Quality assurance in cardiac surgery: setting up the Austrian heart register. Are standard hospital information systems suitable?

Objectives: The Austrian Health 2006 Structural Plan of 28 June 2006 requires that reference centres for cardiac surgery ‘participate in result-quality registers (e.g. heart registers)’. The aim of the project was to determine the conditions under which existing hospital information systems (HIS) would be suitable for the intended heart register system. Methods: Between November 2004 and December 2005, a survey was performed in the Austrian heart centers in order to ascertain the medical requirements, the existing technical and organizational situation, and the demands potential users would make on a comprehensive, national heart register. The possibilities of using existing hospital information systems for this purpose were evaluated on the basis of a criteria catalogue. Results: From the medical point of view, the requirements of a heart register covering the whole of Austria, though complex, are readily definable. The reality of heterogeneous information technology (IT) landscapes, coupled with demands for interactivity (on-line queries to a central cardiac database) and benchmarking the users within a single system, combined with what must objectively be regarded as a small group of users, are the reasons why this function is not provided as standard in any HIS. Conclusion: The level of standardization of predictive models and data records is too low in the light of the local and national demands and expectations of a heart register, so that an adequate Quality Assurance (QA) function for cardiac surgeries, which is based on statistical data, is not offered as a standard module in today's HIS. Copyright © 2008 John Wiley & Sons, Ltd.