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Public Reports: Quality of care - details
EU [2011]   e-Quality in e-Health - Stakeholders' reflections on addressing e-health challenges at the European level. Health First Europe, 2011

This document brings together a series of papers covering:

  • Citizens’ E-Health
  • E-Health and Health Services
  • E-Health in Practice
  • E-Health and Labor Challenges.

"In Chapter 1, we understand why health infor mation should be made available directly to patients and why electronic information is the best means of information sharing. A few important aspects related to these issues are laid down: trustworthiness and comprehensibility. Information should be available to patients in all languages so that when faced with such information, all patients can have the opportunity to understand it with the maximum level of responsibility and data security. Moreover, another feature of modern technologies is technical interoperability, which should be seen as a future ‘must do’ so that information becomes not only mobile but accessible. In light of this, e-health should bring with it the simplification of administrative procedures and should be a source of education and evaluation for the medical profession, facilitating the patient-doctor relationship. In this sense, the two major problems identified in Chapter 1, data protection and interoperability raise a common set of questions that need to be answered in the future: what type of legislation is needed to ensure simultaneously data protection and interoperability, what funding should be allocated for this and how can we bypass connectivity issues?

"Chapter 2 tries to answer just that, explaining why we are so sure that e-health is a tool that empowers citizens. It will deliver key services such as rapid access to medical records, making it possible that a chronic disease could even be remotely monitored or that 5 million yearly prescription errors could be avoided. Thus, it improves the management of healthcare and what is essential to remember is that we know it works. A similar program has already been implemented in Sweden and people there could tangibly feel that it delivered on its promises. In addition, Malta, Germany, Slovenia and Slovakia have developed ID cards where health and illness information is accessibly stored.

"Chapter 3 explains two aspects of ICT technologies: that projects such as the Virtual Physiological Human were a success and that in spite of being an advanced technological tool e-health is still in its infancy and has even greater potential for innovation. Hence, this chapter explains in specific terms what e-health does and most importantly what it could do in practice.

"Chapter 4 [talks] of present and future challenges that affect the medical profession and overall, the EU and its patients. Two articles both recognize that under the pressure of an ageing population phenomenon, healthcare services need the digitisation that could be brought by e-health investments. In this sense, the main points voiced refer to training professionals in the best way possible, facilitating for them both hardware and software material."


 bullet  e-Quality in e-Health
UK  [2008]   Department of Health. High quality care for all: NHS Next Stage Review final report.

The report "sets out the background, overarching vision and next steps [...] for the future of the NHS".

Priorities described in the report include:

  • "Stronger and more proactive focus on public health and helping people stay healthy, with more support to tackle childhood obesity, alcohol misuse and smoking.
  • Clearer and simpler routes to finding the right care 24/7.
  • As much care as possible delivered closer to home, with treatment of major trauma, heart attack and stroke care within specialised centres.
  • Improving the lives of those with long-term conditions by ensuring that patients can take a full part in their own treatment and care, including the use of health plans and more assistive technology to help people manage their own conditions.
  • Improving patient experience by ensuring privacy, dignity and cleanliness, and by providing more information and choice."

 bullet  Complete report [Department of Health]  bullet  Darzi’s report for the digital generation - a commentary on the report [E-Health Insider]
Luxembourg [2005]   Plan National pour la Promotion de la Qualité

"Dans sa session du 15 avril 2005, le gouvernement en Conseil a adopté le Plan National pour la Promotion de la Qualité qui constitue une démarche globale pour l’amélioration de la qualité, inévitable pour consolider la place économique et financière d’un pays.

Le plan national consiste en un premier plan d’action qui prévoit la mise en place de certaines mesures servant à augmenter le niveau de qualité dans les différents domaines, notamment le secteur agricole, viticole, horticole et alimentaire, le secteur hospitalier, le secteur personnes âgées et accueil gérontologique, le secteur des entreprises, le secteur de l'éducation nationale, le secteur métrologie, le secteur transports et le secteur de l'administration publique. "

The Luxembourg National Plan for the Promotion of Quality, published in April 2005, deals with a range range of domains. Chapter 7 (pp12-16) deals specifically with Le secteur hospitalier - the hospital sector and plans for the period 2005-6. Chapter 8 is focused on services for elderly people - Le secteur personnes âgées, accueil gérontologique.


 bullet  Plan National pour la Promotion de la Qualité  bullet  Office Luxembourgeois d'Accréditation et de Surveillance
Spain [2003]   Caminando hacia la excelencia: II Plan de Calidad del Sistema Sanitario Público de Andalucía 2005-2008.


 bullet  Complete report  bullet  III Plan Andaluz De Salud (2003-2008)  bullet  La Consejera de Salud de la Junta de Andalucía (Sevilla)

USA  Crossing the Quality Chasm
Crossing the Quality Chasm

Corrigan JM, Donaldson MS, Kohn LT et al. Crossing the Quality Chasm. A New Health System for the 21st Century. Washington, DC: Institute of Medicine, National Academy of Sciences, National Academies Press; 2001.

The report assigns much of the blame for medical errors (which, as 'To Err is Human' suggested, kill up to 98,000 people pa. in the USA) to shortcomings in the healthcare system and makes proposals for its redesign.

The report "defines six aims: care should be safe, effective, patient-centered, timely, efficient and equitable" –and specifies 10 rules for care delivery redesign.
  1. Care based on continuous healing relationships--care whenever its needed, not just through face to face visits
  2. Customisation based on patient needs and values
  3. The patient as the source of control
  4. Shared knowledge and free flow of information
  5. Evidence-based decision making
  6. Safety as a system property
  7. Transparency: all information available, including the system’s performance on safety, evidence based practice, and patient satisfaction
  8. Anticipation of needs
  9. Continuous decrease in waste
  10. Co-operation among clinicians

Basic premise: "The fundamental aim of modern healthcare is to make the best match between patient need (both recognised and unrecognised) and expectations, and to deliver care in a timely, efficient manner that achieves maximum benefit for the least cost"

 bullet  Institute of Medicine of the National Academies  bullet  Report [National Academies Press]  bullet  Report []  bullet  The IOM Health Care Quality Initiative
USA Envisioning the National Health Care Quality Report
Envisioning the National Health Care Quality Report

Committee on the National Quality Report on Health Care Delivery Margarita P. Hurtado, Elaine K. Swift, and Janet M. Corrigan, Editors. Envisioning the National Health Care Quality Report. Board on Health Care Services, Institute Of Medicine, National Academy Press, Washington, D.C., March 2001

"At the request of the Agency for Healthcare Research and Quality (AHRQ), the IOM committee provides a vision of the design and contents of a report on the quality of the health care delivery in the United States mandated by Congress. The IOM committee report includes 10 recommendations and specific chapters on: defining the framework and types of measures that should be included; selecting measures; evaluating data sources; and designing the National Health Care Quality Report for specific audiences. " [IOM]

 bullet  Complete report -  bullet  The IOM Health Care Quality Initiative
page history
Entry on OpenClinical: 2003
Last main update: 10 October 2009

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