title: Crossing the quality chasm: the role of information technology departments.
abstract: Integrating information technology (IT) into medical settings is considered essential to transforming hospitals into 21st-century health care institutions. Yet the role of IT departments in maximizing the effectiveness of information systems is not well understood. This article reports a 3-round Delphi panel of Veterans Administration personnel experienced with provider order entry electronic systems. In round 1, 35 administrative, clinical, and IT personnel answered 10 open-ended questions about IT strategies and structures that best support successful transformation. In round 2, panelists rated item importance and ranked proposed strategies. In round 3, panelists received aggregate feedback and rerated the items. Four domains emerged from round 1: IT organization, IT performance monitoring, user-support activities, and core IT responsibilities (eg, computer security, training). In rounds 2 and 3, IT performance monitoring was rated the most important, closely followed by clinical support. Strategies associated with each domain are identified and discussed.
authors.affiliation: Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah 84148, USA. charlene.weir@med.va.gov
authors.forename: Charlene R
authors.initials: CR
authors.lastname: Weir
authors.forename: Bret L
authors.initials: BL
authors.lastname: Hicken
authors.forename: Hank Steven
authors.initials: HS
authors.lastname: Rappaport
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Nebeker
mesh_terms: D000328:Adult; D000368:Aged; D016494:Computer Security; D003200:Computer User Training; D003697:Delphi Technique; D005260:Female; D006751:Hospital Information Systems / Q000458:organization & administration*; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D014481:United States; D014584:User-Computer Interface