Evidence-based E-Health Policy - Vitally Important but not a New Call

Michael J. Rigby, Emeritus Professor of Health Information Strategy,
July 04, 2014

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.

Michael Rigby

Rigby M (1999) Health Informatics as a Tool to Improve Quality in Non -acute Care - New Opportunities and a Matching Need for a New Evaluation Paradigm; International Journal of Medical Informatics, 56, 1999, 141-150.

Rigby M (2001.)Evaluation: 16 Powerful Reasons Why Not to Do It - And 6 Over-Riding Imperatives; in Patel V, Rogers R, Haux R (eds.): Medinfo 2001: Proceedings of the 10th. World Congress on Medical Informatics, IOS Press, Amsterdam, 2001, 1198-1202.

Ammenwerth E et al (2004). Visions and strategies to improve evaluation of health information systems: Reflections and lessons based on the HIS-EVAL workshop in Innsbruck. International Journal of Medical Informatics, 2004 Jun 30; 73(6):479-91.

Talmon J. et al (2009. STARE-HI - Statement on Reporting of Evaluation Studies in Health Informatics; International Journal of Medical Informatics; 78 2009, 1, 1-9.

Nyk?nen P. (2011). Guideline for good evaluation practice in health informatics (GEP-HI); International Journal of Medical Informatics, 80, 815-827, 2011.

Brender J (2013). STARE-HI - Statement on Reporting of Evaluation Studies in Health Informatics: explanation and elaboration. Applied Clinical Informatics, 2013; 4: 331-358.

S?rousi B, Jaulent M-C, Lehmann CU (eds.) (2013). Evidence-based Health Informatics - IMIA Yearbook of Medical Informatics 2013; 34-46, Schattauer, Stuttgart, 2013.

Rigby M. et al (2013). Evidence Based Health Informatics: 10 Years of Efforts to Promote the Principle - Joint Contribution of IMIA WG EVAL and EFMI WG EVAL; in S?rousi B, Jaulent M-C, Lehmann CU. Evidence-based Health Informatics - IMIA Yearbook of Medical Informatics 2013; 34-46, Schattauer, Stuttgart, 2013.

WHO(2011)Call to Action on Global eHealth Evaluation - Consensus Statement of the WHO Global eHealth Evaluation Meeting, Bellagio, September 2011; available from http://www.healthunbound.org/content/call- action-global-ehealth-evaluation

IMIA(2012). http://www.imia-medinfo.org/new2/GA/2012beijing/1210GA- beijing-president-WHO.pdf

Conflict of Interest:

MR is retired but undertakes periodic paid and pro bono activities in health information, health policy, and related subjects.

Conflict of Interest

None declared