From minimum data to maximum impact: using clinical data to strengthen patient care.

Society mandates that health care be both effective and affordable. Currently, data about costs of care are more readily obtainable than data about quality, especially in relation to nursing and other nonphysician aspects of patient care. Assessing effectiveness of care requires standardized data aggregated in databases for comparisons across times, conditions, and institutions. Historical and contemporary efforts to identify elements of a minimum data set and develop standards have brought progress but have not resolved all the critical issues. A project involving the University Hospital Consortium and its member institutions has produced a valid and reliable set of standard terms and codes compatible with an existing patient-level database. Future developments need to include better methods for determining resource consumption and for capturing clinical data. The time is near when databases built from clinical data will lead to knowledge that will strengthen patient care.