Introduction

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Abstract
In the past, both health professionals and the public have assumed that the commitment of health professionals to obtaining the best possible outcomes for their patients would guarantee safe and effective health care. Through the work of the Institute of Medicine (IOM) and other leading organizations, however, it has become obvious both to researchers and to society as a whole, that commitment to the betterment of health does not guarantee safe health care practices. As highlighted in “To Err is Human,” 1 a shockingly large number of errors occur, despite the best intentions of providers, and many errors have fatal results. Although there is some debate about the exact number of people who die each year as a result of errors, 2 by and large, deaths do not occur because of individual negligence—rather they result from flawed systems in which people fail to deliver the quality of a care to which they aspire. How can health professionals perform as they both wish and must? A second IOM report released in 20001, “Crossing the Quality Chasm,” 3 identified the critical role that information technology will play in engineering health care systems that produce care that is “safe, effective, patient-centered, timely, efficient, and equitable” (p. 164).

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