Strengthening Health Information Infrastructure for Health Care Quality Governance
Good Practices, New Opportunities and Data Privacy Protection Challenges
Health data constitutes a significant resource in most OECD countries that could be used to improve population health, the quality of health care and the performance of health systems. Rising levels of chronic diseases; concerns about the quality and safety of patient care; the need to assure value for investments in health care; and the need to allocate health resources wisely; are all too important to be left without good evidence for decision making.
This book, based on studies of 19 countries on the development and use of personal health data and of 25 countries on development and use of electronic health record systems, includes results showing good practices, new opportunities and data privacy protection challenges. It finds that well-intended policies to allay concerns about breaches of confidentiality and potential misuse of personal health data may be limiting data use, but that the next five years appear promising, in terms of both the number of countries that plan to implement national electronic health record systems and the number that consider it likely that data from these systems will be used for some aspects of health care quality monitoring. They also appear promising for the further use of existing personal health databases and for the linkage of multiple data sources to generate new evidence.
Progress and challenges in use of personal health data
There is optimism among most study respondents that national health information infrastructure is growing stronger and more capable of supporting health and health care monitoring and research. The technical capacity to undertake data linkage studies is growing and there is optimism about the potential for data from electronic health record systems to be used for health care quality monitoring. Respondents from six countries, however, indicated that it has become harder to use personal health data to monitor health and health care quality over the past five years. Respondents from five countries indicated that it is unlikely or impossible that any data from electronic health record systems will be used for national health care quality monitoring over the next five years. A particular worry across countries today is that legislative reforms that are on the horizon, or that may be stimulated due to the implementation of electronic health record systems, may turn back the clock on the progress that has been made in enabling data linkages and providing access to linked data for research. A second worry is that the quality of data within electronic health records presents a barrier to the creation of national databases. Resource limitations, and not meeting expectations of timeliness, are worries among bodies that approve project proposals and among bodies that conduct data linkages on behalf of others. This chapter presents overall views of the participants to the OECD study of the secondary use of personal health data followed by views about the future use of data from EHR systems from participants to the OECD study on electronic health record system development.