Evidence-based E-Health Policy - Vitally Important but not a New Call
The editorial from Sheikh, Atun, and Bates is welcome in flagging up a key issue in the context of England and the US. However, it is not a new issue, and it is disappointing that they do not acknowledge prior and concurrent work.
The need for, and challenges impeding, evaluation of health information systems have been flagged up much earlier, e.g. Rigby 1999; 2001. Both the European Federation for Medical Informatics (EFMI) and the International Medical Informatics Association (IMIA) have groups which have followed up this theme. Ammenwerth instigated a European workshop which inspired a significant work programme (Ammenwerth et al, 2004), and led to production of reporting standards adopted by the EQUATOR network (Talmon et al, 2009)and guidelines (Nyk?nen et al, 2011) which have been fully elaborated (Brender et al, 2013).
The specific dual challenges behind the editorial by Sheikh, Atun and Bates are the penchant for politicians to decree policy outside their technical knowledge in order to appear progressive, and the generic need for evidence-based policy in health informatics. This latter too has recently been addressed - generically by a dedicated edition of the IMIA Year Book (S?rousi et al, 2013) which included a summary of the concerted actions of a decade (Rigby et al, 2013); and in the context of developing countries by WHO (2011) and through a joint WHO-IMIA Programme (IMIA, 2012).
Moving to evidence-based health informatics policy is vital for effectiveness, efficiency, safety, and enhanced health care delivery and outcomes. Such an approach faces challenges as it cuts across the perceived autonomy of politicians, and the worrying scant regard for a scientific evidence base of some sectors of the supplier industry, while evaluation to produce the evidence continually faces impediments as described. It is therefore vitally important that all innovators and activists work collaboratively to progress the issues.
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Conflict of Interest:
MR is retired but undertakes periodic paid and pro bono activities in health information, health policy, and related subjects.