The keys to governance and stakeholder engagement: the southeast michigan beacon community case study

Implementation of data access and use procedures in clinical data warehouses. A systematic review of literature and publicly available policies

BACKGROUND

The promises of improved health care and health research through data-intensive applications rely on a growing amount of health data. At the core of large-scale data integration efforts, clinical data warehouses (CDW) are also responsible for data governance, managing data access and (re)use. As the complexity of the data flow increases, greater transparency and standardization of criteria and procedures are required in order to maintain objective oversight and control. Therefore, the development of practice oriented and evidence-based policies is crucial. This study assessed the spectrum of data access and use criteria and procedures in clinical data warehouses governance internationally.

METHODS

We performed a systematic review of (a) the published scientific literature on CDW and (b) publicly available information on CDW data access, e.g., data access policies. A qualitative thematic analysis was applied to all included literature and policies.

RESULTS

Twenty-three scientific publications and one policy document were included in the final analysis. The qualitative analysis led to a final set of three main thematic categories: (1) requirements, including recipient requirements, reuse requirements, and formal requirements; (2) structures and processes, including review bodies and review values; and (3) access, including access limitations.

CONCLUSIONS

The description of data access and use governance in the scientific literature is characterized by a high level of heterogeneity and ambiguity. In practice, this might limit the effective data sharing needed to fulfil the high expectations of data-intensive approaches in medical research and health care. The lack of publicly available information on access policies conflicts with ethical requirements linked to principles of transparency and accountability. CDW should publicly disclose by whom and under which conditions data can be accessed, and provide designated governance structures and policies to increase transparency on data access. The results of this review may contribute to the development of practice-oriented minimal standards for the governance of data access, which could also result in a stronger harmonization, efficiency, and effectiveness of CDW.

IT-enabled Community Health Interventions: Challenges, Opportunities, and Future Directions

Rising health information technology (HIT) adoption and the increasing interoperability of health data have propelled the role of IT in community-wide health transformations. Disseminating the challenges and opportunities that the early adopters of community-wide HIT interventions have experienced is critical for empowering the growing demand for community-based health systems. This special issue of eGEMs addresses that need. This issue includes a variety of community-based HIT projects covering topics such as governance, informatics, and learning health systems. These projects represent a diverse set of stakeholders, a wide selection of data sources, and multiple information platforms to collate or exchange data. We hope that this special issue of eGEMs will be the first of several future issues dedicated to community-wide HIT transformations.