AN EVALUATION OF PATIENT DATA MANAGEMENT-SYSTEMS IN DUTCH INTENSIVE-CARE

Objective: To assess the agreement between the functions of seven conf igurations of Patient Data Management Systems (PDMS) and the Dutch spe cifications prepared by the users prior to use. Design: An observation al descriptive study with hospital visits of seven configurations of f ive different PDMS systems including three commercial systems and two locally developed systems, Setting: Seven Dutch level I intensive care units in university and teaching hospitals. Measurements and results: A substantial disagreement was found between the Dutch specifications and the actual functions of the PDMS configurations tested. Between t he PDMS configurations, major differences in key features, including ' 'automated charting'', ''information and care planning'', and ''manage ment information'', were observed. Automated charting is adequately su pported by the three commercial systems. All configurations tested had limited functions supporting care planning. In none of the configurat ions tested was the required function present to support unit manageme nt with reports on resource utilisation and outcome performance. The a utomatic calculation of prognostic scores was either absent or incorre ct. The implementation, the (continuous) configuration and the trainin g required a substantial investment in costs and human resources. Conc lusion: Today none of the PDMSs tested satisfy the Dutch specification s, This can be explained by technical impossibilities of the systems a nd shortcomings in the actual configuration or in the unit organisatio n. The PDMS might beg:a come a valuable tool in improving the quality of ICU practice, but full implementation of these systems according to the specifications still has a long way to go.