International Medical Informatics Association, Geneva, Switzerland.
Int J Med Inform. 2013 Jan;82(1):1-9. doi: 10.1016/j.ijmedinf.2012.11.003. Epub 2012 Nov 20.
The widespread adoption of electronic health records (EHRs) is accelerating the collection of sensitive clinical data. The availability of these data raises privacy concerns, yet sharing the data is essential for public health, longitudinal patient care, and clinical research.
Following previous work in the United States [1,2], the International Medical Informatics Association convened the 2012 European Summit on Trustworthy Reuse of Health Data. Over 100 delegates representing national governments, academia, patient groups, industry, and the European Commission participated. In all, 21 countries were represented. The agenda was designed to solicit a wide range of perspectives on trustworthy reuse of health data from the participants.
Delegates agreed that the "government" should provide oversight, that the reuse should be "fully regulated," and that the patient should be "fully informed." One important reflection was that doing nothing will have negative implications across the European Union (EU). First, continued fragmented parallel non-standards-based developments in multiple sectors entail a substantial duplication of costs and human effort. Second, a failure to work jointly across the stakeholders on common policy frameworks will forego a crucial opportunity to boost key EU markets (pharmaceuticals, health technology and devices, and eHealth solutions) and counter global competition. Finally, and crucially, the lack of harmonized policy across EU nations for trustworthy reuse of health data risks patient safety. The productive dialog, initiated with multiple stakeholders from government, academia, and industry, will have to continue, in order to address the many remaining issues outlined in this white paper.
电子健康记录(EHRs)的广泛采用正在加速敏感临床数据的收集。这些数据的可用性引发了隐私问题,但为了公共卫生、纵向患者护理和临床研究,数据共享是必不可少的。
继美国的先前工作[1,2]之后,国际医学信息学协会召开了 2012 年欧洲值得信赖的健康数据再利用峰会。来自各国政府、学术界、患者团体、行业和欧盟委员会的 100 多名代表参加了会议。总共有 21 个国家派代表出席。该议程旨在征求与会者对健康数据值得信赖的再利用的广泛意见。
代表们一致认为,“政府”应提供监督,再利用应“全面监管”,患者应“充分知情”。一个重要的反思是,欧盟(EU)不采取任何行动将产生负面影响。首先,多个部门继续进行分散的、平行的、非标准化的发展,将导致大量成本和人力的重复。其次,如果不能在利益相关者之间就共同的政策框架进行合作,将错失一个促进欧盟关键市场(制药、健康技术和设备以及电子健康解决方案)和应对全球竞争的重要机会。最后,也是至关重要的是,欧盟各国在值得信赖的健康数据再利用方面缺乏协调一致的政策,这将危及患者安全。必须继续进行来自政府、学术界和行业的多方利益攸关者之间的富有成效的对话,以解决本白皮书概述的许多剩余问题。