Strengthening Health Information Infrastructure for Health Care Quality Governance

Good Practices, New Opportunities and Data Privacy Protection Challenges

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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.


National electronic health record systems

Countries are moving forward to develop databases from electronic health records for monitoring and research. Twenty-two of twenty-five countries report a national plan or policy to implement electronic health records and 20 report starting its implementation. Eighteen national plans include the secondary use of the data. Thirteen countries are using data from electronic record systems to monitor public health, eleven countries to conduct health research and nine countries to monitor patient safety. Barriers to creating and analysing databases from electronic health records reported by countries include concerns with current legislative frameworks, particularly as they apply to data privacy protection (16 countries); problems with the quality of data within EHRs (14 countries); and resource constraints to database creation (nine countries) and to the de-identification of data to protect privacy (seven countries). Data quality concerns include a lack of clinical terminology standards; improper coding; missing data; and variable quality across health care providers.This chapter reports findings from the 2011/12 OECD study of 25 countries regarding current uses of electronic records in physician offices and hospitals; national plans to implement electronic health record systems; implementation of national systems; the development of minimum datasets; the use of structure and terminology standards to code data; the status and technical challenges of database creation from electronic health records; and current uses of data from electronic health records including public health, patient safety and health system performance monitoring.



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