Table 1.

Donabedian based assessment of CMR as a mechanism to support clinical governance.

Structures		Element explored
System Architecture (eg, Open EPR model)		Interface, clinical archetypes, database type, coding systems
Information & Decision Support		Drug databases, interactions, clinical calculators
System Linkages		Patient registrations, laboratory links, Email
Search Function		Across populations, practices, Export functions
Patient access/Control		Access to information through web portals, etc. Attribution
Processes–care and review
	Quality Markers	Data quality, information quality, system accreditation
	Billing/Pay for Performance	Routine data use, parallel billing system
	Supports population level data outputs	Small area, sentinel networks, epidemiology
	Processes that impact on outcomes (demonstrated within the system)	Critical incidents / near misses / confidential reporting; surrogate markers of quality and outcomes/Clinical audit; true outcome measures