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Z. Masic

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Background: One of the main goals of any organization is to achieve certain success, in fact it is the reason for the existence of any organization. Management provides the framework and basis for the control system required to maintain each organization. Management theorists believe that the knowledge and management skills are universal and apply equally to all business processes. Objective: The aim of this article is to present development of health management through history based on facts from appropriate literature as sources. Methods: The method is systematic review of the facts described in the published scientific papers about general and health management stored in scientific databases PubMed Central, Hinari, Scopus, EBSCO, etc., which are relevant to be used in the praxis. Results and Discussion: Management as a method or management skills traces its roots back to the original creation of the human society. In primary community, a human was performing its duties intuitive, and later taught preceding experience, began to plan and organize work activities to help them to more efficiently perform it. That is why it is claimed that management, as a complex activity, is old as human civilization itself. Health management plays a key role in providing a good health care quality, ultimately improving the health of an entire population. Therefore, it is important to provide good education in management to physicians who aspire to be managers and to lead hospitals, clinics and different health institutions. Management in the health care system is an area of scientific management which in terms of economic, socio-economic and socio-political change, crisis and political change, crisis and extraordinary circumstances requires more attention. The world clearly shows a significant interest in the role of all managers in the health sector and highlights the importance of a good and professional managers to solve problems in the functioning of health institutions and their services. At the same time, in the developed countries, the schools of management flourishing by training the managers in managerial skills. Efficiency refers to doing things in a right manner. Scientifically, it is defined as the output to input ratio and focuses on getting the maximum output with minimum resources. Effectiveness, on the other hand, refers to doing the right things. It constantly measures if the actual output meets the desired output. Therefore, efficiency is generally an internal measure and effectiveness an external measure. Conclusion: Health care services, like any other business, need effective managers. Medical and health service managers are either specialists, supervising a clinical department, or generalists, overseeing an entire facility. All management theory in one way or another were good, but could never be uniform for all organizations. That is why today the new theory is based on the fact that each organization requires specific that and that every requires form of management appropriate for it.

Nabil Naser, Z. Masic, Lejla Zunic

Background: Everyday, doctors and individuals in the field of healthcare must make calculated decisions which have important consequences, impacting patients on the individual level, and communities and nations on a more global level. Healthcare professionals must at times make these choices with limited information, resources, and knowledge, and yet is is expected that these decisions are highly calculated and accurate. Objective: The aim of this study was to describe and explaine the importance of medical decision making in physician's practice. Methods: It is cross-sectional study based on reviewing of apropriate scientific literaure stored in scientific databases like PubMed Central Scopus, Embase, Hinary, etc, Results and Discussion: Medical decision making certainly be continuously exposed to it, which is the reason why it could not be of more important. The intricate aspects of medical decision making has been discussed in this article. A decision is a choice varying between several different courses of action that may be pursued. Each decision comes as a result of complex processes which provide two or more options providing results, as well as intro and retrospection, and examination or perspective into the future. As is in everyday life, the principles of decision making are present in medicine as well. In the world of biomedicine, decisions may rely on the available systems of information provided to the decision maker through medical documentation. Additionally, it may ease and expedite the process of medical decision making, a luxury which was not always present for physicians. Conclusion: Medical decision making is highly important to doctors and patients alike, as well as the broader population. Medical decisions are vital - to medical professionals, patients and society. They are difficult, and may provide positive outcomes, or poor complications. They test doctors maximally, and provide insight into the effectiveness of doctors. And finally, from the presented strategy, we can conclude that the mathematical models provides support in diagnosis and therapeutic selection in patients with heart damage by cardiovascular diseases and its helped to pysician, as decision maker, to decide which and when appropriate decision will be used. In health care, shared decision-making is increasingly embraced and recommended. It is important to involve patients in health care decisions, to communicate with them, and to provide patient-centered care, however formal models and evaluations in cardiovascular care are still in their infancy.

Z. Masic, Konny Lajhner, H. Pandza

. Background: Computer simulations can be briefly described as the use of computers to represent the dynamic responses of a tested system, by observing the behavior of another, artificial, system modeled on basis of the test system. Physical modeling has been practiced unconsciously since the beginning of the human species, that is, from the moment when the human mind began to understand all the complexity of phenomena and things that surrounded it in nature. Objective : The aim of this paper is to analyze the implementation of computer's simulation and modeling for educational agenda. Methods : This article is a review of the entire to use models, modeling and simulation by using compiters and ICT for teaching system in undergraduate, postgraduate and continuing education using published information, as well as professional papers and publications about this topic. The simulation methodology is based on computer science, statistics, numerical mathematics, operational research and artificial intelligence, but today it is sufficiently coherent and developed that it can rightly be called a separate scientific discipline. The system model represents a simplified and idealized (abstract) image of a real system. In other words, a model is a description of a real system with all its characteristics that are relevant from our point of view. Results and Discussion: Application of computer simulations in science: Different simulations are used to meet specific requirements of the scientific field and the problem such as: Numerical simulation of a differential equation, which cannot be solved analytically. This category includes theories dealing with continuous systems, such as phenomena in physical cosmology, fluid dynamics ; Stochastic simulation, used for discrete systems, where changes occur on the basis of probability, and cannot be explained by equations. These include genetic changes, and biochemical and genetic regulatory processes; Modeling of molecules and their behavior for the purpose of creating drugs; CFD–Computational Fluid Dynamics.–computers are used to perform calculations, which describe the behavior of liquids and gases; Blue Brain project; Cognitive architecture and Movement of parasites in the human body. Conclusion: This paper presents explanations and examples of the application of computer simulations in order to solve everyday problems encountered, both in medicine and all other branches of science. Conclusion: Computer simulations are an invaluable blend of nature and technology, and are one of the main sources of hope for understanding and improving the world we live in.

ABSTRACT Technological diseases are diseases of the modern era. Some are caused by occupational exposures, and are marked with direct professional relation, or the action of harmful effects in the workplace. Due to the increasing incidence of these diseases on specific workplaces which may be caused by one or more causal factors present in the workplace today, these diseases are considered as professional diseases. Severity of technological disease usually responds to the level and duration of exposure, and usually occurs after many years of exposure to harmful factor. Technological diseases occur due to excessive work at the computer, or excessive use of keyboards and computer mice, especially the non-ergonomic ones. This paper deals with the diseases of the neck, shoulder, elbow and wrist (cervical radiculopathy, mouse shoulder and carpal tunnel syndrome), as is currently the most common diseases of technology in our country and abroad. These three diseases can be caused by long-term load and physical effort, and are tied to specific occupations, such as occupations associated with prolonged sitting, working at the computer and work related to the fixed telephone communication, as well as certain types of sports (tennis, golf and others).

Advances in medicine in recent decades are in significant correlation with the advances in the information technology. Modern information technologies (IT) have enabled faster, more reliable and comprehensive data collection. These technologies have started to create a large number of irrelevant information, which represents a limiting factor and a real growing gap, between the medical knowledge on one hand, and the ability of doctors to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. Education means, learning, teaching, or the process of acquiring skills or behavior modification through various exercises. Traditionally, medical education meant the oral, practical and more passive transferring of knowledge and skills from the educators to students and health professionals. For the clinical disciplines, of special importance are the principles, such as, “learning at bedside,” aided by the medical literature. In doing so, these techniques enable students to contact with their teachers, and to refer to the appropriate literature. The disadvantage of these educational methods is in the fact, that teachers often do not have enough time. Additionally they are not very convenient to the horizontal and vertical integration of teaching, create weak or almost no self education, as well as, low skill levels and poor integration of education with a real social environment. In this paper authors describe application of modern IT in medical education – their advantages and disadvantages comparing with traditional ways of education.

Health care systems today require some important changes. Many patients, doctors and other health professionals with right have suspicions that the health care system are managing available resources and information of interest in an optimal way, and as a result of that, health care that we receive isn’t of best possible quality. Considering the large investment in health systems, and the population with an increasing life expectancy, the mobility of patients and the emergence of new highrisk infectious diseases (HIV, SARS, etc.), modern systems of treatment must be proactive, efficient, economical and safe. To provide a basis for improving the quality of health care the system needs to meet several key preconditions and requirements. Professional groups from the world’s most advanced countries (USA, Japan, EU countries) have recognized the introduction of specialized computer and business solutions to national integrated information system in the field of health as a key component to improve the efficiency of the system, all in order to better manage the information of interest, and optimize the consumption and quality of resource management. Information systems must however meet very important common criteria that are based on openness, integration, security of data management, reliability and modularity. In this way it would ensure the vertical (within single health care institutions) and horizontal (between different separate institutions) interoperability of different solutions, and connectivity of different levels of health care within and outside the borders of individual states. Bearing in mind the requirements mentioned, this paper provides a short overview of Health Level 7 (HL7) as open information and communication technology (ICT) standard that should be adopted at the global level by professionals and users. Without quality standards that meet the needs of the business health systems, and ensure the applicability of existing and new solutions the above vision of integrated health care system is certainly not achievable.

Development of computer networks and introduction and application of new technologies in all aspects of human activity needs to be followed by universities in their transformation on how to approach scientific, research, and education teaching curricula. Development and increased use of distance learning (DL) over the past decade have clearly shown the potential and efficiency of information technology applied in education. Use of information technology in medical education is where medical informatics takes its place as important scientific discipline which ensures benefit from IT in teaching and learning process involved. Definition of telemedicine as "use of technologies based on health care delivered on distance" covers areas such as electronic health, tele-health (eHealth), telematics, but also tele-education. Web based medical education today is offered in different forms--from online lectures, online exams, web based continuous education programs, use of electronic libraries, online medical and scientific databases etc. Department of Medical Informatics of Medical Faculty of University of Sarajevo has taken many steps to introduce distance learning in medical curricula--from organising professional--scientific events (congresses, workshop etc), organizing first tele-exam at the faculty and among first at the university, to offering online lectures and online education material at the Department's website (www.unsa-medinfo.org). Distance learning in medical education, as well as telemedicine, significantly influence health care in general and are shaping the future model of medical practice. Basic computer and networks skills must be a part of all future medical curricula. The impact of technical equipment on patient-doctor relationship must be taken into account, and doctors have to be trained and prepared for diagnosing or consulting patients by use of IT. Telemedicine requires special approach in certain medical fields--tele-consultation, tele-surgery, tele-radiology and other specific telemedicine applications should be introduced to the curricula. Telemedicine and distance learning are best suited for medical education and doctor-to-doctor consultation--first contact between doctor and a patient should stay face-to-face when possible. In this paper, we present the results of the project Introduction and Implementation of Distance Learning at the Medical Faculty of University of Sarajevo and compare it with the following expected outcomes: development and integration of information technology in medical education; creation of flexible infrastructure which will enable access to e-learning to all students and teaching staff; improvement of digital literacy of academic population; ensuring high educational standards to students and teaching staff; helping medical staffto develop "life-long learning" approach in work and education.

Introduction: In spite of great impact of Medical informatics on standardization of education for health professionals and to all stakeholders in healthcare systems and medical staff in order to train them how to control healthcare costs, patient safety and utilization of information technology, complex political structure in Bosnia and Herzegovina caused big difference in curriculums, teachingmethods and quality of knowledge gained amongmedical faculties in the country. Proposing teaching process at Medical Faculty, University of Sarajevo, authors would like to propose pattern of potential united and integrated work in this area in the future.

AIM Standardization of education process and almost every aspect of life in EU moved the authors of this paper to evaluate medical informatics education at medical schools in Bosnia and Herzegovina. A very complex political structure and existence of two entities, one district and ten cantons in the Federation of Bosnia and Herzegovina caused great differences in the curricula, teaching methods and quality of acquired knowledge among medical schools in the country. Also, on the example of the teaching process at the Medical School, University of Sarajevo, the authors propose a future united and integrated system in the area. METHOD Method of the study is descriptive, comparing education in medical informatics at five B&H medical schools. Over 500 students answered questionnaires designed at medical schools in Sarajevo and Tuzla. The questions tackled the contents of the subject of medical informatics, the possibility of acquiring knowledge from both practical and theoretic lessons, "good" and "bad" sides of the curricula as well as students' computer literacy. RESULTS The subject of medical informatics is being taught in at least 3-4 different ways. Medical schools in Banja Luka and Foca/Srbinje are under a strong influence of the University of Belgrade, Serbia and Montenegro; the teaching staff in Mostar are from Croatia; the University of Tuzla has its own way; and Medical School in Sarajevo maintains high quality values and principles. Things and events that distinguish the Medical School, University of Sarajevo is the fact that it is the only medical school in Bosnia and Herzegovina which has a web site of of the Department of Medical Informatics, organized a number of events including a distance learning course, and has a highly competent teaching staff. Medical School in Sarajevo is the oldest medical school in Bosnia and Herzegovina established in 1944. As a required subject, medical informatics was introduced in the academic year 1992/1993, and it is the only medical school in Bosnia and Herzegovina where medical informatics is taught in two semesters, second and eleventh. DISCUSSION Three important areas are discussed: the quality of education in secondary schools should be improved; the lack of multimedia equipment, good LAN, high-speed connection to Internet and well organized web design, and issues related to maintenance of equipment; and students should have free access to computer rooms to enable them to extend their knowledge in spare time; general information about health system should be available to students to allow them to require the role and importance of medical informatics in "real life". Naturally, we raise the question of unique and systematic medical informatics education in the whole country, irrespective of entities, nationality or religion of students. CONCLUSION Medical informatics education at Medical School, University of Sarajevo, is based on the same concept as on prestigious universities all over the world and in accordance with recommendations of the working groups on education of EFMI and IMIA. Other medical schools in Bosnia and Herzegovina should employ the same methodology and system of work in order to have standardized education in medical informatics and to achieve high quality in education. To enable us to follow the European and global achievements in this area, the power of fact should predominate in the education system as well as in the health system.

I. Masic, A. Novo, S. Toromanovic, Almir Dzananovic, Z. Masic, Alisa Piralic, Sejla Deljkovic

Bosnia and Herzegovina (BiH), as developing country in transition, has to shift from traditional ways of learning to the transformation of the university education in accordance with Bologna process and educational standards in European Union. In the light of these changes authors conducted research at bio-medical faculties in Sarajevo in order to address issues of the education of future physicians and especially role of medical informatics in their under and post graduate studies and continuous medical education. As per given results in this study, current quality of medical education at biomedical faculties, University of Sarajevo, is unsatisfactory due to several reasons and some among others are those traditionally seen as "computer literacy". Problems are determined and recommendations are given for decision makers to support transformation of BiH medical educational system to have physicians, dentists, pharmacists and nurses who possess the knowledge, skills and attitudes required to be competent in medical informatics if they wish to incorporate into their practices systematic approaches for promoting and maintaining the health of defined populations.

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