International Journal of Medical Informatics 56 (1999) 169 – 176 Considerations on the quality of medical software and information services Jari J. Forsstro ¨m a, *, Michael Rigby b a Medical Informatics Research Centre in Turku, Uniersity of Turku, Kiinamyllynkatu 4 -8, 20520 Turku, Finland b Centre for Health Planning and Management, Darwin Building, Keele Uniersity, Keele, Staffordshire ST55BG, UK Abstract Fast developments in information and communication technology have made it possible to develop new services for citizens. One of the most interesting areas is health care. Medical knowledge is usually valid all over the world that makes the market global. Information services and decision support software are becoming important tools for medical professionals but also ordinary citizens are interested in health related information. It has been estimated that by the year 2010 the turnover of health care telematics industry may be close to that of the drug industry today. The nature of this global information industry is very different from any industry in history. Since there are no frontiers, no clear products and no shops in the information market, it is difficult to develop any effective legislation. However, the history of medicine has shown that health care sector cannot be free from regulation without risking citizens’ health. The huge commercial potential of the Internet has already been used to promote products and services that have no proven effect on health and that may sometimes be even dangerous. In this paper we discuss the needs and possibilities to assess the quality of medical decision support software and information services. For brevity the terms medical software and medical knowledge are used, but the issues also relate to informatics systems used by any health professional, and to computerised systems used to schedule care or to organise record systems. © 1999 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Medical expert systems; Quality assurance; Medical internet services; Legislation www.elsevier.com/locate/ijmedinf 1. Introduction Information technology (IT) has a great potential in increasing the quality of care and reducing the costs of health care. Software for administrative purposes is now widely used, clinical information systems are spread- ing steadily, but so far very few software systems that could provide decision support for physicians have found their way to clini- cal practice. Use of systems in clinical prac- tice assumes that the software is accurate and reliable, but that assumption may be ill- founded. More recently, a new dimension has arisen in that the Internet is changing the way in * Corresponding author. Tel.: +358-2-2612914; fax: +358- 2-2613920. E-mail address: jari.forsstrom@utu.fi (J.J. Forsstro ¨m) 1386-5056/99/$ - see front matter © 1999 Elsevier Science Ireland Ltd. All rights reserved. PII:S1386-5056(99)00044-1