Objective: To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. Materials and Methods: A prior Organization for Economic Cooperation and Development–led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking. Results: While electronic records are widely used to store and manage patient information at the point of care—all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%—patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist. Discussion: Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons. Conclusion: While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries.
Laws and policies enabling data sharing and data linkage are needed to strengthen national information infrastructure. To develop international studies comparing health care quality and health system performance, actions are needed to address heterogeneity in data protection practices.
Patient-facing mobile health applications (apps) hold the promise to change the way individuals take responsibility for their own health by enabling more effective delivery of health information, allowing better monitoring of symptoms, and encouraging healthier lifestyles. 1 Enthusiasm about the potential of health apps has grown rapidly, generating uncertainty as to who should regulate such apps and how. In most countries, medical device regulation applies only to a subset of high-risk health apps that have well defined medical purposes. However, most health apps available on the market target a wide range of healthrelated issues, including diet and exercise, pregnancy, and mental health, while still being considered nonmedical devices. These apps can collect a variety of personal data 2 and, because they are designed to affect health, it is important to ensure their safety, validity, reliability, privacy, and security. Many low-quality health apps exist that, as well as providing advice that is incomplete, misleading, or wrong, might also fall short of meeting the expected standards in privacy and security. 3,4 In a 2017 report, the Organisation for Economic Co-Operation and Development (OECD) concluded that the use of low-quality, non-medical health apps raises a wide range of ethical, legal, and governance issues, and pointed to the need for international agreement on minimum standards in quality assurance controls. 5 We examined guidance for the development of safe, secure, and reliable apps issued by data protection authorities in nine OECD countries (see appendix for methodological details). All these authorities had reported guidance relating to mobile apps in response to the 2017 Census of the International Conference on Data Protection and Privacy Commissioners. We also examined guidance by national health authorities in the same nine countries, and international guidance issued by WHO and the European Commission (EC). We did a comparative assessment of the guidance against the qualitative indicators and the principles and best practices set out in the 2013 OECD Privacy Guidelines and the 2016 OECD Recommendation on Health Data Governance (appendix).
Objective: To collect data on the practices of molecular genetic testing (MGT) laboratories for the development of national and international policies for quality assurance (QA). Methods: A web-based survey of MGT laboratory directors (n = 827; response rate 63%) in 18 countries on 3 continents. QA and reporting indices were developed and calculated for each responding laboratory. Results: Laboratory setting varied among and within countries, as did qualifications of the directors. Respondents in every country indicated that their laboratory receives specimens from outside their national borders (64%, n = 529). Pair-wise comparisons of the QA index revealed a significant association with the director having formal training in molecular genetics (p < 0.005), affiliation with a genetics unit (p = 0.003), accreditation of the laboratory (p < 0.005) and participation in proficiency testing (p < 0.005). Research labs had a lower mean report score compared to all other settings (p < 0.05) as did laboratories accessioning <150 samples per year. Conclusion: MGT is provided under widely varying conditions and regulatory frameworks. The data provided here may be a useful guide for policy action at both governmental and professional levels.
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