Health Information Systems, Electronic Medical Records, and Big Data in Global Healthcare: Progress and Challenges in OECD Countries

The health sector is behind other sectors of society in the development and use of high-quality data to support a digital transformation in health care. Technologies exist to harmonize, share, access, and utilize health data, even the very large and diverse volumes of “Big Data” that the sector now produces. Harmonized information systems, appropriate skills and attitudes, ethical frameworks, and engaged stakeholders provide the possibility for a positive digital transformation. But progress will remain slow without a significant overhaul of existing institutional and policy frameworks that steer health system behavior. This chapter provides examples of how leading OECD countries are benefitting from digital data and technologies to advance patient outcomes and experiences, health care quality and performance, and research and innovation. It describes the key elements of a successful digital transformation in health care. It argues that a digital health strategy is necessary and that this strategy should include health data governance; standardized and coherent national electronic health record systems; and incentives and allocations supporting capacity for the health workforce and patients to benefit from digital transformation. Further, for the digital transformation to be truly global in scope, cross-country collaboration is needed to develop global standards for data content and exchange, to identify and respond to data security threats, and to develop a harmonized approach to health data governance that facilitates multicountry research and care improvement projects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Similar content being viewed by others

Health Information Systems, Electronic Medical Records, and Big Data in Global Healthcare

The Impact of Digitalization on Quality Management in Health Systems: New Challenges and Opportunities

Big Data Impact on Transformation of Healthcare Systems

References

• Auraaen A, Slawomirski L, Klazinga N (2018) The economics of patient safety in primary and ambulatory care: flying blind. In: OECD Health Working Papers. OECD Publishing, Paris. https://doi.org/10.1787/baf425ad-en
• Baker K, Dunwoodie E, Jones R, Newsham A, Johnson O, Price C, … Hall G (2017) Process mining routinely collected electronic health records to define real-life clinical pathways during chemotherapy. Int J Med Inform 103:32–41. https://doi.org/10.1016/j.ijmedinf.2017.03.011
• BakerHostetler (2019) Managing enterprise risks in a digital world. Baker Hostetler, US. Retrieved from https://f.datasrvr.com/fr1/419/17257/2019_BakerHostetler_DSIR_Final.pdf?cbcachex=990603
• Banks M (2020) Sizing up big data. Nat Med 26:5–6. https://doi.org/10.1038/s41591-019-0703-0ArticleCASPubMedGoogle Scholar
• Barbabella F, Melchiorre M, Quattrini S, Papa R, Lamura G (2017) How can eHealth improve care for people with multimorbidity in Europe? NIVEL and TU Berlin, Utrecht. Retrieved from https://www.icare4eu.org/pdf/PB_25.pdfGoogle Scholar
• Beazley I, Dougherty S, Penn C, Philips L, James C (2019) Performance measurement systems in the health sector and their budgetary implications 7th meeting of the OECD joint network of senior budget and health officials. OECD, Paris. Retrieved May 17, 2019, from http://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=COM/DELSA/GOV(2019)3&docLanguage=En
• Blakely T, Kvizhinadze G, Atkinson J, Dieleman J, Clarke P (2019) Health system costs for individual and comorbid noncommunicable diseases: an analysis of publicly funded health events from New Zealand. (A. Sheikh, Ed.). PLOS Med 16(1):e1002716. https://doi.org/10.1371/journal.pmed.1002716ArticlePubMedPubMed CentralGoogle Scholar
• Businesswire (2018) Amazon, Berkshire Hathaway and JPMorgan chase and Co. to Partner on US Employee Healthcare. Businesswire. Retrieved from https://www.businesswire.com/news/home/20180130005676/en/Amazon-Berkshire-Hathaway-JPMorgan-Chase-partner-U.S
• Calvino F, Criscuolo C, Marcolin L, Squicciarini M (2018) A taxonomy of digital intensive sectors. OECD science, technology and industry working papers, vol 2018/14. OECD Publishing, Paris. https://doi.org/10.1787/f404736a-enBookGoogle Scholar
• Computer World (2019) Q and A: Christiana care health CIO talks up Apple’s health record app. Computer World. Retrieved July 11, 2019, from https://www.computerworld.com/article/3365242/qa-chistina-care-health-cio-talks-up-apples-health-record-app.html
• Cylus J, Williams G, Karanikolos M, Figueras J (2018) Using risk-adjusted capitation for financial resource allocation and purchasing primary health care and social services A rapid review of international experiences and lessons for Finland. Retrieved Nov 29, 2018, from https://thl.fi/documents/2616650/2646346/Finland_RiskAdjustmentBrief_12may.pdf/41a46c24-5c58-47f8-b65a-bbad0995c298
• EHDEN (2019) European health data and evidence network. Retrieved July 11, 2019, from https://www.ehden.eu/
• EU (2019) EU general data protection regulation. Retrieved July 11, 2019, from https://gdpr-info.eu/
• European Commission (2013) Benchmarking deployment of eHealth among general practitioners. European Commission – Directorate-General of Communications Networks. Content & Technology Google Scholar
• European Health Parliament (2016) Digital skills for health professionals. Committee on Digital skills for health professionals. Retrieved from https://www.healthparliament.eu/digital-skills-health-professionals/
• Findlay I, Morris T, Zhang R, McCowan C, Shield S, Forbes B et al (2018) Linking hospital patient records for suspected or established acute coronary syndrome in a complex secondary care system: a proof-of-concept e-registry in NHS Scotland. Eur Heart J Qual Care Clin Outcomes. https://doi.org/10.1093/ehjqcco/qcy007
• Foster J, Bryce J (2009) Australian nursing informatics competency project. Stud Health Technol Inform 146:556–560. https://doi.org/10.3233/978-1-60750-024-7-556ArticlePubMedGoogle Scholar
• Fralick M, Kesselheim A, Avorn J, Schneeweiss S (2018) Use of health care databases to support supplemental indications of approved medications. JAMA Intern Med 178(1):55. https://doi.org/10.1001/jamainternmed.2017.3919ArticlePubMedGoogle Scholar
• Galetsi P, Katsaliaki K, Kumar S (2019) Values, challenges and future directions of big data analytics in healthcare: a systematic review. Soc Sci Med 241:112533. https://doi.org/10.1016/j.socscimed.2019.112533ArticleCASPubMedGoogle Scholar
• Healthcare Weekly (2019) How the “Big 4” Tech companies are leading healthcare innovation. Healthcare Weekly. Retrieved from https://healthcareweekly.com/how-the-big-4-tech-companies-are-leading-healthcare-innovation/
• Hegney D, Buikstra E, Eley R, Fallon T, Gilmore V (2007) Nurses and information technology. Australian Nursing Federation. http://www.anf.org.au/it_project/PDF/IT_Project.pdf
• HL7 International (2020, 02 14) FHIR® R4 (HL7 Fast healthcare interoperability resources, RELEASE 4). Retrieved from http://www.hl7.org/implement/standards/product_brief.cfm?product_id=491
• Hydari MZ, Telang R (2019) Saving patient Ryan-can advanced electronic medical records make patient care safer? Manag Sci. https://doi.org/10.1287/mnsc.2018.3042
• Jo E, Drury P (2015) Development of a virtual diabetes register using information Technology in New Zealand. Healthcare Informatics Research 21(1):49–55. https://doi.org/10.4258/hir.2015.21.1.49ArticlePubMedPubMed CentralGoogle Scholar
• Melchiorre M, Papa R, Rijken M, van Ginneken E, Hujala A, Barbabella F (2018) eHealth in integrated care programs for people with multimorbidity in Europe: insights from the ICARE4EU project. Health Policy 122(1):53–63. https://doi.org/10.1016/j.healthpol.2017.08.006ArticlePubMedGoogle Scholar
• Moreira L (2018) Health literacy for people-centred care: where do OECD countries stand? OECD Health Working Papers. OECD Publishing, Paris. https://doi.org/10.1787/d8494d3a-enBookGoogle Scholar
• National Alliance Of Healthcare Purchaser Coalitions (2018) Employers’ perceptions & actions related to healthcare waste Google Scholar
• NHS Digital (2019) Patient Online Management Information (POMI). Retrieved from https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/pomi
• O’Neill D, Scheinker D (2018) Wasted health spending: who’s picking up the tab? Health Aff. https://doi.org/10.1377/hblog20180530.245587
• Oderkirk J (2017) Readiness of electronic health record systems to contribute to national health information and research. OECD health working papers. OECD Publishing, Paris. https://doi.org/10.1787/9e296bf3-enBookGoogle Scholar
• OECD (2016) Better ways to pay for health care. OECD health policy studies. OECD Publishing, Paris. https://doi.org/10.1787/9789264258211-enBookGoogle Scholar
• OECD (2017) Tackling wasteful spending on health. OECD Publishing, Paris. https://doi.org/10.1787/9789264266414-enBookGoogle Scholar
• OECD (2019a) Health in the 21st century: putting data to work for stronger health systems. OECD Health Policy Studies, OECD Publishing, Paris. https://doi.org/10.1787/e3b23f8e-en
• OECD (2019b) Recommendation of the Council on Health Data Governance. OECD Legal Instruments, Paris. Retrieved from https://legalinstruments.oecd.org/en/instruments/OECD-LEGAL-0433Google Scholar
• OECD (2019c) Using routine data to inform pharmaceutical policies. Retrieved from https://www.oecd.org/health/health-systems/Using-Routinely-Collected-Data-to-Inform-Pharmaceutical-Policies-Analytical-Report-2019.pdf
• Quaglio G, Dario C, Stafylas P, Tiik M, Hoerbst A (2016) E-health in Europe: current situation and challenges ahead. Health Policy Technol 5:314–317. https://doi.org/10.1016/j.hlpt.2016.07.010ArticleGoogle Scholar
• Rudin R, Gidengil C, Predmore Z, Schneider E, Sorace J, Hornstein R (2016) Identifying and coordinating care for complex patients: findings from the leading edge of analytics and health information technology. RAND Corporation, Santa Monica. Retrieved from https://www.rand.org/t/rr1234BookGoogle Scholar
• Safavi K, Bates D, Chaguturu S (2019) Harnessing emerging information Technology for Bundled Payment Care Using a value-driven framework. NEJM Catalyst. Retrieved Oct 20, 2019, from https://catalyst.nejm.org/harnessing-it-bundled-payment-care/
• Shilo S, Rossman H (2020) Axes of a revolution: challenges and promises of big data in healthcare. Nat Med 26:29–38. https://doi.org/10.1038/s41591-019-0727-5ArticleCASPubMedGoogle Scholar
• Skills for Health (2012) How do new technologies impact on workforce organisation? Rapid review of international evidence. Skills for Health, Bristol Google Scholar
• Slawomirski L, Auraaen A, Klazinga N (2017) The economics of patient safety: strengthening a value-based approach to reducing patient harm at national level. OECD health working papers. OECD Publishing, Paris. https://doi.org/10.1787/5a9858cd-enBookGoogle Scholar
• Swedish Ministry of Health and Social Affairs, SALAR (2016) Vision for eHealth 2025 Google Scholar
• WHA (2018) First, do no harm: calculating health care waste in Washington State. Retrieved from https://www.wacommunitycheckup.org/media/47156/2018-first-do-no-harm.pdf

Acknowledgements

The views expressed in this chapter are those of the authors and do not necessarily reflect the views of the OECD or its member countries. The authors acknowledge the contributions of OECD analysts Martin Wenzl, Elina Suzuki, Karolina Socha-Dietrich and Cristina Gall.

Author information

Authors and Affiliations

1. Health Division, Organisation for Economic Co-operation and Development, Paris, France Francesca Colombo & Jillian Oderkirk
2. Health Division, Organisation for Economic Co-operation and Development, Paris, France Luke Slawomirski

1. Francesca Colombo