• Brent James.
• Intermountain Health Care, Salt Lake City, Utah 84111-1486, USA. bjames@ihc.com
• Med Care. 2003 Jan 1; 41 (1 Suppl): I71-9.

BackgroundHealth care information systems in use today frequently fall short of what is needed to meet the demands for data and reporting on performance. Many observers believe substantial improvements in information systems will be necessary if the potential of a national quality measurement and reporting system (NQMRS) is to be realized. A shared vision will facilitate progress in improving information systems.ObjectivesTo articulate a set of guiding principles and operational steps for the development of functional information systems in health care.Research DesignExperience in building such systems for one health care delivery system was used to develop an approach. This was discussed with Strategic Framework Board members and integrated with other considerations for going from a local system to one that could accumulate information for national purposes.FindingsThe key elements of a functional information system include provisions that (1) data should be collected once, (2) aggregation of data for higher-level reports should be anticipated, (3) issues related to privacy and confidentiality must be addressed, and (4) measurement systems should include an audit standard. A seven-step process for developing a functional information system is outlined.ConclusionsA shared national measurement framework is essential because the data systems that health care delivery organizations use are not static. A long-term vision can guide the growth of a data system over time. An NQMRS can be the vehicle that provides the needed vision.

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