Development and application of comprehensive evaluation criteria for efficient hospital information systems

Wagner, S. (2020): Development and application of comprehensive evaluation criteria for efficient hospital information systems.


  • Evaluation of comprehensive practical requirements of hospital information systems
  • Previous catalogues for screening due to smaller scope and lower level of detail
  • Precise and specific analysis to derive concrete improvement potentials
  • Criteria for improvement of existing implementations and selection of software


Materials and methods




Summary points


Background: Data processing is a significant productivity and quality factor for each hospital. Inefficient processes with a lack of structured documentation, transfer, reuse of data and automation lead to delays, loss of time, cost explosion and reduced quality despite improvements of the last years. Doctors spend several hours a day on documentation and still find it difficult to obtain complete information. Integrated hospital information systems can overcome these problems by accelerating access, increasing quality of communication, ensuring timely availability and positive effects on process and result quality. Evaluations of information systems are the prerequisite for development, high-quality as well as efficient care. Available criteria are often too general and not comprehensive enough to be applied directly to a hospital with the goal of global efficiency improvement or concentrate only on single aspects, institutions or user groups.

Objective: Evaluation criteria for efficient hospital information systems including practical requirements of all departments and user groups are the key for achieving an efficient daily working routine emphasizing interdisciplinary cooperation and data reuse.

Methods: Development of the evaluation criteria was based on a combination of intensive literature analysis, hidden external observation for inclusion of practical requirements of doctors and nurses from all departments of a big German hospital, derivation from system goals and a profound product analysis of a market-leading hospital information system including strong and weak points. The creativity method brainstorming was used for collection and structuring of practical requirements. Available third-party systems, paper documentation and extensions were also analyzed in depth. The local implementation at a typical German hospital was compared to the most comprehensive one including all available features and the intended state of maximum efficiency.

Results: A total of 1,102 criteria were developed and tested successfully at a German hospital. Criteria were divided into 959 task-related and 143 cross-functional requirements, structured in tasks and subtasks. Development of criteria and evaluation of the hospital information system covered a master’s thesis in the Master of Health Business Administration (MHBA) study program comprising 347 pages with 240 illustrations, 28 tables, 92 annexes and 1,085 footnotes. With regard to task-related requirements local implementation achieved 2,285 points (79 %), the maximum possible functionality 2,843 points (99 %). For the cross-functional criteria the on-site implementation achieved 379 points (88 %), the most comprehensive one 426 points (99 %). Compared to the overall amount of functions, only a small number of modules was licensed. At a glance, it became clear how efficiency increases could be achieved through further modules, addons and adjustments. Lack of a medical knowledge database for decision support in addition to media discontinuities of documentation in anesthesia and intensive care was of particular importance. Solutions for rising efficiency and elimination of discovered weaknesses were pointed out.

Conclusion: Previous catalogues for evaluation criteria can be used as a first screening solution due to smaller scope and lower level of detail. Comprehensive criteria can be used in a subsequent step for a more precise and specific analysis to derive concrete improvement potentials contributing to an increase in efficiency of everyday hospital life and interdisciplinary collaboration. Unique are the focus on a primary consideration of comprehensive practical requirements and reduction of cross-functional requirements to a minimum. Covering all practical requirements of stakeholders at a hospital is possible by shifting the focus to the specific needs of clinical end users. Specialized systems for departments are no longer necessary if integrated functions of the information system or addons are capable of replacing these at least equivalently. Parameterization and personalization remain important. After all, systems offer numerous functions by default. Many hospital information systems also allow constantly expanding with addons, thereby increasing efficiency. Evaluation criteria depend on use case, objectives and evaluators. Nevertheless, with minor modifications, criteria can be transferred to other institutions, both for evaluation of existing implementations and acquisition of new software. Doctors, nursing staff and patients benefit from documentation support and workload reduction.


Hospital information system, evaluation, assessment, evaluation criteria, efficiency


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