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Table 3 Results of expert interviews related to the component Organization of the HIS Evaluation Framework

From: Improving quality of care through patient-reported outcome measures (PROMs): expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples

NHS PROMs Programme Swedish Quality Registries: SHPR and SKAR
+ Investment and commitment of government, including funding to get programme started
+ Clear ownership of programme by NHS England
+ Standardized data collection protocols
+ SHPR: partly government funded which makes it possible to employ people to sustain, improve, and further develop the registry
- Reforms within the NHS put responsibility for programme at question for some time which, in turn, weakened the programme
- Lack of ownership by clinicians and risk that data is ignored by them given their limited involvement in setting up and running the programme
- SHPR: government funding does not cover research activities
  Limitations of PROMs data in the context of registries need to be taken serious since the data provides foundation for health policy changes
Data governance: question whether data is individual or societal good needs to be clarified ➔ transparency on individual’s right to privacy versus the society’s mandate to provide high quality health care
Capacity building
  + Resources, incl. Government funding, are in place to build up the capacity to collect, analyse, disseminate and implement findings
- Stakeholders, in particular economists and staffing of hospital boards lack training in quality measurement and management
- Dominance of financial matters over quality in hospitals
- Skills and knowledge of an expert in quality management does not fit into a defined role within the NHS
  1. Supporting factors are indicated with a “+”, hindering factors with a “-”, and neutral statements related to the system, including considerations for the future with a “”. For the two Swedish registries, it is explicitly stated if a statement was only provided for one registry. No inferences can be made that this does or does not apply to the other registry since no information on the topic was given by the experts of the other registry