Discussion

Unique is the focus on a primary consideration of comprehensive practical requirements and reduction of cross-functional requirements concerning technical aspects to a minimum. The approach is based on development of assessment criteria by an experienced physician with a medical informatics background and explicit focus on all hospital departments and professional groups from admission to discharge, especially physicians, nurses, service staff, controlling, medical controlling and administration. Since tasks have been divided into different numbers of subtasks, equal weighting of criteria may lead to a partially unintentional over- or underestimation of tasks. Weighting of the criteria could be added as the criteria evolve contributing to individualizability and transferability. Although criteria were developed on basis of a specific HIS, great importance was attached to the fact that criteria represent functions also offered by other manufacturers or which could be retrofitted by parameterization. Therefore, criteria can be used both for improvement of an already existing implementation (see practical example) and for selection of the most suitable application when purchasing software.

Previous studies were carried out mostly by hospital information experts [36]. They focused only on single aspects, such as usability, a special institution or user group, often nurses [7,14,24,38,44–47,49–55,59]. Former studies discussed what can be evaluated and what methodologies to use [2,11,32–34]. In terms of methodology, no questionnaires or consensus procedures were used. Instead hidden external observation combined with literature und system analysis as well as brainstorming guaranteed coverage of actual requirements in practice without neglecting technical framework conditions.

Compared to preliminary work, such as 233 task-related and 102 cross-task requirements [13,36], the developed criteria are much more detailed and specific regarding efficiency of a hospital as a whole. Groups, tasks, subtasks and objectives have been adapted and expanded considerably. Furthermore, criteria go far beyond activities like the platform  “Check IT” [61,62] initiated by Marburger Bund, professional association and trade union for doctors in Germany, which rather serves compact self-assessment of the degree of digitalization of a hospital by individual employees than a global perspective including all stakeholders and fundamentals for an efficient working routine [63], or the HIS-monitor with 107 questions [13].

Previous catalogues for evaluation criteria can be used for a first screening due to smaller scope and lower level of detail. These are easier to handle and allow for quick results. The extremely far-reaching criteria of this study can be used in a subsequent step for a precise and specific analysis to derive concrete improvement potentials contributing to increase in efficiency of hospital life and interdisciplinary collaboration.

Zusammenfassung