Costs and effects of a nursing information system in three Dutch hospitals.

VISION is an integrated nursing information system developed in the Netherlands. In mid-1992, a technology assessment of this system was started: the VISTA project. Its aim is to assess the costs and effects of VISION in three different types of hospitals: a University Hospital, a General Hospital, and a Psychiatric Hospital. The study was financially supported by the Dutch Ministry of Welfare, Health, and Culture. Each hospital selected an experimental ward at which VISION parts were installed (VISION was not yet complete during the study). Also, control wards were selected at which no VISION parts were installed. A series of two measurements were carried out at the experimental and control wards. The first experiences show that VISION can be used in various applications, in different environments. Although the second measurements were done just a few weeks after the installation of VISION parts, first effects could already be demonstrated. Nurses were enthusiastic and the quality of coordination of care increased. Time savings have not yet been demonstrated, but are expected after a longer, more extensive use of the system. Extrapolation of costs for hospital-wide implementation revealed that the costs of VISION are low compared to similar systems in the US. After reviewing the first results, each hospital decided to continue the implementation of VISION parts. More measurements are planned.