Soft systems approach to information problems at the structural level of health care
Different forces are increasing the need for improved methods that measure quality in health care. Elements of structure, process, and outcome need to be identified, defined, and monitored in order to assess quality of health care. Systems theory and methodology have been applied to a broad spectrum of health care problems. Much of the analytical work has taken place at the process/operational level. Accordingly, the information/decision processes are usually supported at the operational/managerial level. The information bases for decisions and action-taking at the structure and policy level however, require further analysis and research. In this research, a problem situation regarding information access and use was identified at the structure level of a "health care system". The problem focused on the barriers, values, and impact of scientific and technical information, as assessed by 36 physicians who play the role of regional coordinators for conducting activities on health education and research within the "system". The hypothesis underlying this work is that a Soft Systems approach can be used as a methodology to understand and learn about the information problems that exist at the structure level of a "health care system". It is estimated that through the inquiry process of Soft Systems Methodology, results can contribute to identify a pathway whereby the role of information access and use on quality of health, at the structure-process and process-outcome levels of health care be established. Soft Systems Methodology was useful both (1) to tackle information problems at the structure level of health care; and (2) to enrich the different concepts of human activity systems that participate in the delivery of health care at the structure, process, and outcome levels. This research provided a model to such approach. Recommendations and further lines of research are also proposed.