Policy Implications of Big Data in the Health Sector

By Vayena, Effy; Dzenowagis, Joan et al. | Bulletin of the World Health Organization, January 2018 | Go to article overview

Policy Implications of Big Data in the Health Sector


Vayena, Effy, Dzenowagis, Joan, Brownstein, John S., Sheikh, Aziz, Bulletin of the World Health Organization


Over the last decade, there has been growing enthusiasm for data analytics as well as growing appreciation of the potential usefulness of so-called big data in transforming personal care, clinical care and public health, and related research. Both the public and private health sectors are investing in the technologies and analytical capabilities needed to unlock the full value of big data. For governments that are interested in using such data, a natural starting point is to link national health-care data sets, to facilitate in-depth analysis of the performance and utilization of health services. At the institutional level, the analysis of electronic health records may greatly expand the capacity to generate new knowledge by creating an observational evidence base to help resolve clinical questions. (1) Analysis of big data is already proving critical in building accurate models of disease progression and providing personalized medicine in clinical practice. It has also facilitated the evaluation of the impact of health policies and improved the efficiency of clinical trials. (2) By encouraging patients to participate in their own care, delivering personalized information and integrating medicine with behavioural determinants of health, the integration of electronic health records with personal data from other sources, e.g. medical devices, wearable devices, sensors and tools based on virtual reality, could also be very beneficial. (3) The value of health research based on non-traditional data streams from Internet-based applications, platforms, e.g. social media and services, e.g. email and online purchasing, has already been demonstrated. For example, during the Zika virus outbreak in 2015, analyses of reports in the online media helped to supplement existing information, close knowledge gaps and allow researchers to estimate transmission dynamics and plan response measures that extended beyond vector suppression. (4)

Big data ecosystem

New opportunities are being opened by the continuing expansion of the possible uses, sources and types of big data. For big data on health, the stakeholders extend beyond health-care providers, patients and research institutions to include businesses, development agencies, national governments, professional societies and other entities that are not necessarily directly related to health research or the delivery of health services. As new analytical models, data sources and stakeholders increasingly build into dynamic relationships, it maybe helpful to think of health-related big data as an evolving ecosystem (Fig. 1). (5) There are several challenges to the future development of this data ecosystem. Governments need to consider how to reshape national policies to advance the use of big data in health while keeping such data confidential, private and secure. Risks may arise not only directly, e.g. from the characteristics and scope of the data, but also indirectly, e.g. from the ways in which the data are combined, the policies, systems and technologies used to manage the data and the ways in which the data may be used. Even basic health data can be misused and lead to discrimination, especially of vulnerable populations. The fair distribution of any new benefits that may arise from the collection and analysis of big data may also pose hard challenges.

Big-data approaches

Despite increasing awareness of the benefits of big data and the related methodological and technological advances that are being made, many countries appear to be slow in adopting approaches based on such data. (6) The reasons may include gaps in funding, leadership and technical expertise and competing priorities within the health system. (7) Many governments are still considering appropriate policy options. In 2015, according to the World Health Organization's Global Observatory for eHealth, only 21 (17%) of the 125 Member States surveyed reported having a policy or strategy regulating the use of big data in their health sectors. …

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