ELSEVIER Decision Support Systems 16 (1996) 209-229 Da on Su rt HMSS: a management support system for concurrent hospital decision making Guisseppi A. Forgionne a,*, Rajiv Kohli b a Information Systems Department, University of Maryland Baltimore County, Catonsville, MD 21228 USA b tlospital Information Systems Department, St. Joseph Medical Center, 7620 York Road, Towson, MD 21204 USA Abstract Mounting health care costs have escalated the pressure on hospitals and other health care providers to control expenses. Conventional hospital information systems help meet the challenge by providing data necessary for policy formation and outcome measurement. Additional decision support systems deliver models that can be used to systematically evaluate the policies. When deployed successfully, each stand-alone system can effectively support a segment of the hospital decision making process. Integrating the stand-alone functions can enhance the quality and efficiency of the segmented support, create synergistic effects, and augment decision making performance and value. A high-level integration framework, known as the management support system (MSS), can be adapted to provide the desired synthesis. This paper demonstrates how management support systems can improve hospital decision making. It overviews the hospital decision making process, presents an MSS for supporting this process, and measures the impact of the MSS on the process and outcomes of decision making. The paper also examines the implications of the analyses for information systems research and health care practice. Keywords: Concurrent engineering; Decision support systems; Decision technology systems; Expert systems; Execu- tive information systems; Health care decision making; Health care games; Health care outcome measures; Health care process measures; Hospital information systems; Intelligent decision support systems; Management support system I. Introduction To be successful in the long term, health care organizations must provide competitive services that are valued by patients. Administrators are adopting the Total Quality Management (TQM) philosophy to help achieve the desired strategic results. For example, a recent study by the Amer- * Corresponding author. E-Mail: KOHLI@UMBC2. UMBC.EDU. ican Hospital Association (AHA) showed that 44% of surveyed hospitals use TQM to improve quality and cut costs [7]. The quality measure will be a composite of service, length of stay (LOS), and efficiency [16,45,58]. Recent reforms will spur health care institutions to follow this trend. In TQM, there is an emphasis on the preven- tion of problems, customer satisfaction, and con- tinuous improvement in the organization's pro- cesses [51]. A quality team is created to identify problems and improve relevant processes in a systematic and integrated manner. Systems are 0167-9236/96/$15.00 © 1996 Elsevier Science B.V. All rights reserved SSDI 0167-9236(95)00011-9