In the current study, York standard framework (suggested by Arksey and O’Malley) was used to design the overall framework of the study Therefore, the steps in the current study are based on the five steps defined by York including:
- Identification of study questions;
- Identification of relevant resources;
- Careful review of the resources;
- Data analysis;
- Gathering, summarizing and reporting of the results.
Each of these steps are explained in the following sections.
- Identification of study questions
In the current study, three main aspects of smart hospitals include general information, design and economic aspects were investigated. Questions for each aspect were defined though formation of a focus group made from medical informatics experts (three faculty members and two Ph.D. students) (table 1).
Table 1: Study questions and corresponding smart hospital aspects
· What is the distribution of existing articles based on publication year?
· What is the distribution of existing articles based on geographical location?
· What is the quality of journals publishing these articles?
· What is the information of the specialized teams in these articles?
· What is the distribution of the articles based on development index of the publishing countries?
· What is the distribution of the articles based on the GDP of the publishing countries?
· What is the distribution of the articles based on their goals?
· What are the technologies used in these articles?
· What is the distribution of the articles based on the type of study?
- Identification of relevant studies
Search team (SMT, NS, MR) designed a comprehensive search strategy in order to identify and retrieve articles relevant to research goals based on the inclusion and exclusion criteria.
The inclusion criteria included articles in English language published before the year 2021 with no limitations regarding the affiliations of the articles.
The exclusion criteria included review articles, conference papers, letters to editor, books, white papers and articles whose full texts were not accessible.
It is necessary to determine concepts and keywords for a search strategy . To this end, keywords were selected in the field of smart hospital based on research goals. The keywords used in the search included smart hospital, intelligent hospital and digital hospital.
Search team (SMT, NS, MR) used these keywords to design the following search strategy in title/abstract fields: ("smart hospital" OR "digital hospital" OR "intelligent hospital"). The publication year of the articles was set to any articles published before 2021. Finally, electronic literature search was conducted on PubMed, Science Direct, Embase and Scopus databases.
- Selection of studies
The research method which is presented as a diagram in figure 1 shows the step-by-step process used to select articles.
After the search, a total number of 741 articles (85 PubMed articles, 131 Science Direct articles, 115 Embase articles and 410 Scopus articles) were retrieved. After removing duplicates (43 articles) 698 articles remained. The search team (MR, NS) then separated relevant articles from irrelevant ones based on inclusion and exclusion criteria. In this step, 647 articles were removed after reviewing the title and abstract of all while for 51 remaining articles, the full text was investigated. After reviewing the full text, 33 articles were extracted from which 18 ones were included in the final study.
- Data analysis
Two researchers (MR, NS), independently extracted necessary data from retrieved articles based on study questions and study goals. Then, the extracted data from articles were compared. In order to calculate the degree of agreement between two researchers, Kapa coefficient was used which was equal to 0.86. In case of facing lack of agreement between two researchers, the third researcher (SMT) was consulted. The final data was then prepared after evaluation by team members and based on suggestions and comments.
- Gathering, summarization and reporting of results
A table was used to gather the data extracted from articles in which the rows represented each article and columns indicated the variables. Then, the table was filled with the collected Data.
Frequency analysis is one of the common analysis methods for data sets which shows the frequency of articles based on each studies variable. In the current study, frequency analysis was used to analyze the data set based on each variable and the results were displayed in various graphs.