Information management (IM) at a health care institution encompasses the management of information, the management of application systems, and the management of information and communication technology whether computer supported or not, that is, IM provides function, performance, and quality of HIS. Management means, as well, the responsible persons and organizational units as the tasks of planning, directing, and monitoring HIS. IM has to be done systematically to enable an orderly processing of information coherent with the goals of the health care institution. While planning and directing are supported comprehensively by basic methods of strategic planning and project management (Brigl, Ammenwerth, Dujat et al., 2005; Haux, Winter, Ammenwerth, & Brigl, 2004; Winter, Ammenwerth, Bott et al., 2001), the monitoring is neglected sometimes and thus insufficiently supported (Ammenwerth, Ehlers, Hirsch, & Gratl, 2007). As nevertheless a continuous and careful monitoring is a very important task in interaction with all other management tasks, we will define the relevant terms and describe the most significant concepts and methods.
Key Terms in this Chapter
Balanced Scorecard: The balanced scorecard (BSC) is a management tool that enables organizations to clarify their vision and strategy and translate them into action. Using BSC, the manager may establish a “balanced” situation between the traditional financial measures and other success factors of an organization. The BSC combines the continuous measurement of performance with a reviewing and refinement strategy as well an ongoing evaluation process. The basic terms are so-called perspectives, for example, potentials (learning and growth), internal processes, customers, and financial perspective. For each perspective, strategic objectives, indicators, and measures to achieve these objectives must be defined.
Reference Model: A reference model presents a kind of model patterns for a certain class of aspects. It can be used to derive a specific model or for purpose of comparison. Comparing a specific model of HIS (or subsystem) with a reference model congruencies and differences may be stated and used for planning and direction of HIS.
Indicators and Characteristic Values: Indicators are variables whose values (characteristics values) represent an aspect of HIS. To discern good and bad quality of information processing and to assess the achievement of goals, one has to compare the current value of indicator with one or more predefined reference values.
IT Service Management: Beside the internal business processes, the focus of monitoring should be the external outcome, as well. To provide an excellent service for all users of HIS and at last to reach a maximum of customer (patient) satisfaction, nowadays the appropriate management tasks are embraced by the term IT service management (ITSM). There are several frameworks describing an architecture for installing and maintaining ITSM. The most known framework is the IT infrastructure library (ITIL), which defines the necessary management processes at tactical level (service delivery) and operational level (service support).
IT Controlling: In this context, the term controlling (or more precisely IT controlling) is restricted to the tasks of information acquisition and data collection as basis for decisions of IM. For this purpose IT controlling applies different approaches and methods, for example, the continuous measuring and interpretation of indicators and characteristic values explaining the current state of HIS, or the realization of evaluation studies.
Monitoring: Monitoring of HIS means the observation as to whether the directives and objectives defined in the strategic information management plan will be achieved, and whether the HIS is able to fulfill the required tasks. Therefore the IM must be able at any time to assess the state of the HIS using quality criteria which can be derived from the objectives. The tasks of monitoring may be linked to strategic level (monitoring of the achievement of strategic information management plan), tactical level (monitoring of projects), and operational level (operational monitoring, that is, verifying proper working and effectiveness of all HIS components).
Evaluation: Evaluation is the act of measuring or exploring properties of HIS (in planning, development, implementation, or operation), the result of which informs a decision to be made concerning that system in a specific context. Contrarily to continuous data collection, evaluation studies are carried out to answer special questions, usually in form of a project with a clear time limit. When possible, for such studies the same criteria and methods as for clinical trials should be applied.