Managing Quality in Health Care: Involving Patient Care Information Systems and Healthcare Professionals in Quality Monitoring and Improvement

textabstractIt is no longer possible to ignore the issue of quality in health care. Care institutions strive to provide all patients with effective, efficient, safe, timely, patient-centered care. Increased attention for quality is also found in discussions regarding use of information and communication technologies (ICTs) in health care processes. In these discussions, ICT is almost always brought into a direct relationship with improving the quality of care, especially ICTs that professionals use directly in patient care, which are also known as patient care information systems (PCIS) [1-4]. Well-known quality reports from the US Institute of Medicine, such as To Err is Human [5] and Crossing the Quality Chasm [6], identify the lack of and delay in ICT development and implementation as a partial explanation for quality problems in existing healthcare systems. Both reports call for wider-scale implementation of PCIS, such as electronic patient records and computerized physician order entry (CPOE) systems. Such systems purportedly bring an end to illegible or lost records and forms, and thus reduce the number of mistakes made. Moreover, intelligent PCIS, such as decision support systems, would potentially support the care professional in making a diagnosis and determining the best course of action, which would make medical practice both more evidence-based and efficient [see also 3,7-10]. A large number of research projects also reflect these positive effects, but the conclusions of systematic reviews are mixed [11-16]