The value of evidence in outcomes-based healthcare (L7)

A Young Gasteiner’s musings on the applications of big data in health

This blog post relates to the ‘The value of evidence in outcomes-based healthcare’ workshop held at the European Health Forum Gastein on the 5th October 2018.

This lunch workshop was organised by IMI Big Data for Better Outcomes (BD4BO), a European research programme that aims to support the transformation of healthcare systems by means of big data. The programme is a collaboration between the European Union, the European Federation of Pharmaceutical Industries and Associations, academia and civil society.

In his introduction to the BD4BO project, Shahid Hanif (Head of Health Data and Outcomes, Association of British Pharmaceutical Industries) described four key enablers required to unlock the potential of big data in improving health outcomes, access, safety and research:

  • Defining a standard set of outcomes with demonstrated value
  • Access to high-quality outcomes data
  • Using data to improve the value of healthcare delivery
  • Increasing patient engagement through the use of digital solutions

As a public health medicine trainee in Malta, I have experienced first-hand the frustrations of grappling with health data siloes that are operationally and geographically close, but do not interconnect. In some instances these systems have not been designed taking into account monitoring and reporting requirements. Additionally, many crucial components of patient records are still paper-based. Coming from such a background where there is much progress to be made for the enablers described to be in place, it can seem very daunting to visualise a feasible path for our health system to reach the goal of unlocking big data’s potential benefits.

As though reading my mind on this last point, panellist Miklos Szocska made an interjection during the debate that I drew hope from. He explained that during his term as Minister of Health in Hungary, the health ministry did not wait until a complex network of digital infrastructure was in place to start using big data, but instead started with using the data already available in projects at a smaller scale. Applying network analytics in this way was successful in saving lives, as well as public money. Dr Szocska stressed the importance of agility and the introduction of innovative business models in these successes.

In reaction to this, a panellist (and a fellow Young Gasteiner) Petronille Bogaert made a valid point that state ministries and national public health institutes often function within bureaucratic systems that put them at a disadvantage when it comes to responding to such challenges with agility. However, moderator Richard Bergstrom’s later comments perfectly encapsulate why these entities should not retreat from the challenge presented by big data despite this; private interests will proceed with developing health applications for big data irrespective of whether public health actors take a seat at the big data table or not.

In light of this, I believe that we should feel compelled to step up toour seat at that table and collaborate with all stakeholders to exert our influence in the interest of public health, such as through the establishment of required standards and governance frameworks. If not, we will miss the opportunity to contribute to shaping developments around big data in a way that addresses public concerns around issues such as ethics, transparency, and security, and reflects the values we wish to uphold in our health systems.


This Blog was written by the Young Gasteiner Beatrice Farrugia


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