Evolution or Revolution? Recommendations to Improve the Swiss Health Data Framework

Martani, Andrea; Geneviève, Lester Darryl; Egli, Sophia Mira; Erard, Frédéric; Wangmo, Tenzin; Elger, Bernice Simone

doi:10.3389/fpubh.2021.668386

Cited by 9 publications

(4 citation statements)

References 46 publications

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“…This was quite similar to the main barriers for information technology use reported among Swiss ambulatory care physicians in 2008 by Rosemann and colleagues [4]. Key recommendations for improving and promoting the Swiss eHealth system include fostering the development of an explicit health data strategy to help create the "right" mindset and attitudes, improving the healthcare information technologies infrastructure, harmonising data access procedures, clarifying privacy and consent issues, and aligning incentives with aims and goals [32].…”

Section: Findings Context Of Existing Evidencesupporting

confidence: 76%

Use of electronic patient records and encrypted email patient communication among Swiss chiropractors: a population-based cross-sectional study

Hincapié

Hofstetter²,

Lalji³

et al. 2023

Preprint

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Background: The implementation of electronic health information technologies is a key target for healthcare quality improvement. Among Swiss chiropractors, reliable data on the use of electronic heath information technologies and distribution of the health workforce was lacking. Objectives: To estimate the prevalence of electronic patient record (EPR) and encrypted email communication use among Swiss chiropractors and describe the geographic distribution of chiropractors in Switzerland. Methods: Population-based cross-sectional study of all active practising members of the Swiss Chiropractic Association (ChiroSuisse) between 3 December 2019 and 31 January 2020. We asked about clinician and practice characteristics, EPR use for clinical record keeping, use of encrypted email for patient communication, and information on EPR and encrypted email communication products used. Multivariable logistic regression analyses assessed the association between clinician and practice characteristics and (1) EPR use and (2) encrypted email use. Results: Among 286 eligible Swiss chiropractors (193 [68%] men; mean age, 51.4 [SD, 11.2] years), 217 (76%) completed the survey (140 [65%] men; mean age 50.7 [11.2] years). The density of chiropractors in Switzerland was 3.3 per 100,000 inhabitants. 47% of respondents (95% confidence interval [CI], 40% to 54%) reported using an EPR in their practice, while 60% (95% CI, 54% to 67%) endorsed using encrypted email technology. Chiropractors aged ≥60 (versus those ≤39) years were 74% less likely to use an EPR system (OR 0.26, 95% CI 0.08 to 0.77), while clinicians from practices with 4 or more chiropractors (versus those from solo practices) were over 5 times more likely to report EPR use (OR 5.6, 2.1 to 16.5). Findings for factors associated with encrypted email use were similar. Conclusions: As of January 2020, 286 duly licensed chiropractors were available to provide musculoskeletal healthcare in Switzerland — just under 50% of Swiss chiropractors used an EPR system in clinical practice, while 60% used encrypted email technology. Better implementation of EPR and electronic health information technologies in Swiss chiropractic practice is possible and desirable for the purpose of musculoskeletal healthcare quality improvement.

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Section: Findings Context Of Existing Evidencesupporting

confidence: 76%

Use of electronic patient records and encrypted email patient communication among Swiss chiropractors: a population-based cross-sectional study

Hincapié

Hofstetter²,

Lalji³

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Breast cancer is a leading cause of women's amenable mortality in Switzerland, where both geographic and socioeconomic inequalities in breast cancer care and stage at diagnosis were documented ( 43 ). Switzerland's healthcare system weakness in tackling health inequalities, implementing health prevention and producing nationwide health data and quality of care indicators was linked to its high decentralization (due to the cantons' autonomy to manage healthcare) ( 44 , 45 ). Regional mammography programs may thus risk reproducing socioeconomic and geographic inequalities in breast cancer outcomes.…”

Section: Discussionmentioning

confidence: 99%

Revisiting the Effects of Organized Mammography Programs on Inequalities in Breast Screening Uptake: A Multilevel Analysis of Nationwide Data From 1997 to 2017

Jolidon

Prez

Bracke

et al. 2022

Front. Public Health

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This study revisits the effects of mammography screening programs on inequalities in breast screening uptake in Switzerland. The progressive introduction of regional mammography programs by 12 out of the 26 Swiss cantons (regions) since 1999 offers an opportunity to perform an ecological quasi-experimental study. We examine absolute income and marital status inequalities in mammography uptake, and whether the cantons' implementation of mammography programs moderate these inequalities, as previous research has devoted little attention to this. We use five waves of the Swiss Health Interview Survey covering the 1997–2017 period and comprising data on 14,267 women aged 50–70. Both up-to-date and ever-screening outcomes are analyzed with multilevel models which assess the mammography programs' within-canton effect. Findings show that higher income women and married women (compared to unmarried women) had significantly higher mammography uptake probabilities. Mammography programs did not moderate absolute income differences in up-to-date screening; however, they were associated with smaller absolute income differences in ever-screening uptake. Mammography programs related to higher screening uptake for married women, more than for unmarried women. In conclusion, we showed absolute income inequalities in mammography uptake which were not revealed by previous studies using relative inequality measures. Mammography programs may have contributed to reducing income inequalities in ever-screening, yet this was not observed for up-to-date screening. This study has implication for preventive health interventions—e.g., cancer screening promotion should pay attention to women's marital status since screening programs may widen the screening gap between married and unmarried women.

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“…As part of this larger project, several activities were conducted, including: a systematic review to identify the main barriers and facilitators to health data processing and harmonisation; 16 analyses of the interplay between data protection law and data sharing; 17 , 18 analyses of how ethics bears on the exchange of health data; 19 , 20 and interviews with more than 60 stakeholders practically involved in the health data infrastructure from both Switzerland and Denmark. 13 , 21 , 22 As a result of these activities, we gathered many insights on the state of the Swiss health data landscape, on the key challenges at the important crossroad where it stands, and on potential ways how to tackle them. To further contribute to the policy debate in our context, as well as to inform the policymaking of other countries who face similar issues in the field of digital health, we aimed at specifying and narrowing down the scope of proposals how to concretely facilitate the secondary use of data for research.…”

Section: Methodsmentioning

confidence: 99%

Sensing the (digital) pulse. Future steps for improving the secondary use of data for research in Switzerland

et al. 2023

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Introduction Ensuring that the health data infrastructure and governance permits an efficient secondary use of data for research is a policy priority for many countries. Switzerland is no exception and many initiatives have been launched to improve its health data landscape. The country now stands at an important crossroad, debating the right way forward. We aimed to explore which specific elements of data governance can facilitate – from ethico-legal and socio-cultural perspectives – the sharing and reuse of data for research purposes in Switzerland. Methods A modified Delphi methodology was used to collect and structure input from a panel of experts via successive rounds of mediated interaction on the topic of health data governance in Switzerland. Results First, we suggested techniques to facilitate data sharing practices, especially when data are shared between researchers or from healthcare institutions to researchers. Second, we identified ways to improve the interaction between data protection law and the reuse of data for research, and the ways of implementing informed consent in this context. Third, we put forth ideas on policy changes, such as the steps necessary to improve coordination between different actors of the data landscape and to win the defensive and risk-adverse attitudes widespread when it comes to health data. Conclusions After having engaged with these topics, we highlighted the importance of focusing on non-technical aspects to improve the data-readiness of a country (e.g., attitudes of stakeholders involved) and of having a pro-active debate between the different institutional actors, ethico-legal experts and society at large.

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Evolution or Revolution? Recommendations to Improve the Swiss Health Data Framework

Cited by 9 publications

References 46 publications

Use of electronic patient records and encrypted email patient communication among Swiss chiropractors: a population-based cross-sectional study

Use of electronic patient records and encrypted email patient communication among Swiss chiropractors: a population-based cross-sectional study

Revisiting the Effects of Organized Mammography Programs on Inequalities in Breast Screening Uptake: A Multilevel Analysis of Nationwide Data From 1997 to 2017

Sensing the (digital) pulse. Future steps for improving the secondary use of data for research in Switzerland

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