Schmidt Andrea E, Abboud Linda A, Bogaert Petronille
Austrian Public Health Institute (Gesundheit Österreich), Department of Health Economics and Health Systems Analysis, Stubenring 6, 1010, Vienna, Austria.
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Arch Public Health. 2021 Jan 29;79(1):13. doi: 10.1186/s13690-021-00531-5.
The Sars-CoV-2 pandemic exacerbates existing inequalities across health care systems globally, both within countries and between countries. It also highlights, like no other crisis before, existing weaknesses in health information systems (HIS). This article summarizes these key challenges for HIS in times of a pandemic and beyond, with a focus on European countries. It builds on the experiences of a large consortium representing HIS experts in key positions in national public health or similar institutes across Europe.
Data were collected in bi-weekly conference calls organized by the InfAct project between February and June 2020. Emerging themes were clustered and analysed around a WHO framework for health information systems (HIS). We analyse strengths of HIS at two levels: (i) dealing with health information directly, and (ii) dealing with other parts of information systems that allow for a holistic assessment of the pandemic (including health-related aspects).
The analysis highlights the need for capacity-building in HIS before a pandemic hits, the relevance of going beyond health information only related to health care but taking a broader perspective (e.g. on vulnerable groups), the need for strong reporting systems on staffing numbers and in primary care. Further, data linkage emerges as a crucial precondition to identify unmet needs for essential health care services in a timely manner. Finally, room for innovation and digitalisation is key to be able to react flexibly in times of crisis. Trust for health information stakeholders is another important factor to create strong HIS.
The strengths and shortcomings of European HIS that have been observed during the COVID-19 crisis highlight the need for strong HIS beyond the crisis. The experiences reported leave as a central message that successful reactions to the pandemic are (also) grounded in strong HIS that ultimately not only benefit the health of the population but also create a number of economic and psycho-social benefits. Strong data reporting schemes may also support fine-tuning of containment measures during a pandemic as well as transition phases.
新型冠状病毒肺炎疫情加剧了全球医疗保健系统中现存的不平等现象，包括国家内部和国家之间的不平等。它还比以往任何危机都更凸显了卫生信息系统（HIS）中现存的弱点。本文总结了疫情期间及之后HIS面临的这些关键挑战，重点关注欧洲国家。它基于一个大型联盟的经验，该联盟代表了欧洲各国国家公共卫生或类似机构中担任关键职位的HIS专家。
数据收集于2020年2月至6月期间由InfAct项目组织的双周电话会议。围绕世界卫生组织的卫生信息系统（HIS）框架对新出现的主题进行聚类和分析。我们从两个层面分析HIS的优势：（i）直接处理卫生信息，以及（ii）处理信息系统的其他部分，以便对疫情进行全面评估（包括与健康相关的方面）。
分析强调了在疫情来袭之前HIS进行能力建设的必要性，超越仅与医疗保健相关的卫生信息而采取更广泛视角（例如对弱势群体）的相关性，建立强大的人员配备数量和初级保健报告系统的必要性。此外，数据链接成为及时识别基本医疗保健服务未满足需求的关键前提条件。最后，创新和数字化空间是能够在危机时期灵活应对的关键。卫生信息利益相关者之间的信任是建立强大HIS的另一个重要因素。
在新冠疫情危机期间观察到的欧洲HIS的优势和不足凸显了危机过后建立强大HIS的必要性。所报告的经验留下的核心信息是，对疫情的成功应对（也）基于强大的HIS，这最终不仅有益于民众健康，还能创造一系列经济和心理社会效益。强大的数据报告计划也可能支持在疫情期间以及过渡阶段对防控措施进行微调。
