What is Balance Scorecard

The information systems have assumed a central role in the health sector. Particularly in the public domain, health institutions have traditionally been marked by management practices based on contextual contingencies without much concern of the accurate results and their assessment. The traditional concern about the low efficiency and effectiveness in managing public resources has been replaced by the emerging and urgent need for rational management instruments and methods. This need presents the opportunity for a new management paradigm that should not be restricted to the financial aspects of health institutions, but it should include all dimensions of core and non-core activities. The budget slippages and ruptures cannot continue being used as the excuse for the need of systematic and permanent increase of financial resources spent on provision of public health services, often justified by an increasing of the population or the average life expectancy. The budget problems and difficulties of the Portuguese State, particularly the urgent need of the expenditure growth control, show the need of a new management paradigm. This demand has caused, on the one hand, a heavy investment in information technologies to support management decisions, and on the other hand, it has shown other problems, such as the difficulty experienced in the architectural integration of information and technologies as well as problems of a significant complexity and high resource consumption. This chapter discusses the current information systems for management decision support in Portuguese public hospitals based on the analysis of a district hospital in Portugal.