A Clinical Information System Research Landscape

Clinical information systems (CIS) could drive progress in health care in the 21st century. We must examine the organizational and social issues surrounding these systems to truly understand their potential use, benefit, and impact on health care delivery overall. After extensive review of the literature on CIS research, we produced a “CIS research landscape.” This landscape enabled us to examine and potentially improve delivery of health care services from the perspective of its major constituents (ie, patients and their families, clinicians, processes for delivering care, organizations, patient populations) by using the information captured in CIS. We then identified aspects of the care delivery system which need to be addressed to improve the quality of care delivered: the care must be safe, effective, patient-centered, timely, efficient, and equitable. In addition to the static picture of this research landscape, we needed to portray the research process and how it relates to operational aspects of health care delivery. The CIS research landscape that we describe should help researchers and research funders alike focus their time, effort, and money on important questions. The answers to these questions should in turn greatly improve the overall health care delivery process. In a subsequent article, we will describe how we used this research landscape in conjunction with the known operational, financial, technical, governmental, and social constraints of Kaiser Permanente (KP) to develop a specific CIS research agenda.