THE IMPACT OF HOSPITAL INFORMATION SYSTEM ON THE WORKING PROCESS OF IMAM JA’FAR SADIQ HOSPITAL, ALBORZ PROVINCE-2016
Shaghayegh Vahdat¹, Somayeh Hessam¹, Jafar Dadashi²

¹Department of Health Services Administration, South Tehran branch, Islamic Azad University, Tehran, Iran

²Department of Healthcare Management, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran

ABSTRACT

This research has been done on the impact of the hospital information system on the staffing of Imam Ja’far Sadiq Hospital in Alborz in 2016. The research method is applied and in terms of data collection method, descriptive-survey method. The statistical population consisted of all employees of contractual, design and contract personnel working in Imam Jafar Sadiq Hospital. In this study, 384 people were selected using Cochran's formula, which were selected by available sampling method. The validity of the researcher-made questionnaire and their reliability were confirmed by Cronbach's alpha with a coefficient of above 0.7. In the descriptive statistics section, mean, standard deviation, frequency and percentage of frequency were used. In the inferential statistics, the inclination and elongation were used to determine the normality of the data. The results of one-sample T-test and Friedman indicate that the hospital information system improves the work process of the staff members of Imam Jafar Sadiq Hospital. Also, the hospital information system has the greatest impact on hospital support and administration and has had the least impact on hospital performance. It should be noted that the results are consistent with most studies performed.

Key words: Hospital Information System, Imam Ja’far Sadiq Hospital, working Process, Staffing.

INTRODUCTION

Hospitals as one of the most important social organizations have a major role to play in improving the health status of the country and providing health care services that must receive the correct medical information for their efficient administration and to provide educational, research and The development of
medical and paramedical sciences, improving the quality of treatment, optimizing the managerial aspects of health care centers, reducing the costs of monitoring
centers, classifying and deducing information so that information can be provided to all decision-makers in an appropriate and appropriate manner. Hospitals,
especially their principals and managers. Therefore, the performance of a complex organization such as a hospital requires access to information that is now collected by the hospital information system¹². Information provided by the system Audit activities: such as scheduling and scheduling, a list of actions to be undertaken in the near future on Hospital Information (HIS) generally includes:

• Workload statistics: such as admission, bed occupancy, and number of surgeries and length of stay.
• Tasks and actions in special cases.

3. The status of employed personnel: such as the load or volume of work of the personnel employed their competence and suitability, patient satisfaction.
4. Financial performance: income and expenses, the amount of liquidity available, actual distribution of funds.

The system is also designed to automate hospital affairs, such as reporting test results, entering physician orders, prescribing drugs, controlling drug stores, central warehouses, nutrition units, and so on. Hospitalized Hospital Software (HIS) is an alternative to manually roaming in the hospital.

The system mechanizes hospital activities from admission to patient clearance, effective communication between departments, as well as faster and more accurate extraction of statistical and managerial reports. The amount of information that is
produced in hospitals and transferred from one part to another is worth attention. Managing this heterogeneous information is a complex task. Therefore, information and communication technology can be very useful and effective in this
regard¹². On the other hand, in hospitals, the source of all management activities, especially in health care, having information comprehensive, relevant and timely. In the health sector, the use of efficient information systems to increase the efficiency, effectiveness and quality of services as well as customer satisfaction is indispensable.
A study on the impact of information systems on employees' work processes has resulted in a variety of outcomes, so that some studies have assessed the changes in the pattern of work resulting from the implementation of an information system, but most studies on changes in the time of documentation have focused. Poissant et al. examined the impact of electronic records of clinical records on the time of documentation of nurses and doctors, and reported that reducing the time of documentation is a deceptive and misleading goal¹¹. Study results in order to gain a deeper understanding of the experiences of nurses and midwives in the use of the clinical information system, nurses and midwives with good clinical information systems showed great tendency toward using this system. On the contrary, there were people who had experienced disparities and failures in the use of clinical information systems quoted by Khawi et al⁹. In Italy, found that 60 percent of nurses were beneficial in assessing the acceptance of doctors and nurses from the hospital information system. The system was
comfortable and 44 percent comfortable and easy to use. 88% of nurses were satisfied with increasing the efficiency of daily activities by the hospital
information system. The results of a study done in American automated hospitals showed that management information, financial and clinical
information systems in all hospitals have led to cost reductions⁴. The results of a study conducted in educational hospitals in Mashhad
showed that 53.2% of the staff were satisfied with the quality of the information system of the hospital information system (Kimiafar et al.)⁸. In Iran, hospital information systems are at an early stage, and despite the significant advances made in recent years, due to changes, more and more financial and technical investment is needed to meet the expectations and needs of organizations and their users. Therefore, in this research, the researcher is trying to assess the impact of the hospital information system on the staffing of Imam Jafar Sadiq Hospital staff. However, the hospital information management system is a set of related components that should provide clinical, managerial, and technical information in
order to support planning, decision making, coordination and control of hospital services, collecting, processing, storing and Logical considerations of society have made demand for quality services a major goal for any hospital². In order to respond to such a need for modernization in the community and medical spheres of the country, hospital information systems need to integrate and provide basic goals such as improving the quality of data, reducing the exchange time, increasing the level of satisfaction, and increasing the quality of services and, finally, reducing costs before trend^{13, 16}. Although the most basic goal of information systems in the health sector is helping management to achieve its ultimate goal of promoting community health, but increasing the accuracy and ease and speed of access to clinical data in the field of treatment in hospital information systems is of particular importance¹⁵. Therefore, comprehensive hospital information system, while providing easy access to data and information, should be effective in realizing the desired outcomes and organizational outputs such as performance and process. On the other hand, considering the importance of performance and process in public hospitals of the country, and the increasing use of hospital information systems, on the other hand, this study evaluated the impact of hospital information system as a modern decision support tool in complex organizations such as the hospital The most important output of the organization is the performance and process of work. Therefore, the researcher in this article is to assess the impact of the hospital information system on the staffing of the employees of Imam Jafar Sadiq Hospital. In order to achieve this goal, the following questions have been asked:

• How does the establishment of a hospital information system affect patients' satisfaction?
• How is the establishment of a hospital information system on hospital nursing services?
• How does the establishment of the hospital information system affect hospital support and office affairs?
• How does the establishment of hospital information system affect access to medical information in patients?
• How does the establishment of hospital information system affect the status of information exchange between hospital units?
• How does the establishment of a hospital information system affect hospital financial performance?
  

METHODOLOGY

The present research is a descriptive-survey data collection method. The statistical population of this research is all employees of contractual, design and contract personnel working in Imam Jafar Sadeg Hospital. In this study, due to the difficulty of selecting the sample, the available and non-random sampling method was used. Given that the size of the community is unknown, the following formula is used to estimate sample size. In this case, the error rate, or d, was considered equal to 0.05. As you can see, the sample size is 384 people. In this paper, a researcher-made questionnaire was used. The questionnaire consisted of 7 general questions and 23 specific questions about the effect of hospital information system on the Likert scale (lowest score of 1, highest score of 5), which was completed by hospital staff. The questionnaire is a five-point scale (fully agree, agree, moderate, opposite, totally opposite), each of which has 5 to 1 points respectively. The validity of the researcher-made questionnaire was verified and their reliability was confirmed by Cronbach's alpha with a coefficient greater than 0.7. In the descriptive statistics section, mean, standard deviation, frequency and frequency were used. In the inferential statistics, the inclination and elongation were used to determine the normality of the data. Then, the results were analyzed using one-sample t-test and Friedman test.

FINDINGS

In this section, the descriptive findings of the research variables are presented first. The variables studied included the impact of the hospital information system on nursing, support and administrative services, access to medical information of patients, the status of information exchange between hospital units and hospital financial performance. In the following, the mean and standard deviation of the variables of the research are presented in the sample. As it is seen in Table 1, the mean of nursing services (4.24) is higher than other variables, and the average of support issues (2.58) is lower than other variables. Regarding the normal data, we can use the parametric tests to examine the research hypotheses instead of nonparametric tests. To analyze the paper questions, a
single-sample T test was used which is acceptable in the results of this test in Table
2: As shown in Table 2, in this test, the average of 3 was considered as the theoretical average and the average of respondents' responses as an experimental mean. The results showed that the average of the respondents' knowledge about the impact of
establishment of the hospital information system on all treatment processes in Emam Jafar Sadegh Hospital (52.2) was higher than theoretical average (3). A
single sample t test also shows that there is a significant difference between the theoretical mean (i.e., 3) and the experimental mean (i.e. the scores obtained from the questionnaire). Therefore, it can be said with 95% confidence that the establishment of the hospital information system improves the hospital's hospital
services, improves the hospital's hospital nursing service, better access to medical information for hospital patients, improves the information exchange between hospital units and improves performance. The financial staff of Imam Jafar Hospital is honest. In the following, the radar chart is used to compare the mean of the impact of the establishment of the hospital information system on improving the work process of
the staff. Radar chart to compare experimental and theoretical mean he following is used in Table 3 to prioritize the effect of establishment of the
hospital information system on improving the working process of the staff working in Imam Jafar Sadeg Hospital. Friedman test is used regarding the ranked average; the impact of the establishment of the hospital information system on the improvement of the work process of employees is as
follows:

• The Impact of Establishment of Hospital Information System on Improvement of Supporting and Administrative Problems.
• Effect of establishment of hospital information system on better access to medical information of patients.
• Effect of establishment of hospital information system on improving the status of information exchange between units.
• The Impact of Establishment of Hospital Information System on Improving Nursing Services.
• Effect of establishment of hospital information system on improving hospital financial performance.

Based on the Friedman test and the significance level of Chi-square in Table 4, the prioritization of the impact of the establishment of the hospital information system on the improvement of the employees' work process is statistically significant (Chi-square = 1063.576 and sig = 0.000).

DISCUSSION AND CONCLUSION

As stated above, the hospital information system is comprehensive software to integrate patient information for the purpose of sending and exchanging comprehensive patient information between departments and other treatment centers in order to accelerate the patient's care and treatment process, improve quality and reduce costs. This includes maintenance, care, diagnosis, counseling,
and treatment, while considering the transfer of medical data and educational issues. As shown in the single-sample t-test, the hospital's information system has affected the work process, and this has had a positive impact and improved process performance. Therefore, the hospital's information system improves support and administration issues, has improved access to medical information for patients, improved information exchange between units, improved nursing services, and improved hospital financial performance. Also, the greatest impact of hospital information system on supporting and administrative affairs and the least impact on hospital financial performance. But researches that are consistent with the results of this hypothesis are Amiri et al.¹, Poissant and colleagues¹¹, Ching-Sheng et al.⁵, Azizi³ et al. Borzekowski et al.⁴ Staggers et al.¹⁴. But research that does not conform to the results of this hypothesis is Kahwi and his colleagues⁹. It is suggested that a hospital information system be developed to improve the information exchange between units for the improvement of the information exchange between units in order to improve nursing, support and office services, in order to improve the financial performance of other hospitals. It is also suggested to other researchers that a comparative study between public and private hospitals should address the impact of the hospital information system on the staffing process and the factors affecting the process of hospital staff.³

CONFLICT OF INTEREST

No conflict of interest associated with this work.

REFERENCES

1. Amiry M, Sadeghi E, Khosravi A, Chaman R. Self assessment of network administrators and users about the effect of hospital information system on the performance and work processes of Imam Hossein Hospital, Shahroud Hospital, Health Information Management. 2012; 8(4): 490-499, 2012.
2. Asefzadeh S. Medical Educations and Health Services. Tehran: Nashre Elmi Farhangi Publication. 1997; 22-75.
3. Azizi A, Abdolkhani R. An investigation the effect of hospital information at Razi hospital performance at Ahvaz. 2011; 2(4), 185-191.
4. Borzekowski R. Measuring the cost impact of hospital information systems: 1987-1994. J Health Econ. 2009; 28(5): 938-49.
5. Ching-Sheng Chang, Su-Yueh Chen, Yi-Ting Lan. Motivating medical information system performance by system quality, service quality and job satisfaction for evidence-based practice, BMC Medical Informatics and Decision Making, 2012.
6. Dehghan R, Ghorbani V. Electronic health Urkish ent strategic need for health care services. Health Information Management. 2004; 1(2): 57-69.
7. Jahani MA, Nasheneh A, Nagavian M, Bijani A, Haddad. Ghamroo Abdi M. Influence of hospital information system on employees' performance and performance from User's Perspective in Hospitals Affiliated to Babol University of Medical Sciences in 2013. Babol University of Medical Sci J. 2013; 16(7), 70-63.
8. Kimiafar KH, Moradi GR, Sadoughi F, Hosseini F. A study on the user’s views on the quality of teaching hospitals information system of Mashhad university of medical sciences- 2006. J Health Admin. 2007; 10(29): 31-6.
9. Khawi M, Soleimani M, Ghazavi S, Alaei S. A Survey of Nursing Staff Viewpoints on the Effects of Hospital Information Computer System on Care Process. Health Information Management. 2014; 4 (2); 193 - 202.
10. Mahmoudzadeh E. Managing the future by coming technologies. 2^nd Tehran: Isiran Institute. 2006; 15-65.
11. Poissant L, Pereira J, Tamblyn R, Kawasumi Y. The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. J American Medical Informatics Association. 2007; 12(5):505–16.
12. Poorahmad A. Review of HIS and its role in medical services development, 2010.
13. Shahmoradi L. Defining evaluation indicators of health information systems and a Model Presentation. Iran: Iran University of Medical Sciences, Faculty of Management and Information; 2006.
14. Staggers N. A usability assessment of AHLTA in ambolatury clinics at a military medical center. Mil Med. 2010; 175.
15. Syamyan H, Ali Golbandi K, Nasiri E and Shahrabi A. Health information management role in hospital management. Scientific Communication Monthly J Iran. 2005; 4(3): 102-12.
16. Arwa M Othman, Eman A. Hamzah, Jamil A Almughales, Abdullah Al-Mikhlafy. Serum positivity of ANA
    and ASMA among Khat and non Khat chewers as markers for autoimmune hepatitis type 1. Universal J Pharm Res. 2017; 2(4): 20-24.
17. Tabibi SJ. Total quality management in health care system. Tehran: Jahan Rayaneh. 2006; 49- 63.

Table 1: Average, standard deviation, minimum and maximum results
of main research

Figure 1: Radar chart to compare experimental and theoretical mean

Table 2: Single-sample T test to analyze the paper questions

 Table 3: Rated average impact of establishment of hospital information system
on improving work process of hospital staff

Table 4: Friedman Test the Impact of Establishing a Hospital Information System
on Improving the Work Process of Employees