title: Learning to leverage existing information systems: Part 1. Principles.
abstract: BACKGROUND
  The success of performance improvement efforts depends on effective measurement and feedback regarding clinical processes and outcomes. Yet most health care organizations have fragmented rather than integrated data systems. Methods and practical guidance are provided for leveraging available information sources to obtain and create valid performance improvement-related information for use by clinicians and administrators.
  At Virginia Mason Health System (VMHS; Seattle), a vertically integrated hospital and multispecialty group practice, patient records are paper based and are supplemented with electronic reporting for laboratory and radiology services. Despite growth in the resources and interest devoted to organization-wide performance measurement, quality improvement, and evidence-based tools, VMHS's information systems consist of largely stand-alone, legacy systems organized around the ability to retrieve information on patients, one at a time. By 2002, without any investment in technology, VMHS had developed standardized, clinic-wide key indicators of performance updated and reported regularly at the patient, provider, site, and organizational levels.
  On the basis of VHMS's experience, principles can be suggested to guide other organizations to explore solutions using their own information systems: for example, start simply, but start; identify information needs; tap multiple data streams; and improve incrementally.
authors.affiliation: Virginia Mason Medical Center, Seattle, USA. nancy.neil@vmmc.org
authors.forename: Nancy
authors.initials: N
authors.lastname: Neil
authors.forename: David
authors.initials: D
authors.lastname: Nerenz
mesh_terms: D003625:Data Collection; D019033:Delivery of Health Care, Integrated / Q000592:standards* / Q000706:statistics & numerical data; D003710:Demography; D005246:Feedback; D006123:Group Practice / Q000592:standards / Q000706:statistics & numerical data; D006751:Hospital Information Systems; D006786:Hospitals, Urban / Q000592:standards / Q000706:statistics & numerical data; D007255:Information Services; D020380:Needs Assessment; D019982:Organizational Case Studies; D010043:Outcome and Process Assessment, Health Care; D019984:Quality Indicators, Health Care; D017749:Total Quality Management / Q000458:organization & administration*; D014861:Washington