Identifying common enablers and barriers in European health information systems.

European countries possess unique health information systems (HISs) and face similar health system challenges. Investigating common enablers and barriers across Europe pinpoint where HISs need improvements to address these challenges. This study aims to identify common enablers and barriers for optimal functioning of HISs across the European Union and associated countries, and to interpret what this means for the further development of HISs in Europe. A qualitative thematic analysis was carried out based on nine countries HISs assessments. Two main observations are made. Firstly, regardless of the differences between HISs, each HIS had its strengths and weaknesses and often the same barriers and enablers arose. Secondly, barriers were identified in all HIS areas. The five most important barriers are (i) fragmentation of data sources, limited accessibility, use and re-use of data, (ii) barriers in the implementation of EHR-systems, (iii) governance issues related to unclear responsibilities, discontinuous financing and weak intra- and inter-sectorial collaboration, (iv) legal gaps and General Data Protection Regulation (mis)interpretation, and (v) limited skilled staff. The enablers identified in this study lead to potential solutions to address these. Solutions can be implemented by national initiatives, but there is considerable added value in a joint European approach. Several international initiatives provide opportunities to improve HISs, but these need to be strengthened and better geared towards tackling the identified&nbsp;barriers.</p

Capacity building in European health information systems: the InfAct peer assessment methodology.

BACKGROUND: A Health Information System (HIS) assessment is an evaluation of the functioning of the main elements that compose a national HIS. Assessors from nine countries performed peer assessments of each other&#8217;s national HIS in the Joint Action on Health Information (InfAct). The aim of this study is to evaluate the advantages and disadvantages of the InfAct peer assessment methodology as well as the different steps involved in this assessment&nbsp;process. METHODS: Each peer assessment included a preparatory desk report, a country visit with semi-structured interviews with local stakeholders, a final report and a follow-up stakeholder meeting. A qualitative content analysis of the peer HIS assessment was performed based on 12 semi-structured&nbsp;interviews. RESULTS: The main advantage of the assessments is its informal atmosphere, high degree of objectiveness and its networking opportunities. Disadvantages are its informal request format and setting for recommendation uptake. The peer assessment helped the assessors to broaden their understanding of the assessed and their own HISs, to gain knowledge on how to carry out an HIS assessment and to practice their organization, communication, reporting and negotiation skills. All steps of the HIS assessment are essential and each contributes to the enriching experience of the&nbsp;participants. CONCLUSION: The InfAct peer HIS assessment methodology strengthened capacity in national HISs by building up the knowledge and expertise in participating countries and as such addressed health information inequalities. This study confirms the value and relatively easy to implement methodology, and therefore recommends its wide and more systematic application across&nbsp;Europe.</p

Towards a sustainable EU health information system infrastructure: A consensus driven approach

BACKGROUND: Health information in the EU is characterised by diversity and fragmentation of health information infrastructures. A well-defined and sustainable EU health information system infrastructure is lacking. The potential of a European Research Infrastructure Consortium on Health Information for Research and Evidence-based Policy (HIREP-ERIC) to take up this role is&nbsp;investigated. METHODS: Two working groups, a BRIDGE Health Steering Committee and the European Commission&#8217;s Drafting Group of the Expert Group on Health Information, discussed the technical and scientific description of the HIREP-ERIC through a consensus-driven modified Delphi&nbsp;technique. RESULTS: Consensus was reached on three aspects of the HIREP-ERIC. First, it was defined as an infrastructure that facilitates interaction of networks and experts in health information by providing central governance and a more permanent collaboration. Second, the infrastructure should be distributed, with a central hub coordinating the operation of distributed networks. Third, it should provide easy access to high quality and comparable data for purposes of research and policy making, and focus its activities around generating, managing, exchanging and translating health&nbsp;information. CONCLUSION: A momentum has been created where representatives from 16 European countries agreed on the HIREP-ERIC as a pragmatic bottom-up approach to strengthen the current EU health information landscape. A Member States’ commitment is needed at senior political level to make this consensus&nbsp;operational.</p