Quarterly Journal of Management Strategies in Health System

Digital Twins as a Tool for Personalizing Nursing Care in the Age of Technology

Aynaz Bagherzadi — 2025-10-08

Today, the use of digital technologies is an inseparable part of healthcare. The emergence of digital twin technology represents a fundamental shift in the delivery of healthcare, with profound implications for nursing care as well. The use of this technology comes with benefits that can herald an improvement in the quality of nursing care, although the practical application of this approach is also accompanied by challenges and limitations. It can be said that digital twin technology has significant potential to enhance nursing care through personalized, predictive, and preventive patient management. It optimizes clinical operations and supports education and collaboration among healthcare professionals. Through accurate virtual models of patients and care environments, nurses can provide more precise, efficient, and comprehensive care tailored to individual and population needs. As these solutions mature, digital twins are poised to become an integral part of nursing practice, improving patient outcomes, healthcare system performance, and professional development, which reflects a new era of digitally empowered nursing care.

Social Factors Influencing University Technology Transfer and Commercialization: A Review Study

Mahdi Khayatan — 2025-10-08

Objective: University technology transfer and commercialization are key pillars of the knowledge-based economy; however, their success is not limited to organizational and economic structures. Despite numerous studies, the role of social and cultural factors has not been comprehensively addressed. The aim of this study is to identify and analyze the social and cultural dimensions influencing this process through a review approach and to provide an integrated picture of the current situation.

Information sources and selected methods for study: This review study was conducted based on non-systematic review method and the PRISMA guidelines. A systematic search was carried out in Scopus, Web of Science, and Google Scholar using defined keywords, with a five-year time limit for English articles and a ten-year limit for Persian articles. Out of 347 initially retrieved studies, after multi-stage screenings (removing duplicates, reviewing titles, abstracts, and full texts), 22 articles were finally selected for analysis.

Results: A review of the literature indicates that various social factors influence the transfer and commercialization of university technology. Social trust, as the primary foundation for the establishment of sustainable collaboration between universities and industry, plays a fundamental role. The culture and organizational structure of universities can also act either as facilitators or as obstacles along the path of innovation. Furthermore, the institutional environment and the capabilities of technology transfer offices are of significance in reducing barriers and creating effective linkages between academia and industry. Ultimately, university policymaking is recognized as the principal guiding factor in this process.

Conclusion: The commercialization of university technology is not merely an economic process; rather, it requires the synergy of social, cultural, and institutional factors. Success along this path depends on trust between universities and industry, flexible organizational structures, and capable technology transfer offices. At the policy-making level, an integrated and forward-looking approach can pave the way for the sustainable development of innovation ecosystems.

Identifying the Dimensions and Challenges of Using Digital Innovation in Hospitals: A Systematic Review Study

Zahra Mirjalili — 2025-10-08

Background: With the advancement of digital technologies, hospitals are increasingly using digital innovations to improve the quality of care, increase productivity, and reduce costs. However, the implementation of these innovations is accompanied by several challenges that can limit their impact. This study aimed to identify the dimensions and challenges of using digital innovation in hospitals.

Methods: The present study was conducted using a systematic review method. To collect data, reputable English databases including PubMed, Scopus, and Web of Science, Google Scholar and Persian databases including Magiran, Iran Medex, and SID, were searched. Initially, 1144 articles in English and 38 articles in Persian published from January 2015 to January 2025 were reviewed which examined the dimensions and challenges of digital innovation in hospitals, and finally 16 articles were included in the study. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies.

Results: According to the survey, the most important dimensions of digital innovation in hospitals include improving the quality of healthcare services, increasing hospital efficiency, reducing healthcare costs, increasing patient satisfaction, and improving hospital information security. Also, key challenges in this field include the lack of appropriate infrastructure and skilled workforce, staff resistance, security concerns and patients data privacy, financial problems, and legal and ethical challenges.

Conclusion: Digital innovation in hospitals can increase the quality of services and patient satisfaction, but its optimal utilization requires addressing financial, infrastructure, security, and human resource challenges.

The Position of Electronic Health Record in Iran’s Health System; A Document Analysis Study

Tahereh Shafaghat — 2025-10-08

Background: Electronic health records are considered fundamental technologies in the health system. The implementation of the electronic health record system in Iran faces many implementation limitations. Therefore, this study aimed to investigate the position of electronic health records (strengths, challenges ahead, necessary measures, stakeholders and responsible institutions) in the Iranian health system and was conducted in the form of document analysis.

Methods: This study was conducted using the document analysis method. After collecting the documents, the following steps were performed: 1) Determining authenticity 2) Determining validity 3) Checking representativeness 4) Checking significance. The sampling method was selective. Every document in the research community that had the keywords electronic health record, electronic medical record, electronic patient record, electronic healthcare record, digital medical record was included in the study. The researcher read the documents several times to familiarize himself with the data. After collecting the data, the findings were extracted through qualitative content analysis.

Results: The benefits of electronic health records include access to citizens' health records, reduction of medical errors, financial management, access to services, ease of access to information, effective role in patient treatment, facilitation of education and research, management and supervision. The challenges facing electronic health records were also categorized into structural, process, managerial and legal areas. The necessary measures to launch electronic health records include sending information on services provided through the DATAS platform to the electronic health record system, updating the online database of the country's health insurance beneficiaries free of charge and continuously, and implementing the process of assessing the eligibility for purchasing services. The responsible institutions include the Supreme Health Insurance Council, the Ministry of Health and Medical Education, and the Medical System Organization.

Conclusion: In order to maximize the benefits of electronic health records, measures such as developing technological infrastructure, training and empowering stakeholders, updating databases, and strengthening cooperation between responsible institutions are essential.

Designing a Model of Exalted Governance in the National Health System

Saeed Hamzeh — 2025-10-08

Background: What distinguishes Exalted governance from other forms of governance is its strong emphasis on Islamic principles and values. In this regard, the present study was conducted with the aim of designing a model of Exalted governance in the Social Security Organization of the Northwest region of Iran.

Methods: This study employed a mixed-methods approach including a combination of quantitative and qualitative methods. The qualitative population consisted of scholarly publications related to health system governance retrieved from reputable academic databases. In the quantitative phase, the population comprised healthcare centers affiliated with the Social Security Organization in the northwest region of Iran. A sample of 360 participants was selected from the management staff of the Social Security Organization’s healthcare departments in the provinces of West Azerbaijan, East Azerbaijan, and Ardabil. A researcher-developed questionnaire was used to collect data. The analysis was conducted using the meta-synthesis approach and structural equation modeling, with Smart PLS ₃ and MaxQDA ₂₀₂₂ software.

Results: The results identified eight dimensions of Exalted health governance: analytical and decision-making abilities, communication factors, infrastructure, strategic actions, organizational culture, general characteristics, organizational/managerial elements, and organizational policies.

Conclusion: These findings clearly demonstrate that achieving Exalted governance within the Social Security Organization of the Northwest region is not possible without a strategic and prioritized focus on key dimensions such as organizational culture, communication structures, and general characteristics. Accordingly, health sector managers and policymakers must implement targeted and well-planned actions in each of these areas.

Investigating the Asymmetric and Nonlinear Effects of Environmental Pollution, Misery Index, Food Production Index, Urbanization Rate, and Household Final Consumption on Life Expectancy in Iran

Moslem Ansarinasab — 2025-10-08

Background: Examining the effects of environmental pollution emissions, the misery index, the food index, the urbanization rate, and household final consumption on life expectancy in Iran can provide valuable insights for policymakers. Therefore, this study investigates the impacts of these indicators.

Methods: In the present study, with the approach of health economics, the effect of the variables of emission of environmental pollutants, especially CO₂ emission, misery index, food index, urbanization rate and household final consumption on the life expectancy of Iranians was estimated using Markov switching regression in in Oxmetrics software for the period 1990 to 2021. Life expectancy was modeled through two regimes: regime1, representing high life expectancy, and regime 2, representing low life expectancy

Results: The results indicated that CO₂ emission variable in both regimes has had a negative and significant effect on life expectancy. In regime 1, there is a negative and significant relationship between the variable of the misery index and life expectancy, which is estimated to be negative and insignificant in regime 2. The food index has a positive effect on life expectancy in both regimes.. In a way, this relationship has been estimated to be significant in regime 1 and non-significant in regime 2. The observed relationship between the urbanization rate variable is negative and significant in regime 1 and positive and significant in regime two. Therefore, it can be said that it had an asymmetric effect on life expectancy. Household final consumption in both regimes has had a positive and significant effect on the life expectancy of Iranians, and its coefficient is higher in regime 1 than regime 2.

Conclusion: Based on the findings of this study, the following policy recommendations are proposed: controlling inflation and reducing unemployment, strengthening social support programs, and protecting the environment. Therefore, policymakers are encouraged to adopt a comprehensive and integrated approach that addresses both economic and environmental dimensions in order to ensure sustainable health and well-being for future generations.

Explaining the Effect of Social Media Addiction Model on Healthy Lifestyle with the Mediating Role of Social Isolation and Mental Health in Students of Shiraz University of Medical Sciences

MohammadAmin Bahrami — 2025-10-08

Background: Nowadays, many students are active on social media and use it for various purposes. Excessive engagement with social media can lead to problems such as mental health disorders and social isolation among students who are considered the future builders of society. These issues may result in academic decline and reduced performance. Therefore, attention to social media addiction and its effects on a healthy lifestyle is of fundamental importance. Accordingly, this study aimed to explain a model of the impact of social media addiction on a healthy lifestyle, with the mediating role of social isolation and mental health among students of Shiraz University of Medical Sciences.

Methods: This study was quantitative, cross-sectional, and applied in nature. The research population consisted of 9,905 students at Shiraz University of Medical Sciences. Using stratified random sampling, 250 students from the faculties of Management, Nursing, and Health participated in the study. The sample size was determined as 250 based on the rule that a minimum of 30 samples is required for each parameter in structural equation modeling (SEM) using the PLS approach. Data were collected using four instruments: the Health-Promoting Lifestyle Profile (HPLP) by Walker, the Bergen Social Media Addiction Scale, the standard Mental Health questionnaire by Keyes, and the UCLA Loneliness Scale. Data analysis was performed using Pearson correlation and structural equation modeling (SEM) with SPSS ₂₅ and Smart PLS ₃ software.

Results: The findings indicated that social isolation and mental health mediated the relationship between social media addiction and a healthy lifestyle. Social media addiction did not directly affect a healthy lifestyle (p > 0.05), but its influence was indirect through social isolation and mental health. Furthermore, social media addiction had a negative impact on mental health. A positive relationship was found between social media addiction and social isolation (p < 0.05).

Conclusion: Social isolation and mental health mediate the impact of social media addiction on a healthy lifestyle. To reduce this addiction among students, it is essential to strengthen healthy lifestyle behaviors, decrease social isolation, and promote mental health through educational and institutional support.

Investigating the Maturity of Intellectual Capital within the Deputy of Management and Resources Development: A Cross-Sectional Study in Shahid Sadoughi University of Medical Science in Yazd

Seyed Masood Mousavi — 2025-10-08

Background: The most fundamental characteristic of 21st-century intelligent organizations is their emphasis on knowledge and information. Intellectual capital, as a set of intangible assets, is considered a vital resource for organizational performance and the ability to innovate, create, and sustain competitive advantages. This study aimed to evaluate the maturity level of intellectual capital within the Deputy of Management Development and Resources at Shahid Sadoughi University of Medical Sciences, Yazd, in 2024.

Methods: This descriptive-analytical study was conducted in 2024. The statistical population consisted of senior, middle, and base-level managers, as well as employees of the Deputy, categorized by departments, including Human Resources Management, Physical Resources and Construction Projects, Financial and Accounting Resources, Support Services, Organizational Development and Administrative Transformation, Budget Planning and Performance Monitoring. The total population was 133 individuals. Data were collected using the Intellectual Capital Assessment Questionnaire and analyzed with Mann-Whitney, ANOVA, and Kruskal-Wallis tests via SPSS ₂₆ software.

Results: Approximately 65% of the participants considered the status of intellectual capital at an average level. Additionally, the findings indicated a significant and direct relationship between marital status and intellectual capital as well as between management domain and the “managed level of intellectual capital maturity.

Conclusion: Considering that the overall mean score of intellectual capital maturity was evaluated as average, further attention and awareness are required to enhance the maturity of intellectual capital to higher levels. Promoting a culture of learning and innovation within the organization can contribute to this enhancement. Additionally, continuous monitoring of intellectual capital through defining performance indicators and periodic reporting can facilitate better management and informed decision-making.