The duration of Master of Science in our department typically is two to four years. The admission to a Master’s program requires at least the completion of bachelor’s degree in the health-related fields, computer or information technology fields. Earning a Master of Science degree typically includes writing a thesis. In the following you can see the information regarding students’ theses:

1. Title: Designing a mobile application for diagnosis and recovery of postpartum depression and evaluating its impact.
   Student’s name: Nazanin Jannati. Supervisor(s): Leila Ahmadian. Advisor(s): Shahrzad Mazhari, Moghadameh Mirzaee.
   Abstract

   Background and Objectives: Mothers' depression is a major public health problem and, if neglected and untreated, its consequences are very serious. Statistics for mothers who suffer from depression are alert to one in every one of the three mothers who suffer from depression. When a mother becomes depressed, she experiences signs and symptoms that can affect all family members. Fortunately, postpartum depression is curable. Although there are effective treatments for depression, 80% of depressed mothers are not being treated. As the use of smartphones is on the rise, software design to help diagnose and help depressed mothers can be effective. Therefore, the present study aims to design and implement a software to diagnose and help improve depression and assess its impact. The results of this study can help identify and help depressed mothers and mitigate their effects.

   Methods: This is an interventional study (2017-2018) using five phases according to the Post-Mother Maternal Depression Guidebook, published by the US Mental Health Services Organization, as follows: The first phase (Assessment) was a descriptive-analytic study to identify the information needs of depressed mothers about postpartum depression and the barriers to treatment of depression from mothers’ point of view. The study population was mothers who referred to medical offices and health centers in Kerman. The inclusion criteria of mothers were the passing of 4-6 weeks of delivery, an Edinburgh test score of over 13, patient satisfaction to participate in the study. The offices and health centers were selected by simple random sampling (drawing). The sample size was calculated using similar studies and Cochran formula. The Persian version of the Edinburgh Postnatal Depression Scale was used to identify depressed mothers. A semi-structured questionnaire designed by the researcher was used to assess the information needs of mothers. The content validity of the questionnaire was confirmed by three psychiatrists and two medical informatics specialists, and its reliability was confirmed by test-retest (r = 0.82). Data were analyzed by SPSS as well as descriptive (mean, percentage, frequency) and analytic statistics (Chi-square test, one-way ANOVA, paired t-test). The second phase (capacity) was a qualitative study to identify and explain the healthcare team experiences of the provision of postpartum depression preventive services. The study population was active healthcare providers in Kerman health centers. Inclusion criteria were at least six months of work experience, ability to answer interview questions and willingness to participate in the study. All health centers in Kerman (16 centers) were selected for access to health care providers, and some health care providers at these centers participated in the interview. The data collection method is a deep and semi-structured interview. Data were analyzed by Lundman & Graneheim’s content analysis method. In the third phase (planning), the recommendations and the content necessary for development in the software were extracted by studying the existing guidelines for the cognitive-behavioral therapy method. In the fourth phase (implementation), a mobile-based software for the Android operating system was designed and used by the research population based on the results of the first and third phases. In the fifth phase (evaluation) of an interventional study, the rate of improvement of mothers with postpartum depression was evaluated in a pre- and post-controlled study. The study population included mothers referred to health centers in Kerman who were divided into intervention and control groups. The inclusion criteria of mothers were the passing of 4-6 weeks of delivery, an Edinburgh test score of over 13, patient’s satisfaction to participate in the study. Three centers (two purposeful centers and one randomized center) out of the 16 health centers were selected to access the samples. The sample size was determined using similar studies and statistical calculations. The Persian version of the Edinburgh questionnaire was used for the diagnosis of mothers’ postpartum depression. Analytical statistics including Wilcoxon, paired-t, Mann-Whitney and Pearson and Spearman coefficient tests were use analyze the data.

   Results: The results of the first phase of the study showed that more than one third of the depressed mothers (77.5%) needed a high level of information on postpartum depression. More than half of participants (55.4%) were searching information daily. The most information needs were related to: taking care of baby and preventing side effect of depression on the baby (51.2%), information about treatment methods (47.5%), depression signs (43.8%). The features from mothers’ point of view to develop a mobile phone application for depression were as follow: providing information to individuals about depression (63.3%), providing consultant’s treatment (55%), communication with physician by mobile phone (52.5%), and determining depression’s phase (50.8%). During the analysis of the second phase of the study, four classes (the special nature of depression, the causes of depression, the structural challenges of providing care, the attempt to sustain and comprehensiveness of services) appeared. Providing services to depressed mothers have problems such as lack of trained force, bad people's bad mark for depression, lack of awareness of depression. Health care providers have provided suggestions for improving the delivery of services in the future, including informing, motivating people, eliminating the causes of depression. The results of fifth phase indicated that, mean score of Edinburgh among control group was 17.39 in first level of two months’ duration, and it was 15.05 at the end of second month (decreased 2.34 score). Moreover, mean score of Edinburgh for interventional group was 17.42 in first level of two months’ duration, but it was 8.18 at the end of second month (decreased 9.24 score). The results of paired t-test illustrate that, differences between score of Edinburgh among interventional and control groups are significant p<0.001 (in both pre-test and post-test stages). However, difference between score of Edinburgh in pre-test stage was not significant (p>0.001) among both groups (interventional and control). The mean score of Edinburgh in post-test stage among interventional group was 8.18 and in control group was 15.05. This reduction is statistically significant (p<0.001). The examination of relationship between demographic variables and score of Edinburgh revealed that there is not significant relationship between age, educational level, income and score of Edinburgh (p>0.05).

   Conclusion: The first step in the development of applications is to identify and pay attention to the needs of users. Considering the method of information and tools used by users can also guide decision makers to implement and run applications. The results of this study can be used to design educational interventions aimed at increasing the awareness of depressed or pregnant mothers about postpartum depression. . Despite the implementation of the health care reform plan and the need for providing free mental health services, the provision of health care to depressed mothers is completely inadequate due to the lack of knowledge of people about the disease and the lack of proper notification of such services. Accurate recognition of these problems and the use of experiences from service providers can be effective in making appropriate decisions.

   Key words: Mobile Health Software, Postpartum Depression, Cognitive Behavior Therapy, Intervention, Mental Health

2. Title: Redesinig and Automation of The Electronic Discharge Summary in Shafa Educational Hospital in Kerman Affiliated with Kerman University of Medical Science
   Student’s name: Farzad Salmanizadeh. Supervisor(s): Afshin Sarafi Nejad, Dr.Abbas Etminan. Advisor(s): Leila Ahmadian, Mohammad Ghaemi .
   Abstract

   Background and Objectives: Hospital Summary Sheet is one of the most important tools for transferring information from hospital physicians to other doctors and plays an important role in the continuity of patient care. The poor quality of the content, the lack of insertion of information, the unavailability of the time required are the main problems in the process of preparation the summary. The standard abstraction training for doctors, the use of audit and feedback methods, and the use of summary sheets of electronic records attached to the clinical database of hospital information systems, which are partly completed in the form of a summary of the case file, are among the most common methods to improve summary sheets. The most common way of generating summary sheets, is to use a summary attached to clinical databases. The purpose of this study was to provide a preliminary prototype for the design of a summary form of the electronic record of the Shafa hospital in Kerman, Iran. We had the plan in accordance with the needs of physicians and making a semi-automated method for most of included information items, using the patients' demographic and clinical information in the Shafa hospital. It creates a legible summary form of electronic records that meets the needs of each hospital ward and using a newly designed form, physicians are encouraged to use the electronic summary form for patient record.

   Methods: This research was an applied study conducted in 1397 in three phases. The first phase consists of recognizing and evaluating the physicians' satisfaction with the process and quality of the content of the summary forms in the Shafa hospital in Kerman; the second phase, including the identification of the information items required by the doctors of the hospital wards for inclusion in the summary sheet electronic form for patient record, and the third phase includes the provision of a MS Windows-based software using the identified tables and data from the HIS database of the hospital, that was evaluated by a group of doctors. The study population consisted of all doctors in 10 health care departments in the Shafa Hospital at the time of the inquiries, with a sample size of 110 for doctors, and 550 completed summary sheets were selected as a quota sample from all archived patient records in hospital. To collect data in the first and second phases, a question set consisting of three questionnaires identifying the required information items for physicians (53 items), assessing the satisfaction of physicians from the process of completing the summary forms (13 items) and assessing the satisfaction of physicians from the quality of the content of the summary forms was used (16 questions) and in the third phase, a questionnaire (11 items) was used to evaluate the software designed by a group of doctors. The content validity of the questionnaires was confirmed by four medical informatics specialists and two doctors and its reliability was confirmed by Cronbach's alpha. For data analysis, we conducted descriptive statistics, Pearson's correlation coefficient, Spearman's rank correlation coefficient, Phi and Kramer's coefficients, multivariate regression and one-way ANOVA were used for analyzing the relationships between different variables in SPSS v.24

   Results: A total of 98 doctors (89%) with an average age of 38 years (range 26-69 years) participated in this study. The results of the first phase indicated that there was no standardized instruction in the Shafa hospital in order to complete the summary records, and the overall satisfaction of physicians from the process of completing the summary forms of the case was 46.65±24.96% and the quality of the summary of the files was44.05±13.19%. In the second phase, a total of 18 pieces of information were identified according to the idea of all doctors in 10 health departments in the study. In the third phase, the designed prototype software, was evaluated by 12 doctors and the overall satisfaction rate was 79.75±13.77

   Conclusion: The results showed that there is no standard and integrated instruction to write a comprehensive and complete summary sheet in the Shafa hospital in Kerman. Physicians are not satisfied with the current process of completing the summary sheets and their content quality in the Shafa hospital. Considering the importance of summarizing the patient records for the continuation and follow-up of patients' treatment, it is necessary to improve the quality of the content of thesummary forms in the Shafa hospital of Kerman by refining the process and effective interventions. In the prototype created in this study, the design was based on the actual needs of physicians and some features like the semi-automatic completion of most information items in the electronic patient record summary form, using the stored demographic and clinical information of patients in the HIS database of the Shafa hospital in Kerman. Considering the positive opinions of physicians who evaluated the designed prototype software, completing and implementing this software in clinical environments can increase the physicians' satisfaction with completing the summary of records and increasing the quality of the content of the summary forms of the records and ultimately can improve the quality of continuous patient care.

   Key words: Electronic Discharge Summary(EDS), Hospital Information Systems(HIS), Patient Discharge Summary, Prototype.

3. Title: A study on effective factors on patients' loyalty and modeling their behavior regarding readmission to educational hospitals of Kerman University of Medical Sciences using non-electronic and elctronic data
   Student’s name: Mina Rostami. Supervisor(s): Leila Ahmadian, Aliakbar Niknafs. Advisor(s): Yunes Jahani.
   Abstract

   Background and Objectives: Nowadays, the growth and development of various industries around the world has led to diversity in customers’ demands and thus the creation of a competitive atmosphere in the market. The healthcare sector is also rapidly growing as a dynamic industry and its competitive atmosphere is increasing. By increasing the competition among healthcare providers, establishing strong relationships with patients can result in their satisfaction and, this may result in patient return to the institution. Therefore, identifying loyal customers and their needs will help managers in resource allocation and management efforts to further enhance the organization's profitability. The aim of this study was to identify and investigate various factors affecting patient's loyalty and their readimission.

   Methods: A cross-sectional descriptive and analytical study was carried out in two phases as follows: 1. This phase was a cross-sectional descriptive and analytic study which was done in the three academic hospitals in 2017 in Kerman, Iran. A sample of 260 patients admitted to these hospitals was recruited. The data gathering tool was an expert-validated questionnaire which its reliability confirmed by Cronbach's alpha. The questionnaire consisted of three main sections: in the first section, demographic data (12 questions), in the second section, patients' satisfaction with the service quality (43 items), and in the third section, patient loyalty to the hospital (3 questions) were measured. Data were analyzed using descriptive statistics, correlation coefficient and multivariate regression analysis by SPSS20. 2. In the second phase of the study, the factors affecting frequency of admission were extracted from the hospital information system in order to discover the rules between the effective factors and the frequency of admission level. After integrating and preparing the dataset, data mining techniques applied to data using SPSS Modeler 18.0.

   Results: In the first phase, the mean score of services quality was calculated 73.72±18.04 out of 100. Among the different quality dimensions, “physician visit” had the highest score with 83.81±19.95 and the “waiting time” dimension had the lowest score with the mean score of 62.45±27.53. The mean score of patients' loyalty was 67.88±29.79, which was 38.8% of the patients in the completely loyal group. Satisfaction with the six dimensions of service quality; “behavior of doctors and employees”, “cost of services”, “hospital environment”, “access to physicians and healthcare institutions”, “provision information to patient” and “acquaintance with hospitals” were identified as the most influencing factors on loyalty. In the second phase, the variables of the frequency of admission and length of stay were identified as effective variables in clustering. The patients were clustered into five clusters: churn patients (frequency of admission= 1), the patients with low number of admission (frequency of admission= 2 or 3), patients with moderate number of admission (frequency of admission= more than 4 times and length of stay=0 day), patients with frequent admission (frequency of admission= more than 4 times and length of stay= 1-9 days - frequency of admission= more than 8 times, and length of stay = 1-9 days), and patients with a high number of admission (frequency of admission=4 times and length of stay= more than 10 days - frequency of admission= 6 or 7 times, length of stay= more than 2 days - frequency of admission= more than 8 times and length of stay= more than 10 days). The decision tree algorithm was made 62 rules in order to behavioral modeling of the patients readmission to academic hospitals that its accuracy was 87.26%.

   Conclusion: The results showed that patient satisfaction with service quality affects hospital choices and increases loyalty. In order to increase patient loyalty to academic hospitals, improving the quality of services along with delivering cost-effective cares, improving hospital environment and providing useful information to patients is recommended. Furthermore, managers should focus on inpatients with longer length of stay in order to provide facilities for patients and their fellows to enhance patients' satisfaction, readmission and loyalty.

   Key words: Data mining, Patient loyalty, Patient satisfaction, Readmission, Behavioral modeling, Knowledge Discovery in Databases (KDD)

4. Title: Designing an educational software for safety in the laboratory of pharmaceutical sciences and evaluating its impact on the knowledge of pharmacy students in Kerman University of Medical Sciences in 2017-2018
   Student’s name: Arefeh Ameri. Supervisor(s): Reza Khajouei. Advisor(s): Alieh Ameri, Yunes Jahani.
   Abstract

   Background and Objectives: Currently, students cannot effectively use traditional educational methods because they are not accessible at any time and place. Moreover, they are voluminous and outdated and have inappropriate graphics. Education through mobile-based applications is one of the alternative educational solutions. But, several cultural and psychological factors can affect the behavior of users towards the use and acceptance of mobile-based educational applications. The objective of this study was to develop and to evaluate LabSafety educational application and its acceptability using UTAUT2.

   Methods: In first stage of this study, the content of LabSafety application for Android was developed and evaluated for educating the safety measures in laboratories. This study was conducted on all pharmacy students in Kerman University of Medical Sciences (n=316) in 2017. Participants were randomly enrolled into three control (n=106), traditional (n=105) and application (n=105) groups using simple random sampling. To assess student’s knowledge before and after the intervention, two valid and reliable (Cronbach’s Alpha=0.94 and 0.93 respectively) questionnaires were used. The mean scores before and after intervention were compared using paired t-test and ANCOVA. Then in second stage, all pharmacy students (n=241) who had experience of using the LabSafety application were selected. Data were collected using a Persian translation of UTAUT2 questionnaire. The participations were provided with an online link to this questionnaire. In this study, out of the 9 constructs of UTAUT2, only 7 constructs (“Performance Expectancy”, “Effort Expectancy”, “Social Influence”, “Facilitating Conditions”, “Use Behavior”, “Behavioral Intention”, “Habit”) were used. The data were analyzed using Structural Equation Model (SEM) and Partial Least Squares (PLS) methods in SmartPLS 3.2.7 software.

   Results: There was no significant difference among the mean scores of the participant’s knowledge in the three groups before the intervention (p=0.82). Age had a significant effect on the mean scores before the intervention (p<0.0001). After the intervention, the mean scores of the application group were 5.52 higher than the scores of the traditional group and 7.30 higher than the scores of the control group (p<0.0001). Mean scores in women were 0.94 higher than in men after intervention (p=0.018). In second stage, “Performance Expectancy” (β=0.12, p=0.01), “Social Influence” (β=0.17, p=0.001) and “Habit” (β=0.50, p<0.0001) had a positive effect on “Behavioral Intention”. “Behavioral Intention” had a significant positive effect (β=0.24, p=0.002,) on “Use Behavior”. The effect of “Habit” on “Use Behavior” in men was higher than in women (β=0.11, p=0.04).

   Conclusion: The use of educational application can effectively increase the knowledge of all age groups of students regarding safety measures in pharmaceutical laboratories. Mobile-based applications with online and offline access, interactive features, and user-friendly interfaces are more attractive and they can be used complementary to practical training. Moreover, the usefulness of educational applications such as LabSafety, their positive impact on the improvement of student’s efficiency can lead to frequent and daily use of these applications.

   Key words: Educational technology; Mobile application; Safety; Laboratory; Pharmacy students; Unified Theory of Acceptance and Use Technology (UTAUT)

5. Title: Designing and evaluating a remote consultation system for ear diseases diagnosable by an otoscope
   Student’s name: Najmeh Pourshahrokhi. Supervisor(s): Leila Ahmadian. Advisor(s): Kambiz Bahaadinbeigy, Dr.Aliasghar Arabi Aianroodi, Dr.Mahmood Darijani, Dr.Moghadameh Mirzaee.
   Abstract

   Background and Objectives: The paucity of Ear, Nose, and Throat (ENT) specialists and their inappropriate distribution in some parts of Iran have limited the access of people living in rural areas to services. Deployment of new technologies to communicate with service providers can partly address this challenge. So, the aim of this study was to design and evaluate a remote consulting system to diagnose the detectable ear lesions using an Autoscope in Kerman province, Iran.

   Methods: This applied descriptive-analytical study was conducted in 2018 in three stages: analyzing the needs of the ENT specialists, designing and evaluating a tele-otology web application. In the first stage, a researcher-made questionnaire was developed to identify the essential elements of tele-otology web application from the viewpoints of ENT specialists working in Kerman. Based on the information obtained from the first stage of the study, the tele-otology web application was designed in the second stage. In the third stage of the study, in order to evaluate the designed system, the web application was implemented in an ENT clinic in Jiroft city. At this stage, 180 patients who referred to the clinic were selected to participate in the study. The patients were asked to sign the consent forms. The remote facilitator provided the clinical information and Autoscope video images from the patients' ears. The ENT specialist's diagnosis using the Autoscope at the clinic was recorded as the benchmark in the patients' information-collection forms. Later, these data were uploaded to the server. Then, two ENT specialists reviewed the patients' files using the cellphone application at two stages and inserted their final diagnosis for each patient in the application independently. Remote diagnoses were compared with the benchmark. Kappa coefficient was used to determine the correspondence between the diagnoses using remote and in-person methods. The sensitivity and specificity were calculated to determine the diagnostic accuracy of the remote procedure. Data were analyzed using SPSS23.

   Results: The results of need analysis showed that the patients' age and gender among the demographic characteristics and disease symptoms including history of ear discharge, dizziness, headache, images of right and left ears, tympanic membrane color and status, ear canal status, and middle ear status among the clinical data were essential for the diagnosis of disease by the physician. Based on the information obtained from the first stage, the tele-otology web application was designed and programmed to work on Android and ios systems. In the third stage, the findings showed that the quality of images taken by the remote facilitator was good and acceptable in 78 percent of cases. In the first review, the first and second specialists had agreement on 69.95 percent and 72.7 percent of the diagnoses made using the Autoscope video images and the in-person diagnoses. These agreement rates were 74.3 percent and 76.15 percent in the second review of experts. The intra-rater agreement coefficient was 73.75 and 74.95 between the diagnoses of otology specialists in two stages.

   Conclusion: Contents of the designed application were determined using the important information pointed out by specialists as the main users of remote medical systems. The evaluation of tele-otology method showed that the remote diagnostic method and the in-person approach were in good agreement. Furthermore, a remote facilitator with limited trainings can provide the Autoscope video images for remote diagnoses. Implementation of this system in rural areas can be an effective step to improve the speed and quality of services. By employment of such systems, physicians who work in rural areas will be able to communicate, discuss, and interact with the experts throughout the world using the Internet. Furthermore, they will not be obliged to send the patients to large cities at the early stages of the disease. Appropriate and punctual implementation of remote therapy accelerates the treatment process, eliminates the need for transfer of the patient to more professional clinics, and consequently reduces the costs. Therefore, considering the inappropriate distribution of ENT specialists in different regions of Iran, application of this method can be a good solution. We recommend the policy makers of the health sector, the authorities of ministry of health, the authorities of budget allocation, and the health system managers to make the necessary investments and take more serious measures to implement the tele-otology system for patients who cannot access services.

   Key words: Remote consulting, Tele-otology, Ear diseases, Autoscope, Diagnostic adaptation, Cellphone application, Design

6. Title: The impact of Emergency Medical Services (EMS) automation system on users workflow and patient care process
   Student’s name: Faezeh Afzali. Supervisor(s): Reza Khajouei. 
   Abstract

   Background and Objectives: Emergency Medical Services (EMS) is one of the most important components of a health care system. One of the problems of hospitals is the lack of information about the condition of the patients sent by the 115 emergency before reaching the hospital in order to provide facilities that are appropriate to the patient's condition. In order to solve this problem, the EMS automation system was implemented at the Kerman University of Medical Sciences teaching and therapeutic hospitals. In this study, the impact of the EMS automation system on patient care process and workflow of users was evaluated.

   Methods: This research is cross-sectional descriptive-analytic study that was conducted on doctors and nurses of emergency triage training and therapeutic hospitals of Kerman University of Medical Sciences and medical emergency technicians of Kerman Medical Accident and Emergency Management Center in the period of 6 months before the implementation of the EMS automation system and 6 months after it. In order, the HIS report was used to evaluate the effect of this system on patient care process and a questionnaire was used to determine its impact on the workflow of the users. Mann-Whitney U test was used to analyze the HIS reports including to compare the average patient's stay in an emergency and hospital and descriptive statistics and Chi-Square test of SPSS 23 software was used to analyze the data of the users' questionnaire.

   Results: Use the EMS automation system generally reduced 3 hours and 45 minutes’ duration of patient's stay in a hospital. Also use this system increased 2.2% the patient's clearance and a 1.3% reduction in mortality rates. In addition, 78% of physicians, 75% of nurses and 83% of technicians said that this system affected their workflow.

   Conclusion: The results of this study showed that the EMS automation system in general increased the speed of provide patient service, readiness of users to provide patient care, number of patients discharged and improvement of the outcome of the patient's treatment. Also, this system reduced the duration of patient's stay in a hospital and its mortality rate. This system has problems such as inappropriate technical infrastructure which is anticipated to be fixed the patient's recovery will be improved, their mortality will be reduced and user satisfaction will be improved.

   Key words: Emergency Medical Services (EMS), Patient Care Process, User, Automation, Health Care Services, Workflow.

7. Title: Design, implementation and evaluation of a Tele-Ophthalmology system to detect diabetic retinopathy in digital images of retina with portable fundus camera
   Student’s name: Sareh Keshvardoost. Supervisor(s): Kambiz Bahaadinbeigy. Advisor(s): Hashem Shadman, Amir Khosro Ghasemi Nezhad, Mohammad Reza Baneshi.
   Abstract

   Background and Objectives: The increasing prevalence of Diabetic Retinopathy in the developing countries has been transformed to a worldwide concern. This problem is preventable with timely diagnosis and treatment but in the majority of cases patient attend in the eye clinics very late because of lack of specialist physician and travel difficulties. Therefore, running a teleophthalmology system can help to manage this disease significantly. This study sought to assess the accuracy of a teleophthalmology system and its affect on reducing unnecessary referrals for the first time in IRAN.

   Methods: This study consists of three parts. The first part was done to find the most important data set for developing a teleophthalmology website from physicians’ point of view. A check list included two parts 1- demographic and 2- clinical data was designed based on clinical guidelines and referral forms to the special diabetes clinics and was filled in by 18 ophthalmologists. In the second part based on the results of the previous part a teleophthalmology website was designed and implemented with PHP pogrammng language. In the third part which was done in the Shafa Hospital and Basir subspecialty eye clinic, 125 diabetic patients were examined by ophthalmologist and then image acquisition of single field, focused on Macula from the retina of patients with non-mydriatic fundus camera of “Horus” was done. These images were uploaded on the teleophthalmology website and assessed by two retina specialists and two general physicians. Finally, the results derived from face-to-face visit as Gold standard and results of digital imaging were put in the SPSS version 25 and analyzed.

   Results: In the first part of this study out of 38 variables, 24 variables were selected with agreement of more than 75% of physicians and 9 variables were selected with agreement of 50 to 75 % of physicians. After designing the teleophthalmology website, in the third part out of 125 diabetic patients eight of them (6.4) % were removed because of low quality of images and finally 117 patients were evaluated. The Sensitivity and Specifity of retina specialists were 90 and 97 percent respectively in comparison to gold standard of face-to-face visits. The sensitivity of referral retinopathy for our retina specialists were 92 and 85 percent respectively. Sensitivity and Specifity of diagnosis of DME was calculated 93 and 100 % for both specialists. Also, the Sensitivity for GPs were 95 and 93 % respectively and the Specifity was estimated about 98 % for both GPs. The diagnosis agreement for GPS in comparison to the face- to -face visits was more than 90 %. Generally, with implementation of this system between 40 to 55 percent of referrals were calculated avoidable.

   Conclusion: Our results as the first ever research done in IRAN showed that the accuracy of teleophthalmology system is high and it has the ability to prevent unnecessary referrals and good for finding treatable patients. The results of this study can be of help to run and expanding such system throughout IRAN and Kerman province to reduce the eye damage by diabetes, decreasing avoidable referrals to the clinics and increasing the availability of specialists visit for people living in the remote and rural area and optimizing using clinical infrastructures for patents in the emergency situations.

   Key words: Telemedicine, Diabetic retinopathy, Teleophthalmology, Design, Evaluation

8. Title: Investigating the satisfaction and recovery rate of patients with stutter using telespeech therapy interventions in Jahrom 2017.
   Student’s name: Maryam Eslami Jahromi. Supervisor(s): Leila Ahmadian. Advisor: Kambiz Bahaadinbeigy.
   Abstract

   Background and Objectives: The shortage of speech therapists and their poor distribution in some parts of the vast countries affect the provision of effective speech therapy services. Investigating the necessary infrastructures for the implementation of telemedicine technology, as well as accepting and using it as facilitator of the delivery of services, is required. The aim of this study was to Investigating the satisfaction and recovery rate of patients with stutter using telespeech therapy interventions in Jahrom.

   Methods: This was a cross-sectional descriptive and analytical study that was carried out in the laboratory department of a university hospital in Ferdows, Iran. This study consisted of three phases. In the first phase patients’ viewpoints and preferences were assessed to receive lab results through the hospitals website and personal email using a questionnaire. In this phases questionnaires were distributed among 200 patients that was calculated using Cronbach`s alpha sampling method. In the second phase, to deliver the test results to patients through the hospital websie a portal was designed. In designing this portal, patients’ viewpoints and priorities in the first phase were considered. In order to respect patient privacy a personalized username and password were assigned to each patient. Also to receive lab results via email patients had to applya username which was the admission number written on his receipt. In the third phase of the study, patients were classified into three groups. The first group received their test results through the hospital website on the date previously had been announced to them when testing. The second group was informed by SMS on the day that their results were ready on the website. This group of patients are informed via SMS only about the time that their lab results is ready and to access the results, they must visit the hospital's website. The third group received the lab results through their personal email. The appointment of patients to study groups, was based on information received from patients in the first questionnaire. Patients' satisfaction were evaluated after receiving lab results through electronic questionnaires.

   Results: The results showed a significant difference in the mean scores of stuttering severity before and after tele-speech therapy (P=0.001). Our findings showed a mean reduction of 13.8% in stuttering scores. There was no significant relationship between demographic variables including age, gender, and education with stuttering severity, the mean of syllables stuttered, and natural speech (p<0.05). The mean and standard deviation of patient satisfaction scores from the applied infrastructures and the telespeech therapy method were 3.15±0.52 and 3.49±0.52, respectively. No significant relationship was found between gender, education level and age with satisfaction (p<0.05). The results of the study showed that the number of speech therapy sessions did not affect the overall satisfaction of patients (p<0.05), but the number of therapeutic sessions had a direct relationship with the satisfaction of the infrastructure used for remote therapy (p<0/05).

   Conclusion: Tele-speech therapy has been effective for the treatment of stuttering patients of any age, gender and educational background, and has improved their speech and decreased stuttering. Given the effectiveness of tele-speech therapy showed by this study, the use of this method can improve patients’ access to speech therapy services in the community, and help them to continue their treatment and adhere to follow-up care plans. The present study showed patients' satisfaction with telespeech therapy. Due to slow internet connection speed in the country, which were raised by most patients as a challenge, planners should invest more to increase bandwidth. This can help health authorities to benefit more from tele-practice method in providing health care especially when the therapist is not available.

   Key words: Skype, Tele-rehabilitation, Patient Satisfaction, Speech Therapy, Stuttering, Videoconferencing.

9. Title: Factors affecting the failure of health information systems in Iran.
   Student’s name: Nadimeh Zakeri Afshar. Supervisor(s): Reza Khajouei. Advisor: Leila Ahmadian, Kambiz Bahaadinbeigy.
   Abstract

   Background and Objectives: The use of information systems in the health sector reduces costs and increases the quality of patients care. Hence, the failure of health information systems can lead to financial costs and even loss of life. This study aimed to investigate the factors affecting the failure of health information systems in Iranian hospitals.

   Methods: This research was a descriptive-analytic study which was conducted in a cross-sectional manner. The research community was hospitals affiliated with type-1 medical universities in Iran. 98 of IT staff of the hospitals with a failed system participated in this study. Data collection tool was a questionnaire consisting of four groups of factors affecting the failure of the health information systems as follows: Human factors, financial factors, managerial and organizational factors, and technical factors. Collected data were then graded based on Likert scale (1-5) and analyzed by Descriptive Statistics, Variance analysis test, Single sample t test and Ratio Test using SPSS software.

   Results: Following results were obtained from the analysis of research data: 98 failed systems were investigated in this study. 53% of failed systems were Hospital Information Systems and the platform of 66% of them (n=64) were databases. 34% of respondents commented that the impact of technical factors on the failure of health information systems were high. Impossibility of integration and exchange with other systems and incomplete software have the greatest impacts on the failure of the health information systems. 59% of respondents Expressed that impact of financial factors on the failure of health information systems were low.

   Conclusion: Overall, the findings showed managerial and organizational factors, technical factors, and human factors are effective on the failure of health information systems. The effect of factors such as human factors, financial factors, managerial and organizational factors and technical factors on the failure of health information systems in Iranian hospitals were compared. This study can help to identify potential factors affecting the failure of the health information systems in hospitals, and successful implementation of new information systems.

   Key words: Health information systems, Barriers, Failure, Success

10. Title: Developing and evaluation of Schizophrenia website and assessing its impact on health knowledge of families of Schizophrenia patients.
    Student’s name: Fatemeh Sadat Tabatabaei. Supervisor(s): Leila Ahmadian. Advisor: Shahrzad Mazhari.
    Abstract

    Background and Objectives: The rapid growth of information technology and the expansion of the Internet across the globe lead to human societies faster access to information. Meanwhile, medical findings have become more prominent due to the importance of application in human life. Both patients and their providers tend to get the latest medical findings with a quick and easy way. One of the chronic diseases that many people encounter with them are mental illnesses, and the most common is schizophrenia. Interaction with patients with schizophrenia is sometimes challenging providers. Caregivers of these patients should have the necessary knowledge about the principles of care for these patients. Acquiring knowledge requires access to credible and cited sources. Today, easy access to the Internet and information technology has created a way to increase knowledge and awareness among protector of schizophrenic patients. This study aimed Developing and evaluating of Schizophrenia website and assessing its impact on health knowledge of families of Schizophrenia patients. in Kerman city in 1395.

    Methods: This study is an applied study which was done by the descriptive-sectional method in Kerman city, in 1395- 1396. Firstly, by a semi-structured questionnaire, the information needs of the families of patients with schizophrenia were identified. Then, considering the patient's information needs, the website was designed using ASP.NET software and was approved by the experts in terms of content. Then, in an experimental study, using the structured questionnaire, health knowledge of protector before and after the implementation of the website was examined. The validity of the used questionnaires in this study was evaluated by three experts and their stability was confirmed by using Cronbach's alpha coefficient with correlation coefficient of 0.8. After website design, user satisfaction was measured, the website was introduced to the families of schizophrenia patients and others, and they were asked to visit the website for a period of 1 month. The satisfaction of families and other visitors from the site was also examined using a questionnaire placed on the website. Data analysis was done by SPSS and Excel soft wares using descriptive statistics (including abundance calculation, percentage, and average) and analytical (including paired-samples T-test).

    Results: Results show that 90% of the subjects have access to the Internet and the most information need of the families of schizophrenic patients were regarding the treatment of patients, general information on the disease and prevention and medication. People have expressed a strong desire to create a website for the purpose of accessing to information about schizophrenia. The findings showed that there is a significant difference between the overall average scores Health knowlege before and after the implementation of the website (p = 0.039), and this average increases after using the web site (54.25) compare to before using it (49.3). In this study, the results of the findings indicated that there was a significant difference between the mean scores of health knowledge in most of the subjects. Meanwhile, the highest average score, after using the website, was related to the score subjects obtained regarding common symptom of schizophrenia (4.15%), disease symptoms (3.1%), minimum time for the effect of medicinal therapy (3.5%), the best way to improve the condition of the patient after medical treatment (2.7%). This website has 13 main menus (introduction, patient empowerment, strategies, illusion control, patient compliance, response to delirium, elusions, marriage with patients with schizophrenia, exercise, nutrition, what you need to know, communication with us, about us and our services). The strategies menu included 3 sub-menus and the menu what you need to know has 4 sub-menus and our services include 3 sub-menus. During the 1 month period, 2500 people visited this website, and 138 people completed the questionnaire. Findings of the present study indicated that 86 percent (119 person) of users indicated ease of use of the website, and 68 person (49 percent) of users also were satisfied with the speed of access to the website. In addition, the majority of respondents, 125 users (90.5%), said that the existence of such a website is beneficial for schizophrenic patients.

    Conclusion: Schizophrenia is considered to be the most severe psychiatric disorder that affects the quality of life of individuals and families. If families of patients become aware of their illness and have the necessary knowledge about the disease including: nutrition and the way to deal with the disease, medication treatment, and etc., they can play an effective role in the treatment and recovery process. Since many users search for their medical information in the website environment and this information affects their decision making, in this regard, it is important to provide accurate, comprehensive, and understandable information. The results of the need-assessment study were used to create a specialized website for schizophrenia (schizo.knrc.kmu.ac.ir). By using this website, information was provided to the families of patients about schizophrenia. Finally, health knowledge was evaluated before and after the implementation of the website. Generally, the findings of this section showed that in most cases the average score of health knowledge had significantly improved. The highest increase of the scores were related to the score subjects obtained in common symptom in schizophrenia, the symptoms of the disease, the minimum duration of medicinal therapy. In this study, the results of user satisfaction from the website showed that users were satisfied with the quality of services provided by the website and found it useful for schizophrenic patients. Also, users had requested the addition of the following sections regarding interaction with patients and patients' families and the introduction of specialists in the field of schizophrenia, news and scientific achievements in this field.

    Key words: Schizophrenia, Evaluation, examining,Health knowlege, Design, Website.

11. Title: Information needs assessment, Information sources, Readiness, Internet use, Pregnant women.
    Student’s name: Soodabeh Kamali. Supervisor(s): Leila Ahmadian. Advisor: Reza Khajouei, Kambiz Bahaadinbeigy.
    Abstract

    Background and Objectives: Care and support of mothers and access to relevant and useful information during pregnancy are very important for families. Although in today's society, electronic systems and the Internet as one of the rapid information sources, play an important role in providing health information and related services, unfortunately, pregnant women to access to required information, use less these information sources. This study was aimed to assess the information needs and readiness of pregnant women having an academic degree to use the Internet for seeking the required health information about pregnancy and childbirth.

    Methods: A descriptive analytical and cross-sectional study was carried out in 2016. The study population consisted of pregnant women having an academic degree who attended antenatal clinics and obstetricians/gynecologists’ offices in Kerman, Iran. A sample of 384 pregnant women was selected using Cochran's sample size. To reduce the sampling error, the sample size was increased to 400 pregnant women. Data were collected by a self-administrated questionnaire, the validity of which was confirmed by four medical informatics experts and an obstetrician/gynecologist, and the reliability was confirmed by Wilcoxon test (P-value= 0.01).

    Results: Most of pregnant women needed information about care of fetus physical and psychological complications after delivery, development and growth of the fetus, pregnancy nutrition and special tests during pregnancy. The least information need was related to consumption of tobacco and alcohol during pregnancy. The mean score of information need during pregnancy and childbirth was 14.05 out of 20. The most common information sources of health information used by pregnant women were physicians, the Internet and family members/friends/colleagues. This study showed pregnant women's readiness to use the Internet to seek required health information about pregnancy and childbirth in terms of infrastructure, affordability and skills was moderate (the mean score of 12.77 out of 20). Also, the results demonstrated that the participants had low anxiety when using the Internet (the mean score of 5.52 out of 20) and more than half of the pregnant women had interest in using the Internet for health-related information during pregnancy.

    Conclusion: Since mothers are responsible for the care of themselves and their babies, they must be taught the items that they need more. Therefore, their information need should be taken into consideration when planning training programs for pregnant women. We recommend to involve mothers actively in determining their training needs and to prioritize their training needs in order to improve the effectiveness of the programs. On the other hand, one of the contributing factors to the successful implementation of Internet applications is readiness to useAttention to education, training and involvement of pregnant women in designing such applications, it seems. Because, readiness assessment before implementation will reduce, the risk of failure of implementation of information and communication technologies.

12. Title: Classification of External Causes of Injuries in Shahid Docter Bahonar Hospital Using International Classification of External Causes of Injuries (ICECI) System.
    Student’s name: Shabnam Padidar. Supervisor(s): Leila Ahmadian. Advisor: Moghadameh Mirzaei, Kambiz Bahaadinbeigy, Reza Khajouei.
    Abstract

    Background and Objectives: Injuries, in all countries of the world, threat peoples’ health and are the most important causes of death and disability. Worldwide, every year more than 5 million people die as a result of injuries caused by accidents. These injuries impose a financial burden onboth community and goverments. Developing and implementing injury prevention program is essential to reduce the adverse effects of these injuries. Any prevention of injury and damage requires access to accurate statistics regarding external causes of injuriesand this can be achieved by using data collected and summarizedthrough international classification systems. The purpose of this study isto classifythe external causes of injuries in ShahidDocterBahonarHospital using international classification of external causes of injuries (ICECI) System.

    Methods: This research is a cross-sectional study using descriptive-analytical method.,Asample of 322 injured individuals who referred to the emergency department of ShahidBahonar Hospital between December 2015 and March 2016 was recruited. To collect the data a six-part form was used. The form includes data about 1) demographic information, 2) current and previous history of diseases, 3) external causes of injuries, 4) how the patient arrives in the hospital, 5) interval timebetween the incident and arrival of the patient to the hospital and 6) the lengthof stay of patient and the outcome of the treatment period. Data were collected at three pointsin time a day, in the morning, evening and at night. To complete the form researcher referred to emergency department of ShahidBahonar Hospital in Kerman and collectthe data. The form was completed by interviewing patients and reviewing their medical records. The collected data coded based on ICECI system, which consists of two parts: core and other section. The datathen analyzed using descriptive and analytic statistics by SPSS software version 19.

    Results: Of the 322 injured patients, 138(43%) referred to the hospital due to an accident. Most injured patients have been injured in public transportation. Injured patients mostly were drivers of land transport vehicles, that were in unintentionally incident. The least mechanism resulted in injury is biting with 5 cases (2%), which has occurred equally, at home and public places, that were unintentionally. Men with 238 cases (73%) were more injured than women. The average length of stay in the hospital was 2 days.Most patients left the hospital with partial improvement.Findings of the study showed that 70% of external causes of injuries were covered by the ICECI system. Of the encoded data by this system, 47% were encoded by the main section of system and 53% by the other sections.

    Conclusion: As the most mechanism resulted in injury was accident, therefore developingcontrol tools and improving urban-road infrastructures, can greatly help to reduce unintentional accidents. Since in this research, some ofthe external causes of injuries couldnot be classified by the ICECI system, therefore the findings of this studycould identify the deficiencies of this coding system, and help its developers to complete and modifythe system in next versions.

    Key words: International Classification of External Causes of Injuries, Causes of Injuries, Hospital, ICECI

13. Title: Need assessment of deaf and hearing-impaired people and to develop and implement an interactive, educational website based on their information needs and to evaluate its user satisfaction.
    Student’s name: Zahra Amir Teimoori.Supervisor(s): Kambiz Bahaadinbeigy. Advisor: Reza Khajouei, Moghadameh Mirzaei.
    Abstract

    Background and Objectives: Hearing loss is recognized as one of the most common disabilities in the world. Deaf and hearing impaired are disabled people who، due to obstruction in their hearing channel، have to gain all their experiences via other senses، including the visual sense. The deaf and their families need to gain information about issues such as communication options، technology for hearing impairment، rehabilitation، etc. Therefore، the use of telecommunication technologies such as websites can be beneficial to the deaf in improving communication and information gains، and internet can serve the deaf as a useful source of information and as a means of facilitating communications as it removes audial barriers. The aims of this study were to investigate the information needs of deaf and hearing-impaired people and to develop and implement an interactive، educational website based on their information needs and to evaluate its user satisfaction.

    Methods: This cross-sectional study was conducted in three phases in Kerman، Iran، during 2016-2017. In the first phase، a descriptive-analytical study was coducted. Data were collected using a semi-structured questionnaire the validity of which was confirmed by experts and its reliability was approved by Kappa test coefficient. Data were analyzed using descriptive and analytical statistics by SPSS and R and excell softwares. In the second phase، a website was designed using Joomla application by employing the results of the first phase. After approval of the user interface of the website by experts، the content of the website was determined. Adobe Premiere software was used to provide educational clips. In the third phase، a descriptive cross-sectional study was conducted. In this phase، the website was introduced to the deaf، their parents and their teachers and they were asked to visit and use the website during a period of 2 months. In order to measure user satisfaction، an electronic questionnaire was designed and was made available through the developed website. Data were analyzed using SPSS and Excel softwares.

    Results: The mostly reported needs of the deaf people were related to their personal health (82/6%)،Communication with hearing loss specialists (85/9%)، deafness and hearning impairment (39/1%)، Cochlear implant (38%) and ear illnesses and disorders(31/5%). Most of the deaf used sign language and hearing aids، and more than half of them had access to computer at home and had the ability to use it and the Internet. There was a significant relationship between the age of the people who used sign language and hearing aids with their information needs.The developed web site had six main menus. Overall، 642 visitors visited the website in a period of two months and 86 questionnaires were completed. The majority (98.8%) reported that such a website is very useful for deaf people. Visitors were mostly satisfied with the educational clips. 66.3% of the users evaluated the website as "excellent"، 27.9% as "good" and 5/8% as "average" (mean score =0/61 ±4/6).

    Conclusion: This study highlighted the most important information needs of those with deafness and their parents. These information were used to develop a specialized website (www.deafpeople.ir) to provide comprehensive and quality information in relationship with the educational needs of the deaf. In this part of the study، designing this educational and interactive web site for the deaf in their native language which is also very much understandable، besides providing the necessary training to the deaf، can also serve as a tool to educate their parents and giving them the skills to interact with their children. The results of the third phase of the study showed that the users believed that the developed website was effective and could meet the information needs of the deaf.

    Key words: deaf، information needs، evaluation، website، internet.

14. Title: A Study on the completeness of information communicated from hospital information systems to the national Electronic Health Record (SEPAS) and evaluation of its minimum data set in the first quarter of 2015.
    Student’s name: Reza Abbasi. Supervisor(s): Reza khajouei. Advisor: Moghadameh Mirzaei.
    Abstract

    Background and Objectives: Failure in communication of information and partial (incomplete) communication of information between hospital information systems and the Iranian electronic health record (SEPAS) reduces the quality of information. Correctly, timely and accessible health care information has a critical role in planning for improvement, progress and support for health services. Monitoring and improving the quality and quantity of this information helps to understand the status of collected information in the electronic health record. In Iran, the low quality of information of some hospital records is a barrier for sending them from hospital information systems to Iran’s electronic health record namely SEPAS. Due to the lack of integrity in the transmission of information from health information systems across the country, to the SEPAS, it is necessary to determine the standard and essential data for this system. The purpose of this study was to identify the errors, reasons for communication information, and completeness of the not send records from the hospital information systems(HIS) of Kerman University of Medical Sciences, and also design and evaluation of a minimum data set for communicate information to SEPAS.

    Methods: This descriptive-analytical study was conducted in the first three months of 2015 in three phases. In the first phase, using a researcher-made checklist, SEPAS errors and reasons of not communicating information of 882 medical records were identified.. In the second phase, a checklist is designed based on the guideline of exchanging information with SEPAS (4.42 ver) that is available in the ministry of health website. In this phase, the rate of completeness of information of 882 records from the HIS to the SEPAS was investigated. In the third phase, using a researcher-made questionnaire, the perspectives of twenty-seven faculty members of medical informatics and health information management, as well as, hospital directors, managers, and IT and HIM administrators of 6 affiliated hospitals with Kerman University of Medical Sciences was investigated in terms of evaluation and designing the minimum data set of SEPAS. Content validity of the questionnaire was confirmed by experts. The reliability of the questionnaire was determined by Cronbach's alpha (α =0.95). Data analysis was performed using SPSS.22 and descriptive and analytic statistical tests such as Fisher and Chi-square to investigate the relationship of errors and the information completeness with type of hospitals and hospital information systems.

    Results: By reviewing 882 hospital records, 1256 errors from 41 different types of errors were identified and classified into 4 categories. Financial-administrative errors (61%), national code-related errors (23%), clinical errors (9%) and other errors (7%) were all the errors in SEPAS, respectively. The most important errors causing failure to send information to SEPAS were national code and clinical codes errors (32%), and unrecorded patients' insurance numbers (18%). In total, errors were divided into two categories: system errors (65%) and human errors (35%). Also, the relationship between the errors in SEPAS and the three examined hospital information systems was significant (P<0.0001).Also, the completeness of the demographic and clinical information of 882 hospital records that not communicate to SEPAS was 54%. The recording of some information elements was accompanied by typos (n=13) or recording of less and more characters by users (n=32). In total, about 50% (253) of the information elements were filled with zero number. The results of the third phase showed that participants agreed to obligatory send the following 14 data elements, which are currently optional. These data elements include patient’s name, surname, father’s name, nationality, cell number, job, address, residence place, zip code, passport number, diagnosis date, death time, death place and the unit of hospital where patient died. Participants also demanded 31 data elements as compulsory items to be added to demographic and clinical minimum data sets of SEPAS.

    Conclusion: This study identified the errors in exchanging information from hospitals to the SEPAS, and divided them into system-related errors and human errors and their subgroups. The results showed that different hospitals using the same hospital information systems may have different types and rates of errors when exchanging information between systems. Also, the quality of information is not only related to information systems, but also the effort and precision of users while entering data is also very effective. Determining the same minimum data set, using methods such as user training, designing systems to provide proper feedback when entering incorrect data, and requiring the completion of information elements during the admission, treatment and the clearance of patients can greatly help to improve the level of completeness of information in the information systems. MDSs designed in this study were based on the result of the collective wisdom of related professionals, such as health information management specialists, physicians and other individuals who are directly and indirectly associated with patients and their information. It seems that these data sets can improve data collection, quality and efficiency of information and also it can facilitate the patients care processes.

    Key words: Electronic health record, SEPAS, Errors of SEPAS, Information exchange, Completeness, Minimum data set.

15. Title: Designing a dataset for hospital deductions and determining the effect of its distribution on deductions rates in hospitals contracting with health insurance of Sarcheshmeh Copper Complex.
    Student’s name: Nasrollah Maghsoodi Gooshki. Supervisor(s): . Advisor: Moghadameh Mirzaei, Kambiz Bahaadinbeigy, Leila Ahmadian.
    Abstract

    Background and Objectives: Effectivemanagement of hospitals involves activities such as monitoring the flow of medication, controlling treatment, and issuing bills for patient treatment. A major hidden challenge between insurance companies and hospitals is the way medical care expenses of insured patients are reimbursed. In some cases, the insurance deductions lead to losing revenues by hospitals. This objective of this study is twofold: 1) identifyingfactors that result in deductionsbased on quantitative and qualitative evaluations of inpatient bills, and 2) examining the effect of delivering deduction data set to hospitals, on reducing these deductions.

    Methods: This interventional study was conducted in 2015 and 2016 on hospital bills of patients hospitalized over 6 hours in 28 hospital and Limited surgical center having health insurancecontracts withSarcheshmeh Copper Complex. This hospitals were divided into two intervention and controlgroups in a three month period. Data were collected from patients bills using a checklist. To identify the qualitative and quantitative factors resulting in deductions, the researchersconducted a qualitative and quantitative evaluation of hospital bills based on relativevalue unitsystemsof health services, annual tariffs approved by the council of ministers andspecificandgeneral guideline for investigating medical documentation. A listof quantitative and qualitative factors leading to deductionswith their monetaryamount per hospital was sent to each intervention hospital. After three months from the delivery of deductions to the interventionhospitals groups,the researchersagain assessed the amount of deductions using a quantitative and qualitative evaluationover a three-month period. Collected data of both before and after of intervention were analyzed using SPSS.

    Results: The results ofcomparingthe amount of deducitonsbefore and after intervention of both groups of hospitals showed that after delivery of hospital deductions data set to intervention hospitals,the amount of deductions in surgical and anesthetic services sections (p<0.03), medications and supplies (p<0.04), and other medical procedures (p<0.05) was reduced. The results of comparing the difference in the amount of deduction reductions between two intervention and control hospitals showed that the rate of deductions in intervention hospitals was reduced "41826349" Rials compared to control hospitals.

    Conclusion: According to the findings of this study it can be concluded thatdeliveringonly deduction data sets to hospitals has little effect on amount of deductions. However, according to the results of other studies (24, 25, 26), a combination of delivering the deduction data sets resulted from quantitative and qualitative evaluation, general and specific guideline for investigating medical records, training for corrective actions, supervision of insurance experts,using alerting tools, and software application to control deductions and other educational actionscan play a vital role in reducing deductions and result in increasing revenuesfor hospitals.

    Key words: health insurance, inpatient, hospital deductions, quantitative and qualitative evaluation.

16. Title: Use of GIS to show the distribution of maternal mortality in Kerman in 2015.
    Student’s name: Fatemeh Salehei. Supervisor(s): Leila Ahmadian. Advisor: Kambiz Bahaadinbeigy.
    Abstract

    Background and Objectives: Improving maternal health is globally introduced as an important health priority. This point indicates the need to strengthen the delivery of health services to provide adequate care at any time and place that women need. Therefore, identification of places that require care delivery can help to properly distribute health services. Geographic Information System(GIS) is a modern technology that helps to make sound policy and decisions to promote patients’ health. The purpose of this study was to use GIS to show the distribution of maternal mortality in Kerman in 2015.

    Methods: First we systematically searched all English and Persian papers that designed GISs in the field of maternal health care. Papers indexed in PubMed,Scopus and Science direct databases until October 2015 were included. Beside variables visualized on GISs, all other investigated variables were extracted from the included papers. To identify the high priority areas for maternal care and services, first articles, books, forms, standards and guidelines were explored in order to extract indicators and sub indicators relevant to the maternal health. In the next step a questionnaire was designed and data elements were entered into the questionnaire. Questionnaire was designed based on AHP (Analytic Hierarchy Process) method. In order for the aim of this study to be fulfilled, the indicators should be weights of importance. One of the best and most common method for this goal is AHP method. The AHP is a multi-criteria decision making approach that uses a multi-level hierarchical structure of objectives, criteria, sub criteria, and alternatives. The data are derived by using a set of pair wise comparisons. These comparisons are used to obtain the weights of importance of the decision criteria, and the relative performance measures of the alternatives in terms of each individual decision criterion. The questionnaires were completed by 15 experts in various field of health care who were related to maternal health. Fifteen individuals were recruited in this study 12 of whom were experts in health information technology, midwife, nurse, geography, expert in health family and health information management (a total of 12 people, consisting of two experts in each field) and three of whom were general practitioners and obstetricians. The validity and reliability of the questionnaire were confirmed by three medical informatics experts and test-retest method, respectively. Data were analyzed by Expert Choice software in order to specify the weight and importance of each indicator. The information was then added to Geographic Information System (GIS) to analyze and create the related maps.

    Results: In this study, 40 out of 5458 retrieved articles were selected as relevant and reviewed by the authors. Most studies visualized variables “distance to health facilities” and “travel time to them” (n=33) on GISs. Women’s access to hospitals plays an important role in identifying high priority areas which need maternal care and services. More than half of the mothers in Kerman have a moderate level of access to maternal care services. There is an association between facilities that are provided for pregnant women and the existence of healthcare centers. Moreover, there is a negative correlation between maternal death and the number of facilities provided for medical care and services for pregnant women.

    Conclusion: The application of GIS provides us with the capability to identify high priority areas which need maternal care. According to current population policies in Iran and the probable increase in the fertility rate, it is wise to plan proper schedules to improve health care services for pregnant women in Kerman.

    Key words: Maternal health services, Geographic information system, Iran

17. Title: Usability Evaluation of user interface of Picture Archiving and Communication Systems (PACSs) and the Key factors influencing the selection of this system.
    Student’s name: Misagh Zahiri Esfahani. Supervisor(s): Reza Khajouei. Advisor: Kambiz Bahaadinbeigy, Leila Ahmadian.
    Abstract

    Background and Objectives: PACS is an evolving healthcare technology that is used for storage, retrieval, management, distribution and presentation of medical images. In recent years, some health care centers have been installing PACS in Iran, but this system has not been used properly until now. One of the problems facing the implementation of this system is inability to select and purchase the PACS. In order to decide and select an appropriate PACS, the various capabilities of the software should be investigated. In the meantime, the usability is one of the most significant factors. However, since usability is ignored, users would have some problems with the system. Kerman University of Medical Sciences has 11 educational centers. At the time of this study, this University was in the process of selecting and purchasing a PACS. Three demonstrations PACS, named as Infinite, Medal and Marco were provisionally installed in three different medical centers for the purpose of comparison and evaluation. The purpose of this study is to compare the usability of 3 PACS and identify factors influencing the PACS selection.

    Methods: This is a composite study is and was done in three separate sections. In the first section, we systematically searched all English papers in PubMed, Scopus and ScienceDirect databases on evaluation studies of PACS. Data were extracted from relevant articles based on the checklist to determine the types of evaluations and their outcomes. The second section was done by evaluating the usability of three PACS, using the think aloud (TA) method and questionnaire. Five usability characteristics including efficiency, effectiveness, satisfaction, error, and memorability were compared in 3 PACS. The third section was a study about factors influencing the selection of PACS. It was done by observing the compliance rate of the selected system with usability criteria and a semi-structured interview with 10 expert decision makers in PACS purchasing, including radiologists, IT specialists and medical equipment experts. Data analysis was carried out using the contractual content approach of Lundman and Grennym.

    Results: he survey of 74 studies showed that 27 articles were done in the USA. Among various evaluation methods, the evaluation of time with %28 and quality of health services with %24 were the most types of evaluation. The most evaluations were conducted in educational hospitals (n = 48) and on integrated PACS (n = 59). The collected data in second section showed that tasks were done easier and in less time in the PACS A and users were more satisfied with doing their tasks in this PACS. Based on the participants' performance on assigned tasks, we investigated the usability features of each PACS. In two variables, including mouse click, keystroke and errors test results were not significant (p>0.05). In other variables (efficiency, effectiveness, satisfaction characteristics), there was a significant difference between PACS (p<0.05). In the third section of this study, analyses were achieved 11 sub category and 2 categories. All participants believed that usability was the most important factor in the selection of this system. Factors influencing the PACS selection were divided into specific and general factors. Specific factors include 6 sub categories: "Usability", "learning from the experiences of leading centers in PACS implementation". "Interoperability with other PACS (integration)", "Specialized training and research capabilities", "Compatible hardware", "Decision maker group". Also, general factors influencing the PACS purchasing include 5 sub categories: "Price", "Domestic or froing software", "Presentation of PACS vendors", "Quality", "Management and systematic".

    Conclusion: Results of this study showed that usability test plays a more important role in selecting a PACS in a developing country and it can be used as one of the critical criteria in PACS selection. The results of usability test can be helpful (applied) for institutions in PACS selection and system developers in order to understand the features of a user-friendly PACS

    Key words: PACS, Usability, Software, Selection, Picture archiving and communication system

18. Title: Designing a Minimum Data Set for the hospital statistics system in order to standardize the exchange of statistical data with higher levels in Iran.
    Student’s name: Narges Baniasadi. Supervisor(s): Reza Khajouei. Advisor: Kambiz Bahaadinbeigy, Maryam okhowati.
    Abstract

    Background and Objectives: Minimum data set (MDS) is a standard tool for data collection and registration as well as a foundation for health information systems. Nowadays the lack of a minimum data set for the registration and management of statistics in hospital information management systems and different ways of data collection make an inconsistency between the indexes of health statistics in different health centers and hospital .Therefore the structured reporting has important role in development health information systems like electronic health records. The results of this study can make a standard tool to record and collect required data and statistical indicators for hospital information system in the future as well as preparation of a standard framework statistical to use in statistical softwares.

    Methods: This research was a descriptive study in 2015 which was conducted through three stages. 1- Determination of set of data elements associated with the hospital in national and international level 2- Extraction, summarization and classification of data elements and drafting the required minimum data set 3- The draft assessment using the Delphi technique and design the final version was performed. In this study sources identification of information and data collection related to the field of hospital statistics from Kerman University of Medical Science, hospital centers, other Medical science universities in the country and the official website of the World Health Organization (WHO) at the international level as well as information derived from communication and correspondence with experts in the country about purpose of study were discussed. The finding analysis performed based on descriptive statistics, such as relative and absolute frequency.

    Results: The first draft the minimum data set of hospital information systems was suggested in three categories includes population, resource utilization and evaluation of the quality of care. In the first stage of the Delphi technique, 23 participation experts (including technology and health information manager, medical informatics and medical staffs’ statistics of university of type 1) commented on 120 elements of the studied cases in the draft of minimum data set of hospital systems and achieved to consensus of 75%. In the second stage, from the remaining of 16 elements (11.8%), 9 cases recognized as necessary and 7 cases were eliminated as unnecessary. The minimum data set of hospital systems, including data elements in three main categories of population, exploitation of resources and the evaluation of the quality of care was approved.

    Conclusion: The first step in the Hospital Information Management (HIS) is hospital statistical data collection. This study showed there is not a national minimum data set about hospital statistics that are necessary and required for health care providers. The first and most important step towards standardization of data collection at the national level, is creation of a minimum data set of statistical hospital data. Based on the consensus of experts about the necessity of the suggested data elements in the minimum data set, application of this recommended MDS as the bases for statistical data collection in Iran was recommended.

    Key words: Minimum data set , Data elements , Statistic, Hospital

19. Title: Development and implementation of an interactive website for pediatric asthma and evaluation of its user satisfaction.
    Student’s name: Rezvan Ansari. Supervisor(s): Leila Ahmadian, Nasrin Bazargan Harandi
    Abstract

    Background and Objectives: Knowledge acquisition by parents of children with asthma plays an important role in the treatment of children disease. Thus, it is important to understand parents’ information needs and provide this information through available methods such as a website. The aims of this study were to evaluate the information needs of parents of childeren with astham, and to developand implement an interactive website for pediatric asthma and finally to evaluae its user satisfaction.

    Methods: This cross-sectional study was conducted in three phases in Kerman, Iran, in 2015-2016. In the first phase a descriptive-analytical study was coducted . Data were collected using a semi-structured questionnaire that its validity was confirmed by experts and its reliability was approved by test-retest. Data were analyzed using descriptive and analytical statistics by SPSS and R softwares. In the second phase, the website was designed using Joomla application by applying the results of the first phase. After approval of the user interface of the website by experts, the content of the website was determined. In the third phase a descriptive cross-sectional study was conducted. In this phase, the website was introduced to the parents of children with asthma and they were asked to visit and use the website during a period of 3 months. In order to measure user satisfaction, an electronic questionnaire was designed and was made available through the developed website. Data were analyzed using SPSS and Excel softwares.

    Results: The participants demanded information concerning asthma nutrition, prevention, treatment, medications as well as general information and information about etiology of the disease respectively. The results showed that the fathers use the Internet significantly more than the mothers. There was a statistically significant relationship between participants’ educational level and the type of resources they use to obtain information. The developed web site has five main menus. Overall 1010 visitors visited the website and of these, 150 completed the questionnaire. All of them reported that in general the entire website was informative and useful. Of the participants 98% reported that the medication section, 93 % the management and treatment section and 90 % the nutrition section more useful than the other sections of the website. About 83.3% of the users reported that ease of use of the website was "quite easy". Users of the website had high satisfaction with the information content of the website. The results indicated that overall the users were satisfied with the website (mean score = 4.93 ± STD 0.262).

    Conclusion: This study highlighted the most important information needs of parents of children with asthma. These information were used to develop a specialized website (www.asthmanet.ir) to provide comprehensive and quality information in association with pediatric asthma. In this study, by creating an interactive website, we provided an educational tool for parents and help them to learn the essential points about treatment and prevention of disease progression. The users believed that the developed website was effective and could meet the information needs of parents of children with asthma.

    Key words: Pediatric Asthma, Information Needs, The Internet, Website

20. Title: Estimation of aviodable referrals in terms of using videoconference for telepsychiatry consultation.
    Student’s name: Mitra Soleimani.Supervisor(s): Kambiz Bahaadinbeigy. Advisor: Reza Khajouei.
    Abstract

    Background and Objectives: Telemedicine refers providing health and education services when there is a distance between the service provider and recipient. One of the most important telemedicine fields in the world is the telepsychiatry. Since this is a new field in Iran, this research aims to have a practical study for the first time. In case of success, the solutions can be provided for development of telepsychiatry and providing daily services, and due to the high prevalence of neurological disorders, it will be a great help to the society.

    Methods: This research project is composed of two parts:The first part is a systematic review in the application of telepsychiatry in the developing countries with a purpose to assess the status of the specialized field of telepsychiatry in the developing countries. The relevant articles were extracted from PubMed database based on a check list with measured validity and reliability. In the second part, with a telepsychiatry project in Kerman, in addition to have a consent survey on the doctors and patients, the percentage of personal references and intercity travels that are avoided due to the video conferencing system for telepsychiatry will be investigated. Hence, using the questionnaires that were already designed, the consent of psychiatrists from the telepsychiatry and prevention from the personal references are measured, and the patients were also asked for their opinion on telepsychiatry using another designed questionnaire.

    Results: The results of 13 studies showed that 6 articles from India, 2 articles from South Africa, and 1 article from the developing countries such as Turkey, Somalia, Poland, Brazil and Pakistan were extracted. The results of the first part show that due to the benefits of telemedicine in the developing countries, these systems are not popular in the field of telepsychiatry. The results of the second part show that the patients are highly satisfied from the telepsychiatry and prefer to use the video conferencing system to follow-up the disease. The results of the consent questionnaire also showed that a high percentage of patients don’t need the personal reference and the telepsychiatry is sufficient for the patients.

    Conclusion: The results of this study represented that the telepsychiatry system can be an appropriate solution to replace the face-to-face encounter of the patients and doctors in the remote areas with little access to the facilities. This method resulted in the consent of patients to a favorable level.

    Key words: telepsychiatry, psychiatry, telemental health, Telemedicine, satisfaction, video conferenc, teleconsultation

21. Title: Development, implementation and evaluation of an online laboratory results delivery system in Ferdows hospital in 2015.
    Student’s name: Azam Sabahi.Supervisor(s): Leila Ahmadian. Advisors: Reza Khajouei, Moghadameh Mirzaei
    Abstract

    Background and Objectives: The application of different technology to deliver laboratory results is increasing. However studies have shown that there is a lack of consensus on best practices in direct patient notification of abnormal results. In this study, the results of laboratory tests of patients were provided through personalized email and hospital website. This study examined patients’ satisfaction, viewpoints and priorities before and after receiving their results.

    Methods: This was a cross-sectional descriptive and analytical study that was carried out in the laboratory department of a university hospital in Ferdows, Iran. This study consisted of three phases. In the first phase patients’ viewpoints and preferences were assessed to receive lab results through the hospitals website and personal email using a questionnaire. In this phases questionnaires were distributed among 200 patients that was calculated using Cronbach`s alpha sampling method. In the second phase, to deliver the test results to patients through the hospital websie a portal was designed. In designing this portal, patients’ viewpoints and priorities in the first phase were considered. In order to respect patient privacy a personalized username and password were assigned to each patient. Also to receive lab results via email patients had to applya username which was the admission number written on his receipt. In the third phase of the study, patients were classified into three groups. The first group received their test results through the hospital website on the date previously had been announced to them when testing. The second group was informed by SMS on the day that their results were ready on the website. This group of patients are informed via SMS only about the time that their lab results is ready and to access the results, they must visit the hospital's website. The third group received the lab results through their personal email. The appointment of patients to study groups, was based on information received from patients in the first questionnaire. Patients' satisfaction were evaluated after receiving lab results through electronic questionnaires.

    Results: The email group in compare with the group website considered availability of electronics results the main reason for receiving the laboratory results electronically (n=65, 61.9%, n=42, 44.2%, p = 0.0354) . In compare with the group website, more people in the group e-mail announced that they have high confidence to preserve the confidentiality of received information electronically (n=62, 59%, n=44, 46.3 %, p=0.03). Also the number of people who reported high satisfaction of receiving lab result were significantly higher in group email (n = 83, 79%, n=53, 55.8%, p=0.045). After receiving the results electronically, in comparison with the website group , more people in the group e-mail reported they are demanding to receive normal (n=74,70.5%, n=55,57.9%) and abnormal (n=51,48.6%, n=39,41.1%) results electronically (p<0.0001).

    Conclusion: The results of this study showed that patients prefered to receive lab results via e-mail and they were more satisfied with this method. It seems that the reason for this choice is related to recognition, awareness and ease of access. On the other hand pay attention to the viewpoints and priorities of patients to receive lab results will be lead to more satisfaction and trust.

    Key words: Laboratory test results, Patient portal, Patient preference, E -mail, Website, system evaluation, online services

22. Title: Investigating the accuracy of a Persian Speech recognition system by physicians in real health care service environment.
    Student’s name: Zahra Karbasi.Supervisor(s): Kambiz Bahaadinbeigy. Advisor: Leila Ahmadian, Reza Khajouei, Moghadameh Mirzaei
    Abstract

    Background and Objectives: speech-recognition software is defined as a way of promoting the potential for data entry and data entry process. Speech recognition promises to reduce information entry costs. This study was conducted to investigating the accuracy of a Persian Speech recognition system by physicians in real health care service environment.

    Methods: In the first section a systematic review of the literature was conducted in August 2015 by searching PubMed. Also, we performed a manual search of the published references in the domain of speech recognition technology (SRT). The literature that only in connection with use of Speech Recognition Systems by Physician in Health Care were examined. Data were extracted from these studies based on the following items: country, type of Speech Recognition Software, Language, Sample size, setting in using systems, cost effectiveness, accuracy of the systems and satisfaction evaluation of participants. Of 1077 articles 27 articles met the inclusion criteria. In the second section the professional version of NEVISA software was purchased and installed on computer of specialists in teaching hospitals in Kerman, the sample size was 15 physicians and the speech recognition software was used in various status. In the third section after implementing the software by physicians in hospitals, questionnaire surveys were distributed between physicians.

    Results: The results showed that 27 articles have been done in America. Forty-four percent of the papers used Dragon software . accuracy in six article was more than 90%. The accuracy of speech-to-text systems in our study was72 percent and understandable concept was 64.5 percent.

    Conclusion: Based on our study results, speech recognition systems in the health sector can be defined as a new method of data entry for the physician. This technology has numerous advantages and limitations. Software Nvisa as the persian software in Iran can be promoted as a method of data entry.

    Key words: Speech recognition software, Voice recognition system, Physicians, Human transcriptions

23. Title: Need assessment, implementation and evaluation of a telepathology system in Kerman province.
    Student’s name: Sadrieh hajesmaeil Gohari.Supervisor(s): Kambiz Bahaadinbeigy. Advisor: Leila Ahmadian, Reza Khajouei.
    Abstract
24. Title:
    Student’s name:
25. Title:
    Student’s name:
26. Title:
    Student’s name:

1. Background and Objectives: Telepathology is one of the subspecialties of telemedicine that is performed in three methods: store and forward, real time and virtual. Due to the importance of telepathology diagnosis for the lives of patients and misdiagnosis in this area could lead to wrong decisions and change the course of treatment, the use of telepathology system for advice can help to make better decisions for the correct diagnosis. Considering the above mentioned values, in this study, researches in the field of telepathology in the world, need assessment of pathologists and implementation and evaluation of telepathology system in the Kerman province have been discussed.

   Methods: This study was done in three separated sections. In the first section, the PubMed database was searched for the systematic review study and the data were extracted from relevant articles based on the checklist that its validity and reliability had been confirmed. In the second section, the pathologists’ opinion about their needs regarding getting advice from more experienced physicians was asked based on the pre-designed questionnaire that its validity had been established. In the third section, a pathologist, faculty member of the Kerman University of Medical Sciences, has diagnosed 80 slides once by viewing original slides and then by viewing taken photos and he has recorded his diagnosis in the checklist that its validity and reliability was measured. Final the accuracy of telepathology system in comparison to conventional method as golden standard was measured.

   Results: The results of 71 related articles showed that 25 studies in America, 52 studies in the national level and 59 studies on slide had been conducted. In 37 studies the specific anatomical part had been examined. The Nikon camera has mostly used to take photos of the slides. In 39 studies, an online method had been used to send images and videos and static telepathology method had been used in most studies. In the most studies, telepathology had been shown as an accurate and reliable method for training and consultation, in 37 studies the cost of telepathology system had been considered but only in 9 studies, satisfaction of those who had used telepathology system was measured and in 43 studies the telepathology project had been conducted between pathologists. In the second part of the study, the collected data showed that articular and bone tissues, soft tissue and lymphoid system are the three anatomical parts that need more consultation respectively. In terms of pathologist specialty for consultation, soft tissue, articular and bone and lymphoid system are the top three specialty areas that consultant pathologist should be expert in. In the third section, 82 pathology slides were diagnosed and the original diagnosis compared with the diagnosis based on the photo and final the diagnostic accuracy of 86.5% obtained for the telepathology system.

   Conclusion: The result of this study showed that static telepathology due to its high diagnostic accuracy could be used widely in Iran considering priorities about anatomical parts such as articular and bone tissues, soft tissue and lymphoid system. But it should be noted that successful implementation of telepathology system depends on a variety issues such as meeting standards in this field, legal, ethical, financial and security issues, satisfaction of the participants, training technicians and giving appropriate clinical information.

   Key words: Telepathology, Systematic review, Need assessment, Pathologist, diagnostic accuracy