ABSTRACT
The UK National Health Service (NHS) has seen enormous change in the last decade, not only in the provision of health care, but also in terms of how the service is managed. The implementation in 1991 of the 1989 White Paper (‘Working for Patients’) resulted in the separation of purchasers of health care services from providers of such services, the separation requiring purchasers and hospital providers to contract for the provision of services. The reforms have implied a need to reform management information systems (MIS) within healthcare organizations. Increasingly, the production of accurate, relevant and timely information within such organizations have become key features relevant to their success. However, the difficulties inherent in producing such information have been exacerbated by the inability of healthcare organizations to extract meaningful information from existing operational systems (for example, patient administrative systems). This problem has to some extent been addressed in the NHS Management Executive information management and technology strategy, developed to support the 1989 reforms. A key element of the strategy relating to the needs of large acute hospital trusts was the development of a full range of integrated, patient-based, operational systems which were to be linked to appropriate managerial systems, thereby creating a hospital information support system (HISS) (see Figure 17.1).
