The increasing complexity of current and future distributed systems requires that middleware solutions be carefully designed to meet essential properties such as timeliness, efficiency, reliability, and scalability.
The most frequently used framework is that from the Institute of Medicine [12], which highlights the aims for any quality improvement intervention and should include safety, effectiveness, patient centeredness, timeliness, efficiency and fairness.
In 2001, the Institute of Medicine issued a challenge to the American health care system to improve the quality of care by focusing on six major areas: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.
Healthcare quality is made up of multiple domains including safety, effectiveness, patient-centeredness, timeliness, efficiency and equitability [ 81].
The Institute of Medicine provides similar characteristics of quality, including safety, effectiveness, patient-centredness, timeliness, efficiency and equity [ 3].
According to the Institute of Medicine [ 3] quality of care is a multidimensional concept consisting of at least six domains: effectiveness, safety, patient centeredness, timeliness, efficiency and equitably.
Everything is about timeliness and efficiency.
The Institute of Medicine (IOM) specified six domains of quality: safety, timeliness, effectiveness, efficiency, equity and patient/family-centredness [10].
Health care organizations have increasingly embraced industrial methods, such as the Toyota Production System (TPS), to improve quality, safety, timeliness, and efficiency.
The IOM specified six attributes of quality, differing somewhat from Donabedian's seven: safety, timeliness, effectiveness, efficiency, equity and patient/family-centerdness.
Use of mobile phone technology might improve the timeliness and efficiency of public health surveillance.
