Information and communication technologies (ICTs) have gained an increasing role as key enablers of health care reform, to improve access to health services, quality of care, and health system productivity. ICTs and the new models of care they enable require, however, a major shift from traditional practices. Change is therefore fraught with difficulties.
While the potential gains from greater use of these technologies have been apparent for years, most countries are still facing major implementation and adoption challenges. This highlights the large gap between what is possible and where we are now, with little known about how to fully leverage ICTs to improve the health and wellness of the population. Data on successful adoption and use across countries is therefore an essential learning tool for policy development in this area.
Recognising this need, the OECD in 2008 launched a multi-stakeholder initiative to develop a robust measurement framework and comparable cross-national measures. This task was accomplished in 2013 with the publication of an OECD Guide to Measuring ICTs in the Health Sector.
What is the aim of the Guide?
This OECD Guide to Measuring ICTs in the Health Sector has been developed with the aim to provide a standard reference for statisticians, analysts and policy makers in the field of health Information and Communication Technologies (ICT). The objective is to facilitate cross-country data collection, comparisons and learning to assist governments in understanding the barriers and incentives to ICT use and realise the far-reaching economic and social benefits from their application.
Who developed the Guide?
An OECD Expert Group representing 30 countries (including India, Brazil, and Egypt, as well as the European Commission (EC), the World Health Organization (WHO) and the Business and Industry Advisory Committee to the OECD (BIAC) and four expert sub-groups or Task Forces, chaired respectively by J. Zelmer (Canada), P. Hämäläinen (Finland), M. Sprenger (the Netherlands), J. Thorpe (United Kingdom) brought a range of relevant expertise and country representation to this initiative.
Within the OECD Secretariat, this project was developed by Elettra Ronchi who acted as project manager and coordinator. The project was carried out in close cooperation with Dr Ashish Jha (Harvard University School of Public Health), who led this effort as Chair of the OECD Expert Group on benchmarking health information and technologies, and Julia Adler-Milstein (University of Michigan).
The Expert Group reports to the OECD Health Committee via the Health Care Quality Indicators Expert Group (HCQI Expert Group); and the OECD Committee on Digital Economy Policy via the Working Party on Measurement and Analysis of the Digital Economy.
Who is the intended audience for the Guide?
The guide is written for countries that seek to produce national measures of the availability and use of health ICTs that can be compared to those of other countries. The guide is specifically targeted to those who will be implementing the data collection efforts and calculating benchmark measures.
What does the Guide contain?
There are two primary components of the guide. The first is the model survey. It is composed of self-contained modules that ensure flexibility and adaptability to a rapidly changing environment. The use of core modules (as an add-on to existing national surveys or as a stand-alone survey) allows measurement on an internationally comparable basis. Additional modules and new measures can be added to respond to evolving or country-specific policy needs in this area. Each module contains sample questions and there is an accompanying glossary with explanations of key terms.
The second component of the guide is a methodological guide to aid implementation and promote validity and comparability of resulting benchmark measures. The guide describes the types of meta-data, such as response rates and sampling approaches, which countries will be asked to report in order to help assess the validity of their data. To promote comparability, the guide leverages international classifications of health care delivery settings (e.g., hospitals) as well as health care professionals (e.g., general practitioners) to ensure consistent interpretations of the target populations and respondents.
This project was generously supported with grants by Health Canada, the Commonwealth Fund (CMW), the European Commission Directorate General for Health and Consumers and Directorate General Connect (EC- DG Connect), the Ministry of Health of Spain, the German Federal Health Ministry, and the Office of the National Coordinator for Health Information Technology (ONC) at the US Department of Health and Human Services. Three international workshops were held to advance this work, the first in Barcelona in 2010 co-sponsored by the Ministry of Health of Spain, the second in Paris in 2011 co-sponsored by the ONC and the CMW Fund, and the third in Brussels co-sponsored by the EC-DG Connect.