality rate was 12.5% (295/2351) among all patients and 64.5% (147/228) in ICU wards, respectively. The number of cases with comorbidities including hypertension, chronic cardiac disease, diabetes, chronic neurological disorders, chronic kidney disease, chronic hematologic disease, malignant neoplasm, moderate or severe liver disease, dementia and fauvism in the ICU was significantly higher than the general wards. CONCLUSION: Most characteristics of our patients were similar to those reported in other studies; however, our patients were younger and suffered from a less severe disease. The mortality rate in the ICU was higher than other studies.

Implementation of regional COVID-19 registry in Hormozgan (RCovidRH), Iran: Rationale and study protocol.

Background: The rapid outbreak of COVID-19 has resulted in a global pandemic in 2020. Information sources such as disease registries through accessing quality, valid, accurate, and timely data empower researchers and health authorities to study and develop appropriate actions. Our study describes the protocol for implementation of regional COVID-19 registry in Hormozgan province (RCovidRH). Methods: We followed approved phases for the development of RCovidRH to cover the population in Hormozgan. Missioned to develop and implement the protocol, the registry's steering committee was made up of 10 members from subject fields of the registry at the core and 5 subgroups. The main purpose of the registry is to provide a comprehensive information profile of demographic, clinical, laboratory, imaging, and treatment data of confirmed and probable COVID-19 patients in Hormozgan. The data is retrospectively and prospectively collected. Case report form (CRF) was mainly based on International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) CRF. A web-based, 2-language software was also developed to facilitate data collection and storage. Data analysis is to be conducted with collaboration of clinical physicians, data-mining specialists, and epidemiologists after reaching appropriate sample size. Results: We included data related to demographic and identification, onset and admission, signs and symptoms at hospital admission, admission signs and symptoms, comorbidities, pathogen testing, assessment, laboratory, imaging, complications, treatment and medication, and outcomes. We found this registry was limited by incomplete clinical data for small fraction of outpatients, incomplete or inaccurate address by referred people due to fear of social rejection, delay in data entry at the facilities due to workload. Conclusion: This registry via organizing clinical and epidemiological COVID-19 data increases the potentiality of joint studies. Recognition and coordination of a registry is highly important to solve its limitations to collect data. Other universities and provinces can apply our model to develop COVID-19 registries or data sets for this disease.

Optimized Patients' Length of Hospital Stay with Interventions Based on Health Information Technology: A Review Study.

BACKGROUND: Information and communications technologies (ICTs) may facilitate shorting length of stay (LOS) of patients through the optimization of processes and delivery services. OBJECTIVES: This study aims to provide technology-based solutions and interventions based on health information technology (HIT) that have optimization potentials of patients' LOS. METHODS: This review study searched papers in PubMed, Scopus as well as Google Scholar without presuming time limits by the end of 2019. English and Persian Papers were included, which addressed an association between the ICT and LOS as well as its positive effect in shortening LOS. RESULTS: Identified technologies were finally classified into eleven groups. Based on the findings, common health technologies such as health information systems, telemedicine especially tele-consultation, electronic discharge planning tools, and visual analytical dashboards in order to expedite the process and help to optimize LOS seem appropriate. CONCLUSIONS: HIT-based interventions have potential that may support better management of processes related to patients' admission, hospitalization, and discharge. However consistently evaluation along with using any new technology is necessary.

Surgical Patients Follow-Up by Smartphone-Based Applications: A Systematic Literature Review.

BACKGROUND: Telemedicine technology with the development of mobile applications (apps) has provided a new approach for the follow-up of patients. OBJECTIVES: This study aims to carry out an overview of the studies related to the use of mobile apps in the follow-up of surgical patients. METHODS: In this study, an electronic search of four databases included PubMed, Scopus, Embase, and web of science was carried out. It included studies in the English language from the beginning of 2009 to June 2019. RESULTS: Twenty-three articles were selected for the final analysis, that all of them were published from 2015 onwards. In most studies, fourteen to thirty-days follow-up period for different outpatient and inpatient surgeries was planned. Apps' components in the studies mostly include indexes for evaluation of recovery quality, pain level, and the surgical site infection. The most important achievement of studies included feasibility, early detection of complications, reducing unscheduled in-person visits, patients' self-efficiency, and satisfaction. CONCLUSIONS: Our review showed that mHealth-based interventions have potential that may support better management of post-discharge systematic follow-up of surgery patients.

The design and implementation of the software tracking cervical and lumbar vertebrae in spinal fluoroscopy images.

AIM: Manual analysis of neck kinematics is usually associated with measurement errors and it requires the use of software capabilities. Considering laboratory usage, software has been developed to solve the associated problems. MATERIALS & METHODS: Fluoroscopic images taken from 78 women were used to design and evaluate the performance of the software. The software was implemented using C# language, according to the case-based reasoning technique. RESULTS: The viewpoints of experts suggest accuracy of the software in tracking and calculations, which meets their information requirements. CONCLUSION: Using the software could help physiotherapists to accomplish their work in decreased time and with improved accuracy.

Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

BACKGROUND: There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. OBJECTIVES: The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. MATERIALS AND METHODS: This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. RESULTS: The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. CONCLUSIONS: It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

The Comparison of the Minimum Data Set for Elderly Health in Selected Countries.

INTRODUCTION: Ongoing increase in the elderly population in many developed countries has drawn attention to health of this age group. Recording adequate and relevant data for the elderly is considered as the basis for future planning for this segment of society. So this study was conducted to compare minimum data about elderly health in selected countries. METHODS: This review study was conducted through Internet and library studies. Key words were extracted from search engines and data bases including Google, Yahoo, Google Scholar, PubMed, ProQuest and Iranian National Medical Digital Library. Inclusion criteria included English language with no time limits. All articles, research projects, theses, guidelines and progress reports were retrieved from the United States, Sweden, Japan and Iran and reviewed. Also, websites of organizations responsible for elderly health in selected countries were visited and their documents were reviewed. Results from this search were provided narratively and finally were presented within comparison tables. FINDINGS: The findings of this study showed that elderly data in the selected countries are collected around four axis including minimum demographic data, medical histories, health assessment and financial data of elderly health. DISCUSSION AND CONCLUSION: Given the importance of the minimum data set of elderly health for future planning, the use of experiences of leading countries in elderly health seems necessary; however, localization of it according to the country's needs is inevitable.

Information technology governance domains in hospitals: a case study in Iran.

IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.

The Effect of Educational Intervention on Medical Diagnosis Recording among Residents.

INTRODUCTION: Studies indicate that using interventions including education may improve medical record documentation and decrease incomplete files. Since physicians play a crucial role in medical record documentation, the researchers intend to examine the effect of educational intervention on physicians' performance and knowledge about principles of medical diagnosis recording among residents in Hormozgan University of Medical Sciences(HUMS). METHODS: This quasi-experimental study was conducted in 2010 on 40 specialty residents (from internal medicine, obstetrics and gynecology, pediatrics, anesthesiology and surgery specialties) in Hormozgan University of Medical Sciences. During a workshop, guidelines for recording diagnostic information related to given specialty were taught. Before and after the intervention, five medical records from each resident were selected to assess physician performance about chart documentation. Using a questionnaire, physicians' knowledge was investigated before and after intervention. Data were analyzed through one-way ANOVA test. RESULTS: Change in physicians' knowledge before and after education was not statistically significant (p = 0.15). Residents' behavior did not have statistically significant changes during three phases of the study. CONCLUSION: Diversity of related factors which contributes to the quality of documentation compels portfolio of strategies to enhance medical charting. Employing combination of best practice efforts including educating physicians from the beginning of internship and applying targeted strategy focus on problematic areas and existing gap may enhance physicians' behavior about chart documentation.