Abstract
Evidence-based medicine (EBM) is the correct use of the best evidences in clinical decision making for patient care. Hospital Information Systems (HIS) can act as a bridge between medical data and medical knowledge through context-sensitive merging and filtering of patient data, individual clinical knowledge and external evidence. The aim of this study was to determine the ability of HISs to establish EBM in Iran. This descriptive cross-sectional study was carried out on HISs of 30 hospitals from March 2011 to October 2011. Data were collected using a researcher-constructed checklist including applicant’s background information as well as information based on research objectives: clinical decision support system (CDSS), reference databases, contextual and case-specific information, clinical and administrative data repositories and Internet-based health information. Face and content validity of the checklist were assessed by the qualified specialists and then the data were analyzed using descriptive statistics and SPSS 16 software. The results of the study revealed that the HISs lacked the essential components to providing access to CDSS, reference databases and Internet-based health information in 19, 16 and 20 hospitals were 63.3 %, 53.3 % and 66.7, respectively. Twenty-two hospitals (70 %) had more than two-thirds of the essential components to access clinical and administrative data repositories; 23 hospitals (76.7 %) had at least one essential component to access contextual and case-specific information. It can be concluded that the ability of the HISs to establish EBM in providing access to the clinical and administrative data repositories is better than other research objectives. Furthermore, more attention should be paid to other related objectives.



Similar content being viewed by others
References
Sackett, D. L., Rosenberg, W. M., Richardson, W. S., Hynes, R. B., and Muirgray, J. A., Evidence-based medicine: what it is and what it isn’t. BMJ 312:71–72, 1996.
Rodrigues, J., Information systems: the key to evidence-based health practice. Bull. World Health Organ. 78(11):1344–1351, 2000.
Sackett, D. L., Straus, S. E., Richardson, W. S., Glasziou, P., Haynes, R. B. Evidence-Based Medicine: How to Practice and Teach EBM. BMJ; 2000.
Jeffrey, A., and Timothy, C., History and development of evidence- based medicine. World J. Surg. 29:547–553, 2005.
Soltani, A., Evidence based medicine, 2nd edition. Tehran University of medical science, Tehran, 2008 [In Persian].
Rube, T. Electronic health information: The key to evidence-based medicine and improved patient care. Gov. Insights 2008.
Soltani, A., Allameh, F., Hoseiny, M., and Forooqi, N., Evidence based medicine. Ketabmah-Oloomfonoon J. 1(3):63–65, 2007 [In Persian].
Zarin-ar, A., What is evidence based medicine. Homa-ye-Salamat J. 20:71–74, 2008.
Hunt, D. L., Haynes, R. B., and Hanna, S. E., Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review. JAMA 280:1339–1346, 1998.
Firooz, A. R., and Khatami, A. R., A review on evidence-based medicine. Iran. J. Dermatol. 7(26):101–111, 2004 [In Persian].
Bukken, S., An informatics infrastructure is essential for evidence- based practice. J. Am. Med. Inform. Assoc. 8:199–201, 2001.
Sackett, D. L., and Rosenberg, W. M., The need for evidence- based medicine. J. R. Soc. Med. 88:620–624, 1995.
Mckibbon, K. A., Evidence-based practice. Bull. Med. Libr. Assoc. 86:369–401, 1998.
Wells, L., Role of information technology in evidence based medicine: advantages and limitations. Internet J. Healthc. Admin 4(2), 2007.
Aminpour, F., Medical informatics: concepts and applications. Iran. J. Med. Educ. 4(2):95–103, 2004 [In Persian].
Mueller, M. L., Ganslandt, T., Frankewitsch, T., Krieglstein, C. F., Senninger, N., Prokosch, H. U. Workflow analysis and evidence- based medicine: Towards integration of knowledge-based functions in hospital information systems. Proc AMIA Symp. 330–334, 1999. PMC2232821.
Hemiear, M., Improving patient safety with technology. Int. J. Med. Inform. 73(7–8):543–546, 2004.
Humphreys, L., Electronic health record meets digital library: a new environment for achieving an old goal. J. Am. Med. Inform. Assoc. 7(5):444–452, 2000.
Humphreys, B. L., and Lindberg, D., The UMLS project: making the conceptual connection between users and the information they need. Bull. Med. Libr. Assoc. 81(2):170–177, 1993.
Ahmadi, M., Barabadi, M., and Kamkar Haghighy, M., Evaluation of hospital information system in the medical records department. Health Inf. Manag. 7(1):16–23, 2010.
Information Technology Department of Kashan Universitiy of Medical Sciences. List of Companies producing HIS Soft ware, Kashan: Iran,2011
Iran Trade Organization’s computer. List of active non government computer’s companies in E.Health & Medical IT. Available on: http://www.irannsr.org/index.php. a
Clamp, S., and Keen, J., Electronic health record: is the evidence base any use? Med.Inform. Internet Med. 32(1):5–10, 2007.
Wright, A., Sittig, D. F., Ash, J. S., Sharma, S., Pang, J. E., and Middleton, B., Clinical decision support capabilities of commercially-available clinical information systems. J. Am. Med. Inform. Assoc. 16(5):637–644, 2009.
Falt-Lisk, S. New hospital information technology: is it helping to improve quality. MATEMATICA policy research, Inc 2006; 3:1–4. available at from: http://www.matematicampr.com/health/qualityofcare.asp
Macias-chapula, C. A., Rodea-Castro, I. P., Mendoza-Guerreo, J. A., Gutierrez-Carrasco, A. Hospital virtual libraries in latin America and the Caribbean: A web metric analysis. Research unit, hospital general de Mexico 2005.
Young, J. M., and Ward, J. E., Evidence-based medicine in general practice: beliefs and barriers among Australian GPs. J. Eval. Clin. Pract. 7(2):201–210, 2001.
Hersh, R., and Hickam, H., How well do physicians use electronic information retrieval systems? A framework for investigation and systematic review. JAMA 280(15):1347–1352, 1998.
Zare, V., Evidence based medicine approach among clinical faculty members. Med. J. Tabriz Univ. Med. Sci. Health Serv. 28(1):61–66, 2006 [In Persian].
Mansson, J., Nilsson, G., Bjorkelund, C., and Strender, L.-E., Collection and retrieval of structured clinical data from electronic patient records in general practice. Scand. J. Prim. Care 22:6–10, 2004.
Langarizade ,M. A study of software utilization in medical records departments in teaching hospitals of medical science based in Tehran. [Thesis]. Tehran: Iran University of medical science; 2003. [in Persian]
Hadianfard, A. The survey of hospital information system structure in Shiraz hospitals. [Thesis]. Tehran: shahid Beheshti University of medical science; 2002. [in Persian]
Acknowledgments
This study is the result of the MSc thesis (a project no.9033). The authors would like to thank research deputy of Kashan University of Medical Sciences for providing financial support.
Conflict of interest
There is no conflict of interest between the authors.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rangraz Jeddi, F., Abazari, F., Moravveji, A. et al. Evaluating the Ability of Hospital Information Systems to Establish Evidence-Based Medicine in Iran. J Med Syst 37, 9904 (2013). https://doi.org/10.1007/s10916-012-9904-5
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-012-9904-5