Link to this article: http://journals.cambridge.org/abstract_S0269727000005650How to cite this article: M. P. Ryan and W. Dodd (1993). The measurement of process and the role of information technology. SynopsisProcess of care is the most immediate, relevant and susceptible to improvement of Donabedian's three elements of quality assurance. To place the study of process in context, the history of quality assurance in English-speaking countries is reviewed, with particular emphasis on the U.S.A. A range of methods are examined in detail and examples are provided to illustrate their strengths and weaknesses. Particular attention is paid to the use of explicit and implicit criteria. The importance of information technology in monitoring the process of care cannot be over-stated. Limited audit is possible with manual records but all substantial projects require computer support. The value of capturing data from operational systems rather than from dedicated projects is emphasised. Attention is drawn to the key importance of structured records and minimum data sets; these allow information to be pooled and process studies to be generalised. Examples are given of quality assurance projects which have used information technology. Finally potential future developments are reviewed with particular reference to clinical guidelines and computer-based clinical decision support systems. M. P. Ryan and W. Doddthis reason it must be recognised that the use of information technology does not provide the solution to the problems associated with previous attempts to measure process (WHO 1989). It must be seen as an aid whose importance will grow as techniques in the evaluation of process improve with experience.