An evaluation of Patient Data Management Systems in Dutch intensive care

Objective: To assess the agreement between the functions of seven configurations of Patient Data Management Systems (PDMS) and the Dutch specifications prepared by the users prior to use. Design: An observational descriptive study with hospital visits of seven configurations of five 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 the PDMS configurations, major differences in key features, including "automated charting", "information and care planning", and "management information", were observed. Automated charting is adequately supported by the three commercial systems. All configurations tested had limited functions supporting care planning. In none of the configurations tested was the required function present to support unit management with reports on resource utilisation and outcome performance. The automatic calculation of prognostic scores was either absent or incorrect. The implementation, the (continuous) configuration and the training required a substantial investment in costs and human resources. Conclusion: Today none of the PDMSs tested satisfy the Dutch specifications, This can be explained by technical impossibilities of the systems and shortcomings in the actual configuration or in the unit organisation. 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.