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American Journal of Medical Quality, Vol. 21, No. 6, 382-393 (2006)
DOI: 10.1177/1062860606293150
© 2006 American College of Medical Quality

Crossing the Quality Chasm: The Role of Information Technology Departments

Charlene R. Weir, PhD

Geriatric Research, Education, and Clinical Center and Salt Lake Informatics, Decision Enhancement and Surveillance Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, Department of Medical Informatics, University of Utah, Salt Lake City, Utah, charlene.weir{at}med.va.gov

Bret L. Hicken, PhD, MSPH

Geriatric Research, Education, and Clinical Center and Salt Lake Informatics, Decision Enhancement and Surveillance Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah

Hank (Steven) Rappaport, MD

Office of Information, Veterans Health Administration, Department of Veterans Affairs, Salt Lake City, Utah

Jonathan R. Nebeker, MD

Geriatric Research, Education, and Clinical Center and Salt Lake Informatics, Decision Enhancement and Surveillance Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, Department of Internal Medicine, University of Utah, Salt Lake City, Utah

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.

Key Words: computerized medical records system • Delphi techniques • informatics • organization and administration


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