The Austrian Health 2006 Structural Plan of 28 June 2006 requires that reference centres for heart surgery 'participate in result-quality registers (e.g. cardiac registers)'. The aim of the present study was to identify a suitable scoring model for the Austrian register during the run-up to its creation. During the period from November 2004 to December 2005 a survey was done of the actual situation, the organisational and economic possibilities, and the requirements of all Austrian heart centres. General and also specific Austrian basic conditions were defined. Scoring models were then classified and evaluated. The characteristics 'national and international comparability', the associated 'distribution of the scoring system' and 'detailed scientific discussion of the applicability' were found as the main criteria for selection. Economic aspects such as survey and analysis costs, and the everyday practicability of gathering data in the actual situation revealed by the survey, were also included in the evaluation framework. It could be demonstrated that under the given circumstances, the EuroSCORE represented the suitable predictive model.

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The development of models for risk stratification in cardiac surgery goes back a number of years. In 1989, the Society of Thoracic Surgeons (STS) created the first database version for use in the USA. In the year 2005 alone, the data from 234,532 operations were recorded in a structured way by 654 participating institutes. The value of these collected data is described by Ferguson (Ferguson, Dziuban, Edwards, Eiken, Shroyer, & Pairolero, 2000): “Because of their collective efforts, the goal to establish the STS National Data Base as a ‘gold standard’ worldwide for process and outcomes analysis related to cardiothoracic surgery is becoming a reality.” The number of research projects deriving from this is correspondingly large (The Society of Thoracic Surgeons National Database Access and Publications Task Force, 2006).

SummaryObjectives: The Austrian Health 2006 Structural Plan of 28 June 2006 requires that reference centres for cardiac surgery 'participate in result-quality registers (e.g. heart registers)'. The aim of the project was to determine the conditions under which existing hospital information systems (HIS) would be suitable for the intended heart register system. Methods: Between November 2004 and December 2005, a survey was performed in the Austrian heart centers in order to ascertain the medical requirements, the existing technical and organizational situation, and the demands potential users would make on a comprehensive, national heart register. The possibilities of using existing hospital information systems for this purpose were evaluated on the basis of a criteria catalogue. Results: From the medical point of view, the requirements of a heart register covering the whole of Austria, though complex, are readily definable. The reality of heterogeneous information technology (IT) landscapes, coupled with demands for interactivity (on-line queries to a central cardiac database) and benchmarking the users within a single system, combined with what must objectively be regarded as a small group of users, are the reasons why this function is not provided as standard in any HIS. Conclusion: The level of standardization of predictive models and data records is too low in the light of the local and national demands and expectations of a heart register, so that an adequate Quality Assurance (QA) function for cardiac surgeries, which is based on statistical data, is not offered as a standard module in today's HIS.