Hospital Information System Research Articles

Public Hospital Workers' Views on the Process of Switching from the Hospital Information Management System to the e-Health Information System in a Province

The purpose of this study is to investigate the views, reasons for satisfaction, and difficulties encountered by medical staff members regarding the Hospital Information Management System (HIMS) in state hospitals located in Amasya and its surrounding areas. It also assesses the knowledge and experiences of healthcare professionals with e-Health apps in public hospitals, emphasizing their opinions and recommendations for assistance, training, adaptation, and involvement throughout the integration of these applications into healthcare services. The goal of the study is to better understand how healthcare professionals feel about digital technologies and to provide suggestions for raising the caliber of healthcare services. The Amasya Provincial Health Directorate oversees four facilities where the research was carried out. Following permission by the ethics committee, data gathering was underway on April 22, 2024, with a pilot research carried out in April of the same year. There are 913 healthcare workers in the population, and a minimum sample size of 405 at a 95% confidence interval was found to be appropriate. Using the'stratified, simple random' approach, the sample was selected and split into three strata based on occupational groupings. With a median age of 37, 38.8% of the 405 participants were female. 34.2% of physicians, 33.7% of midwives, nurses, and health officers, and 40.4% of medical secretaries and data entry staff expressed satisfaction when HIMS satisfaction was analyzed. The system's capacity to decrease errors and enhance workflow was one of the primary factors contributing to user satisfaction. Furthermore, 42.7% of individuals worked nights. Compared to other professional groups, physicians utilized e-health applications like e-prescription and e-report more frequently. Physicians were more likely to employ telemedicine than other healthcare professionals, who were less knowledgeable in this field. The study recommends developing training methodologies specific to various professional groups and expanding the use of e-Health applications. The study highlights the need for regular in-service training, a more robust technical infrastructure, and user-friendly interfaces to boost healthcare personnel' satisfaction with e-Health. In summary, this study offers important information for strengthening e-Health and HIMS applications and presents important suggestions for raising the caliber of healthcare services through digital transformation.

October 7th 2023 mass casualty incident in southern Israel: lessons for emergency preparedness and management

Abstract Background Mass Casualty Incidents (MCIs) pose significant challenges for healthcare systems. While policies are typically crafted based on past experiences, the lessons learned from each incident play a crucial role in enhancing emergency preparedness. On October 7th, 2023, Israel came under the largest terror attack in its history. During an ongoing terror attack, more than 1300 Israelis were killed, and more than 200 were abducted to Gaza. During the first day of the attack, 1457 casualties were evacuated to a hospital, approximately half of them to Soroka University Medical Center (SUMC). This MCI surpassed conventional MCI challenges, necessitating a need to face the unexpected under fire. Through a description of this extreme MCI, we delve into the challenges faced, the strategic interventions deployed to address them, and the invaluable lessons learned. Methods Injury characteristics, severity and outcomes of casualties are presented based on the medical records of all casualties arriving to SUMC between October 7th 6:30 a.m. and October 8th 7:00 a.m. Data regarding patient influx, capacity and hospital resource utilization, were collected from the Patient Registration System and other hospital information systems. Results During the incident, a total of 673 injured arrived at SUMC within a mere 24-h period, at a peak rate of 83 injured per hour. The mean casualty age was 29.6, with male predominance. Gunshot wounds and shrapnel injuries were the dominant types of injuries. Out of the casualties arrived, about half were hospitalized or transferred to receive definitive care at other hospitals after initial care at SUMC. Mortality rate was low, at 2.9% of those admitted alive. Conclusions In this article, we describe the injury characteristics and outcomes of casualties seen at SUMC on October 7th 2023, during one of the largest MCIs in history. We present a detailed overview of the challenges encountered, strategies implemented to address them and lessons learned. These insights hold global relevance, offering actionable guidance for the refinement of future emergency protocols and policies on a global scale.

Security Quality Measurement Based on ISO/IEC 25023 Quality Model Case Study: Hospital Management Information System

Hospitals need to protect the security of data assets, where data assets are an important part of the continuity of hospital operations. In connection with the protection of data and information assets in the hospital, it has become a requirement for the hospital information technology team to carry out a security audit of the hospital management information system (HMIS). In this study, we measured the quality of the HMIS software in X Hospital using ISO 25023 which focused on the security aspects of the outpatient service module and drug services in the outpatient pharmacy unit. The security aspect based on the ISO 25023 standard consists of five main characteristics, namely: confidentiality, integrity, non-repudiation, accountability and authenticity. In the early stages, calculations are carried out to find the value of each measurement standard which is denoted by (X). The X value is based on the standard calculation range of values 0 and 1. The threshold value is determined at 0.80 to categorize the point quality whether it is not good or has met the ISO 25023 quality point. The results of software quality measurements show Internal Data Corruption Prevention is worth 0.75 and is at below a predetermined threshold value. Based on these results, it is recommended to improve one of them by replication the database to minimize the possibility of Internal Data Corruption Prevention. In this study, all aspects of software quality have an average value above the threshold, so it can be concluded that HMIS in RS X meets ISO 25023 standards.

Economic burden of cardiovascular diseases among elderly patients in Iran: a case from a developing country

BackgroundCardiovascular diseases (CVDs) are the leading cause of mortality and morbidity worldwide, particularly among the aging population. This study aims to evaluate the economic burden of CVDs among Iranians aged 60 years and older.MethodsA cost-of-illness study was conducted using a prevalence-based approach from a societal perspective. Cost analysis employed the bottom-up micro-costing method to assess direct medical and non-medical costs, while indirect costs were calculated using the human capital approach. Data were sourced from medical records of individuals aged 60 and older with CVDs registered in the hospital information systems of public and private hospitals in southeastern Iran. Additionally, structured face-to-face interviews were conducted with 160 caregivers or relatives serving as companions of elderly patients, using a structured questionnaire to gather data on healthcare utilization. Sensitivity analyses were performed, along with projections of the future economic burden of CVDs.ResultsThe annual total cost of CVDs among people aged 60 years and above in Iran was estimated at US$ 1,885,091,171.7 (about 1.88 billion), equivalent to 1.27% of the Iran’s GDP in 2021. Direct medical costs accounted for 90.62% of the total, with 54.72% attributed to ambulatory care. The average cost of CVDs per patient was US$ 446.2. The results of two-way sensitivity analysis provided an estimated cost range between US$ 1.2 billion and US$ 2.7 billion. By 2030, the total cost of CVDs is projected to reach US$ 21 billion.ConclusionsThe elderly population with CVDs imposes a growing economic burden on Iran’s healthcare system and society. This underscores the urgent need for effective and cost-effective interventions to prevent and manage CVDs in Iran.

Factors Influencing the Implementation of the Hospital Management Information System on the Quality of Service

An information system serves as a formal mechanism that supplies management with precise and timely data essential for decision-making, facilitating successful planning, oversight, and operational functions. This research employs a quantitative methodology with a cross-sectional design. The research population comprises employees utilizing computer systems in units linked to SIiMRS, with a sample size of 125 individuals. This research indicates that human resources significantly influence the implementation of SIMRS on service quality at RSU Bethesda Gunungsitoli, with a p-value of 0.000, which is less than 0.05. The hardware significantly influences the implementation of SIMRS on service quality at RSU Bethesda Gunungsitoli, evidenced by a p-value of 0.001, which is less than 0.05. The implementation of software in SIMRS affects the quality of service at RSU Bethesda Gunungsitoli, evidenced by a p-value of 0.014, which is less than 0.05. Data management significantly influences the implementation of SIMRS on service quality at RSU Bethesda Gunungsitoli, evidenced by a p-value of 0.035, which is less than 0.05. The LAN conditions significantly influence the implementation of SIMRS on the quality of service at RSU Bethesda Gunungsitoli, evidenced by a p-value of 0.023, which is less than 0.05. The findings of the multivariate analysis indicated that human resource factors exerted the most significant impact on service quality at RSU Bethesda Gunungsitoli. The continuity variable is indicated as 7.807, signifying that respondents with proficient human resources possess a 7.807 likelihood of enhancing the quality of service at RSU Bethesda Gunungsitoli.

Forecasting Daily Radiotherapy Patient Volumes in a Tertiary Hospital Using Autoregressive Integrated Moving Average (ARIMA) Models.

The purpose is to predict the volume of patients treated daily with radiotherapy using the autoregressive integrated moving average (ARIMA) model. In this retrospective study, data from the billing records detailing daily radiotherapy treatment sessions were extracted from the Hospital Information System and analyzed. The study included all patients treated from January 2004 to December 2022. The analysis was divided into two parts: First, the data were summarized using descriptive statistics. Second, time series forecasting with the implementation of an ARIMA model for estimating patient volumes. For the ARIMA modeling process, the Akaike Information Criterion (AIC) was used for classical model optimization. The Mean Absolute Percentage Error (MAPE) was used for evaluating between different models. Residual analysis was performed in each model using the Ljung-Box test, Jarque-Bera test, and heteroskedasticity test to identify autocorrelation, normal distribution, and variances that could undermine the reliability of the model. A total of 895,808 radiotherapy sessions were included in the study. The median number of radiotherapy sessions per day was 181 (150, 205). A clear transition to more modern radiotherapy equipment, particularly the Truebeam accelerator, was observed, indicating a growing dependency on advanced techniques such as volumetric-modulated arc therapy (VMAT), stereotactic body radiation therapy (SBRT), and stereotactic radiosurgery (SRS). The best ARIMA model predicted an increase in demand, projecting an average daily patient volume of 279.40 by 2030. The study highlights the need for advanced forecasting methodologies in healthcare resource planning and emphasizes the importance of considering environmental and external factors for effective and accurate resource allocation strategies.

A needs assessment of hospital management and leadership training among Indian medical undergraduates

BackgroundMedical undergraduate students are often unaware of the managerial aspects of operating a healthcare facility. This leads to confusion and a sense of being lost when they assume administrative roles, highlighting the need for hospital management and leadership training. This prompted us to evaluate the needs of medical undergraduates concerning these crucial aspects.MethodsAn exploratory study was conducted on 240 medical undergraduate students to assess the medical undergraduates’ need to learn about hospital management and leadership training, their views about the importance and their self-perceived knowledge of the various elements of hospital management and leadership training. A meticulously validated questionnaire, comprising three essential parts, based on the Likert scale was effectively employed in the study. Part A asked students to evaluate the importance of 15 selected elements of hospital management and leadership training, ranging from not important to very important, in their role as a doctor. Part B required the students to assess their self-perceived knowledge levels on a scale from no knowledge to very adequate for the same 15 elements. Part C inquired about the students’ opinions on including these topics in their curriculum and, if so, the appropriate timing.ResultsNearly 75% of the students felt that time management, stress management, and patient safety issues were very important for their role as doctor. Closely following these were communication/ public relation skills, hospital information system & record keeping, quality improvement/assurance, law, ethics & code of conduct. Only 25% of the students reported their self-perceived knowledge as very adequate for almost all the elements. For inclusion in the curriculum, the majority wanted to learn about these elements and throughout the course was the preferred timing.ConclusionThe students felt that hospital management and leadership training were pivotal for their roles as doctors. They expressed a lack of sufficient knowledge in these areas and the need for these important aspects to be included in their curriculum as a longitudinal course.

Critical Success Factors and Acceptance of the Casemix System Implementation Within the Total Hospital Information System: Exploratory Factor Analysis of a Pilot Study.

The health care landscape is evolving rapidly due to rising costs, an aging population, and the increasing prevalence of diseases. To address these challenges, the Ministry of Health of Malaysia implemented transformation strategies such as the Casemix system and hospital information system to enhance health care quality, resource allocation, and cost-effectiveness. However, successful implementation relies not just on the technology itself but on the acceptance and engagement of the users involved. This study aims to develop and refine items of a quantitative instrument measuring the critical success factors influencing acceptance of Casemix system implementation within the Ministry of Health's Total Hospital Information System (THIS). A cross-sectional pilot study collected data from medical doctors at a hospital equipped with the THIS in the federal territory of Putrajaya, Malaysia. This pilot study's minimum sample size was 125, achieved through proportionate stratified random sampling. Data were collected using a web-based questionnaire adapted from the human, organization, and technology-fit evaluation framework and the technology acceptance model. The pilot data were analyzed using exploratory factor analysis (EFA), and the Cronbach α assessed internal reliability. Both analyses were conducted in SPSS (version 25.0; IBM Corp). This study obtained 106 valid responses, equivalent to an 84.8% (106/125) response rate. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.859, and the Bartlett test of sphericity yielded statistically significant results (P<.001). Principal component analysis identified 9 components explaining 84.07% of the total variance, surpassing the minimum requirement of 60%. In total, 9 unique slopes indicated the identification of 9 components through EFA. While no new components emerged from the other 7 constructs, only the organizational factors construct was divided into 2 components, later named organizational structure and organizational environment. In total, 98% (41/42) of the items had factor loadings of >0.6, leading to the removal of 1 item for the final instrument for the field study. EFA ultimately identified 8 main constructs influencing Casemix implementation within the THIS: system quality, information quality, service quality, organizational characteristics, perceived ease of use, perceived usefulness, intention to use, and acceptance. Internal reliability measured using the Cronbach α ranged from 0.914 to 0.969, demonstrating high reliability. This study provides insights into the complexities of EFA and the distinct dimensions underlying the constructs that influence Casemix system acceptance in the THIS. While the findings align with extensive technology acceptance literature, the results accentuate the necessity for further research to develop a consensus regarding the most critical factors for successful Casemix adoption. The developed instrument is a substantial step toward better understanding the multidimensional challenges of health care system transformations in Malaysia, postulating an underpinning for future fieldwork and broader application across other hospitals.

More hypertensive crises in women than in men in a single emergency department

Abstract Introduction Hypertensive crises are a common presenting complaint in the emergency department. A hypertensive crisis includes hypertensive urgencies defined as a systolic and/or diastolic blood pressure greater than 180/120 mmHg and hypertensive emergencies with additional hypertension-mediated organ damage (HMOD). In the literature there is very little data regarding the distribution between men and women in hypertensive crises. Most data suggest a balanced distribution or a higher frequency in men, especially compared to premenopausal women. Methods We retrospectively analysed patient data in our hospital information system from 2022 using ICD-10 diagnoses at discharge. We included inpatient as well as outpatient cases that presented to our emergency department between 01/01/2022 and 31/12/2022 with one of the following ICD-diagnoses at discharge: - I10.01, Benign essential hypertension With mention of hypertensive urgency - I10.91, Essential hypertension, unspecified With mention of hypertensive urgency - I11.01, Hypertensive heart disease with (congestive) heart failure With mention of hypertensive urgency - I11.91, Hypertensive heart disease without (congestive) heart failure With mention of hypertensive urgency - R03.0, Elevated blood-pressure reading, without diagnosis of hypertension Then we compared the difference of the median age at presentation between men and women using the independent t-test. Results We identified 397 patients with a hypertensive crisis in the year of 2022. Overall the percentage of women in the collective of patients with any type of hypertensive crisis diagnosis was 73.0 % and thus a lot higher than the percentage of men. Women were on average 7.7 years older at presentation (p &amp;lt; 0.0001). Discussion: On the basis of the available data the causes for the distribution between men and women in hypertensive crises can only be speculated. On the one hand women may measure their blood pressure more frequently than men and the urge to call an ambulance or seek medical attention may be higher. On the other hand it could be possible that arterial hypertension in general has differences in the course and underlying mechanism with a higher frequency in blood pressure peaks, symptoms at lower blood pressure values and antihypertensive medication could be less effective depending on the type of drug. Also arterial hypertension may be underdiagnosed in women. The difference in the age at presentation is probably due to a later hormonal adjustment after the menopause as shown in the literature. The findings of this small observational study should be further investigated in larger trials.

Prognostic Value of Shock Index, Modified Shock Index, and Age Shock Index in Patients with Sepsis in the Intensive Care Unit

Objective: We aimed to evaluate the usability of the Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (ASI) in predicting clinical outcomes and mortality in sepsis patients followed in the intensive care unit. Methods: Records of patients admitted to the intensive care unit of Muş State Hospital between January 2022, and April 2024, who developed sepsis were retrospectively recorded from the hospital data system. Results: A total of 127 patients were included in the study. The average age of these patients was found to be 50.83±12.01 years. The average age of discharged patients was 46.14±10.12 years, while the average age of deceased patients was 58.54±10.89 years. In the gender distribution, 63.78% of all patients were male and 36.22% were female (p=0.028). SI was determined as 0.88±0.33 in discharged patients and 1.11±0.32 in deceased patients (p=0.0002). MSI was found to be 1.45±0.33 in discharged patients and 1.68±0.32 in deceased patients (p=0.00001). ASI was determined as 40.73±18.41 in discharged patients and 64.94±22.85 in deceased patients (p=0.0001). The cut-off value for SI was found to be 0.76, with an AUC value of 0.69. The cut-off value for the MSI was determined to be 1.35, with an AUC value of 0.72. The cut-off value for the ASI was found to be 38.76, with an AUC value of 0.85. Conclusion: All three shock indices were statistically significant in predicting mortality in sepsis patients. We believe they are valuable indices that can be used bedside and non-invasively in intensive care units.

Analisis Pengaruh Penerapan SIMRS Terhadap Kinerja Pegawai di Unit Rawat Jalan RSUD X

Hospital Management Information System abbreviated as SIMRS is an information technology system that is a system that can process everything in the hospital in the form of coordination networks, reporting and administrative procedures to obtain precise and accurate information. SIMRS is one of the components that can affect employee performance where SIMRS helps employees in completing all services. The purpose of this study was to see the effect of SIMRS in improving employee performance. This research uses quantitative research with descriptive methods conducted at Arifin Achmad Hospital, Riau Province. This research was conducted through distributing questionnaires with 67 respondents, namely Outpatient Employees of RSUD Arifin Achmad Riau Province who use SIMRS. The results of this study obtained from the processing of research data show that the influence of SIMRS has a significant effect on the Performance of the Outpatient Unit of the Arifin Achmad Hospital Riau Province. This can be seen with a sig value of 0.002 &lt;0.05.

Development and implementation of a guideline-based decision support system for etiological diagnosis of Sustained Monomorphic Ventricular Tachycardia (SMVT)

Abstract Background Guideline (GL)-based decision support systems (DSSs) play a significant role in supporting physicians in their decision-making processes by providing structured clinical guidance. While these systems have shown significant success in enhancing practitioner performance and patient outcomes in general practice, their application in the context of ventricular arrhythmias remains limited. Moreover, the clinical etiological diagnosis of ventricular arrhythmias presents various challenges for healthcare professionals, such as adherence to updated diagnostic criteria and understanding of complex arrhythmia mechanisms. Purpose In this study, we aim to design, implement, and evaluate a guideline-based decision support systems for etiological diagnosis of sustained monomorphic ventricular tachycardia (SMVT), which could potentially address critical challenges associated with the disease diagnosis and management. Methods To comprehensively capture the semantics embedded in clinical guidelines, we first developed a dedicated knowledge graph tailored to the clinical decision-making. This involved extracting entities and relationships pertinent to key decision procedures from ESC guidelines for ventricular arrhythmias, clinical textbooks or literatures. Subsequently, we translated instances within the knowledge graph into archetypes within openEHR, amplifying the interoperability of clinical information. To enhance the interpretability of the DSS, we established executable diagnostic and treatment processes to offer visual representation of clinical steps in diagnosis and treatment. Ultimately, we constructed a decision support engine to implement the GL-DSS, and its effectiveness was evaluated with anonymous real-world data. Results The proposed GL-DSS was found to be quite feasible and could provide etiological diagnosis for SMVT. The knowledge base for the constructed GL-DDS included more than 2000 entities and relations, which played a vital role in representing disease pathogenesis. The proposed system can map the clinical entities to a set of openEHR archetypes, thus mitigate the interoperability issues of the hospital information systems and CDSS data integration. Also, this module improved system usability and ensured that guidelines could be easily translated and updated into decision support tools. Real-word medical records from 20 patient were collected for model evaluation, the results showed that the GL-DSS covered most of the entities and relations between diseases and diagnostic evidence recorded in clinical texts and achieved a diagnosis accuracy of 80%. Conclusions The results demonstrated that our proposed GL-DSS could completely and accurately capture the diagnostic information under the concrete EHR data. Thus, the implement decision support system could have the potential to improve clinical decision-making, patient care, and outcomes in this specialized medical domain.

Association Between the Use of Proton Pump Inhibitors and Severe Clinical Outcomes in COVID-19 Patients: A Retrospective Observational Study.

Background Proton pump inhibitors (PPIs) increase the risk of pneumonia secondary to PPI-induced hypochlorhydria. We aim to investigate the association between PPI and disease severity in coronavirus disease 2019 (COVID-19)-positive patients and the risk of hospitalizations in Muscat, Oman. Methodology COVID-19-positive patients aged 18 years and above at the time of diagnosis were included in this retrospective observational study. The details of the patients were retrieved from the electronic health records of the Al Shifa Hospital Information Management System and Tarassud. The composite primary endpoint was COVID-19 admission to a government tertiary hospital ward or intensive care within 14 days of diagnosis. Results A total of 506 COVID-19-positive patients were identified during the specified period. The mean age was 44 ± 15 years. The majority of the patients were Omani, and a female preponderance was observed. Overall, 104 (20.4%) patients were current PPI users. Admission due to COVID-19 was significantly associated with the presence of comorbid conditions such as diabetes mellitus (p = 0.001), hypertension (p = 0.001), and chronic kidney disease (p < 0.001). However, current PPI use (p = 0.140) was not significantly associated with an increased risk of hospitalization. Conclusions This data suggests that the use of PPIs during COVID-19 infection did not increase the risk of severe COVID-19 infection and poor outcomes leading to hospitalization in Muscat, Oman. However, the presence of other medical comorbidities, such as diabetes and hypertension, was associated with a higher risk of adverse clinical symptoms that resulted in hospitalization.

Performance Analysis of Slamet Riyadi Hospital Pharmacy Installation Surakarta Using Balanced Scorecard Method

This study aims to determine the extent to which the performance of the Pharmacy Installation of the Hospital Class III 04.06.04 Slamet Riyadi Surakarta with the Balanced Scorecard method. This study is a non-experimental study with an exploratory and descriptive design. Data were collected retrospectively and simultaneously with in-depth interviews with pharmacists of the pharmacy facility, staff and patient questionnaires, and direct observation. Data were analyzed descriptively and compared with existing standards. The findings indicate that 1) Financial perspective performance, TOR values are not yet in accordance with standards, the average GPM value is in accordance with the standard of 20-33% and the GROS value has not met the standard. 2) Customer perspective performance shows that there is high patient satisfaction with the performance of the Hospital Pharmacy Installation. However, there is a significant gap between satisfaction with its performance and patient expectations. Customer retention has increased customer acquisition in period one to period two. 3) Internal business perspective performance shows that drug availability reaches an optimal 100%, dispensing time for compounded prescriptions meets the standard, but for non-compounded prescriptions has not met the standard. PIO is delivered optimally 100% on information on indications, dosages, rules of use, side effects and related contraindications and how to store drugs have not been given to all patients. 4) The performance of the learning and growth perspective shows that satisfaction and work enthusiasm have a high category and the Hospital Information Management (SIM) system has not been optimally integrated. 5) The results of the SWOT analysis are included in quadrant II with a diversification strategy.

Building bridges - Fostering collaborative education in training dental informaticians.

Dental informatics is an emerging discipline. Although the accreditation agency governing dental education programs asserts the importance of informatics as foundational knowledge, no well-defined dental informatics courses currently exist within the standard predoctoral dental curriculum. There is a nationwide lack of dental informatics academic programs. This training gap is due to a lack of qualified dental informaticians to impart knowledge on dental informatics. This paper aims to introduce a novel conceptual framework for an interdisciplinary dental informatics program in preparing students to become dental informaticians. In 2023, we developed a standalone graduate certificate program in dental informatics at Indiana University (IU) School of Dentistry in collaboration with IU Luddy School of Informatics, Computing, and Engineering and IU Fairbanks School of Public Health. Feedback was collected through online surveys to assess course quality from students who took Introduction to Health Information in Dentistry. Feedback was analyzed qualitatively, utilizing a thematic analysis approach. Common responses relevant to dental informatics education were grouped into themes. Five major themes emerged during our analysis of the students' feedback: foundational knowledge and skills; experiential learning: learning by doing; access to resources and working on clinical information systems; health promotion through team-based learning; and retention of knowledge assessment and application. A conceptual framework was formulated through these themes as a guideline for future program improvement. This interdisciplinary educational program framework showed how students and faculty from various disciplines could collaborate, learn from each other, and bring in expertise from different domains. The collaboration happens in clinical, laboratory, and virtual settings to acquire hands on learning through practice and research projects. The developed conceptual framework aligned with the interdisciplinary nature of dental informatics. It can potentially be adopted by other interdisciplinary informatics programs in health and non-health care disciplines.

Evaluation of the Effect of Vaccination Status on Lung Involvement and Hospitalization in COVID-19 Patients

Background: The spectrum of COVID-19 in adults ranges from asymptomatic infection to mild respiratory tract symptoms to severe pneumonia with acute respiratory distress syndrome (ARDS) and multiorgan dysfunction. In our study, it was aimed to investigate the effects of COVID- 19 vaccine on lung involvement and hospitalization. Materials and Methods: Cases over the age of 18, who had a history of contact with cases infected with COVID-19 or had clinical findings suggestive of COVID-19, who applied to the emergency department and who were diagnosed with COVID-19 by reverse-transcriptase-polymerase chain reaction (RT-PCR) were included in the study. Age, gender, comorbid diseases, hospitalization status, thorax tomography findings, and vaccination status in the last 3 months of the patients included in the study were obtained by examining the hospital information system and patient files. Results: Our study included 496 patients. One hundred eighty-three of the cases were vaccinated and 42.6% (n = 78) of the vaccinated patients were male. Of the 313 unvaccinated patients, 36% (n = 113) were male. Comorbid disease was observed in 55.2% (n = 101) of the vaccinated patients and 38.7% (n = 121) of the unvaccinated patients. Of the 313 unvaccinated patients, 72.2% (n = 226) were discharged from the emergency department, 19.8% (n = 62) were admitted to the service, and 8% (n = 25) were admitted to the intensive care unit. Of the 183 vaccinated patients, 78.1% (n = 143) were discharged from the emergency department, 16.4% (n = 30) were admitted to the service, and 5.5% (n = 10) were admitted to the intensive care unit. In the vaccinated patient group, both the service admission rate and the intensive care hospitalization rate were found to be significantly lower than the non-vaccinated patient group (p &lt; 0.05). Thoracic tomography findings of 32.9% (n = 103) of 313 unvaccinated patients were reported as CORADS 1-2-3, and thoracic tomography of the remaining 210 patients was reported as CORADS 4-5. The number of patients whose thorax tomography report was CORADS 4-5 was found to be significantly higher in the unvaccinated group than in the vaccinated group (p &lt; 0.05). Conclusion: In our study, it was found that vaccination significantly reduced hospitalization in COVID-19 patients. Although the mean age was higher in the vaccinated patient group, both the service admission rate and the intensive care admission rate were found to be lower.

Model For Improving The Performance Of Hospital Management Information System Services Through Transformational Leadership

The role of Transformational Leadership in hospital organizations is very important, where hospitals are organizations that have a complex environment, there is a lot of unclear information. With the increase in health services to the community along with changes in demographics, changes in health service technology, and the adoption of new information technology. So performance measurement is important in order to improve the quality of health services. The aim of this research is to find out how transformational leadership influences the success of hospitals management information systems (HMIS). The method used was a quantitative descriptive and verification survey with 181 respondents from 15 hospital in the city of Bandung. The sampling technique uses proportionate stratified random sampling. Data analysis using structural equation modeling (SEM) with partial least squares (PLS). The findings of the proposed hypothesis are that the quality of technology, transformational leadership, and users have a significant effect on service performance. Users can mediate technology quality, transformational leadership and service performance. Conclusion of the study is the novelty of the development of the information system success model by adding the context of transformational leadership in evaluating the success of the information system, where transformational leadership has a positive effect on improving the performance of hospital management information system services through users. Implications of the results of this study contribute to the development of an information system success model that can be used to evaluate the success of information systems in general.

EFFECT of daily antiseptic bathing with octenidine on ICU-acquired bacteremia and ICU-acquired multidrug-resistant organisms: a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study.

Antiseptic bathing has garnered attention in an effort to reduce hospital-acquired infections. Previous studies have shown the efficacy of antiseptic bathing in high-risk environments, such as intensive care units (ICUs), using chlorhexidine. In this study we aimed to evaluate the effectiveness of octenidine as a potential alternative due to its established popularity and widespread use in Europe. We compared the rates of ICU-acquired primary bacteremia and ICU-acquired multidrug-resistant organisms (MDROs) in a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study using octenidine-impregnated and placebo washcloths. On 44 ICUs in 23 hospitals throughout Germany, we compared individual ICUs with themselves over two 12-month time periods. All data were obtained digitally via hospital information systems as individual ward-movement data and microbiological test results; both endpoints were algorithmically derived. 104,039 ICU episodes from 93,438 patients with 712,784 microbiological test results were analyzed, thereby detecting 1508 cases of ICU-acquired primary bacteremia and 1871 cases of ICU-acquired MDRO. Bathing with octenidine-impregnated washcloths prevented ICU-acquired primary bacteremia; a risk reduction of 17% was seen homogeneously across all participating ICUs (adjusted hazard ratio (HR) 0.83, 95% confidence interval (CI) [0.75; 0.92], p = 0.0003). This reduction affected predominantly coagulase-negative staphylococci (53%) and enterococci (17%). However, no intervention effect was seen for ICU-acquired MDROs (adjusted HR 0.98, 95% CI [0.83; 1.15]). Heterogeneity among intra-ICU intervention effects on MDRO acquisition was substantial. Antiseptic bathing with octenidine may be effective in preventing ICU-acquired primary bacteremia, particularly due to Gram-positive bacteria and common skin commensals.

Equestrian-associated injuries of the hand: a retrospective analysis of injury mechanisms and patterns.

Hand injuries are frequently caused by sports and are associated with long periods of inability to work and high economic health costs. After ball sports and cycling, the most common cause of hand injuries is horseback riding. Therefore, measures should be taken to prevent these risks and increase safety in sports, however data characterizing equestrian sports-associated injuries are limited. A retrospective monocentric cohort study was performed including 39 patients (mean age: 35 ± 2.6 (range 9-65) years, female 89.7% who sustained an injury to the hand while practicing equestrian sports during 2016-2021 and presented to our hand surgery center. Data analysis was performed to characterize the trauma mechanism and injury patterns by evaluating the clinical information system and conducting telephone interviews. Overall, 53.8% of the injuries occurred while leading the horse owing to traction by bridles or a lead rope on the fingers, whereas only 33.3% were caused by a fall and 12.8% by a bite injury. The majority (87.2%) of cases were injuries to the phalanges (metacarpus: 7.7%; carpus: 5.1%). Fractures were present in 51.3% of cases. The most serious injuries included avulsion amputations in 23.1% of patients (10.3% subtotal; 12.8% total amputation). Equestrian-associated injuries occur more frequently during horse handling than riding, resulting in severe avulsion amputations due to traction of the lunge or bridle, requiring complex microsurgical treatment. We recommend that appropriate protective gloves are worn for prevention of hand injuries. Additionally, the use of self-opening panic hooks with overload protection can prevent excessive traction. III.

Analysis Of The Implementation Of Management Information Systems In Budi Setia Langowan Hospital

The rapid and extensive development and progress of information technology today, so that for an agency / company the information used as a basis for administration and data processing is an application system in various fields that are required to use the information system. Good service quality is the implementation of a reliable, effective and efficient Hospital Management Information System (SIMRS) and upgradeable. The hospital information system has an important role in clinical and administrative services. Hospitals that use a website-based system (SIMRS) are designed to integrate the main functions of the hospital into one integrated system stored in a database center. This study aims to analyze the implementation of a hospital information system using the PIECES method. The type of research used is qualitative.