Legal assessment tool (LAT): an interactive tool to address privacy and data protection issues for data sharing

Enhancing Patient Safety Culture in Hospitals

Patient safety has become a top priority for healthcare organizations. A better patient safety environment is associated with a lower probability of significant complications. Training programmers is critical to promoting patient safety and minimizing misunderstandings. The quality, performance, and productivity of the healthcare industry can be dramatically improved by changing the patient safety atmosphere operating within the hospital sector. Hospitals can significantly reduce medical errors and adverse events by implementing the program and training programmers to prioritize patient safety. This will improve patient outcomes and increase efficiency and effectiveness. Creating a patient safety culture within hospitals will contribute to a higher standard of care and improved overall performance in the healthcare industry. Hospitals can identify systemic problems and implement proactive measures to prevent future incidents by creating an environment in which healthcare professionals feel comfortable reporting errors. A patient safety culture encourages collaboration and open communication among healthcare teams leading to more effective and coordinated care.

My data choices: Pilot evaluation of patient-controlled medical record sharing technology

Patients desire greater control over sharing their digital health data. Consent2Share (C2S) is an open-source consent tool offered by SAMHA and the VA to support granular data sharing (GDS) options that align with patient preferences and data privacy regulations. The need to validate this tool exists. We pilot tested C2S with 199 English and Spanish-speaking patients with behavioral health conditions (BHCs) and patient guardians. Data were analyzed using mixed methodology. All participants desired granular control over the sharing of their health data. Most participants (87%) were highly interested in using a tool that offered granular options for executing data sharing decisions, with over half (55%) indicated that being able to specify the data type, data recipient, and data use purpose made them more willing to share their medical records. Majority (83%) indicated that the supported data type sharing categories satisfied their data-sharing privacy preferences. Majority (87%) also reported that knowing the purpose of data use made them more comfortable in sharing. Some participants (28%) accessed the education materials provided on data type sharing options. Patients want granular choices when sharing medical records. Consent2Share and its supported data type sharing categories are adequate to capture patients’ data sharing preferences. Further development is needed before deployment in clinical environments.

Burn injuries in primary care in the Netherlands: Risk factors and trends

BACKGROUND

Research to date has mainly focused on burn injuries treated in secondary care. This study aims to provide knowledge on the epidemiology of burn injuries in primary care, to give directions for burn prevention.

METHODS

Data were derived from routine electronic health records of general practices and their out-of-hours service organisations in the Netherlands that participated in the Nivel Primary Care Database 2010-2015. We studied risk factors and trends.

RESULTS

The average burn injury prevalence rate was 4.40 (95% CI 4.27-4.53) per 1000 person-years in daytime general practice care and 1.47 (95% CI 1.46-1.49) per 1000 inhabitants in out-of-hours care. Children of 0-4 years old, especially boys, and young adult women had a higher risk. Burn injury risk was higher during the summer months and around New Year's Eve. Living in low socioeconomic and strongly urbanised neighbourhoods was associated with a higher risk of burn injury than living in other neighbourhoods.

CONCLUSION

Dutch general practitioners have a large share in burn care and therefore can play a significant role in burn prevention. Prevention may be most effective in the summer and around New Year's Eve, and specific attention seems to be warranted for low socioeconomic groups and strongly urbanised neighbourhoods.

Governing Personalized Health: A Scoping Review

Genetic research is advancing rapidly. One important area for the application of the results from this work is personalized health. These are treatments and preventive interventions tailored to the genetic profile of specific groups or individuals. The inclusion of personalized health in existing health systems is a challenge for policymakers. In this article, we present the results of a thematic scoping review of the literature dealing with governance and policy of personalized health. Our analysis points to four governance challenges that decisionmakers face against the background of personalized health. First, researchers have highlighted the need to further extend and harmonize existing research infrastructures in order to combine different types of genetic data. Second, decisionmakers face the challenge to create trust in personalized health applications, such as genetic tests. Third, scholars have pointed to the importance of the regulation of data production and sharing to avoid discrimination of disadvantaged groups and to facilitate collaboration. Fourth, researchers have discussed the challenge to integrate personalized health into regulatory-, financing-, and service provision structures of existing health systems. Our findings summarize existing research and help to guide further policymaking and research in the field of personalized health governance.

Society for Immunotherapy of Cancer clinical and biomarkers data sharing resource document: Volume I-conceptual challenges

The sharing of clinical trial data and biomarker data sets among the scientific community, whether the data originates from pharmaceutical companies or academic institutions, is of critical importance to enable the development of new and improved cancer immunotherapy modalities. Through data sharing, a better understanding of current therapies in terms of their efficacy, safety and biomarker data profiles can be achieved. However, the sharing of these data sets involves a number of stakeholder groups including patients, researchers, private industry, scientific journals and professional societies. Each of these stakeholder groups has differing interests in the use and sharing of clinical trial and biomarker data, and the conflicts caused by these differing interests represent significant obstacles to effective, widespread sharing of data. Thus, the Society for Immunotherapy of Cancer (SITC) Biomarkers Committee convened to identify the current barriers to biomarker data sharing in immuno-oncology (IO) and to help in establishing professional standards for the responsible sharing of clinical trial data. The conclusions of the committee are described in two position papers: Volume I-conceptual challenges and Volume II-practical challenges, the first of which is presented in this manuscript. Additionally, the committee suggests actions by key stakeholders in the field (including organizations and professional societies) as the best path forward, encouraging the cultural shift needed to ensure responsible data sharing in the IO research setting.

Legal and ethical framework for global health information and biospecimen exchange - an international perspective

Background

The progress of electronic health technologies and biobanks holds enormous promise for efficient research. Evidence shows that studies based on sharing and secondary use of data/samples have the potential to significantly advance medical knowledge. However, sharing of such resources for international collaboration is hampered by the lack of clarity about ethical and legal requirements for transfer of data and samples across international borders.

Main text

Here, the International Clinical Trial Center Network (ICN) reports the legal and ethical requirements governing data and sample exchange (DSE) across four continents. The most recurring requirement is ethical approval, whereas only in specific conditions approval of national health authorities is required. Informed consent is not required in all sharing situations. However, waiver of informed consent is only allowed in certain countries/regions and under certain circumstances. The current legal and ethical landscape appears to be very complex and under constant evolution. Regulations differ between countries/regions and are often incomplete, leading to uncertainty.

Conclusion

With this work, ICN illuminates the unmet need for a single international collaborative framework to facilitate DSE. Harmonising requirements for global DSE will reduce inefficiency and waste in research. There are many challenges to realising this ambitious vision, including inconsistent terminology and definitions, and heterogeneous and dynamic legal constraints. Here, we identify areas of agreement and significant difference as a necessary first step towards facilitating international collaboration. We propose the establishment of a working group to continue the comparison across jurisdictions, create a standardised glossary and define a set of basic principles and fundamental requirements for DSE.

Orchestrating differential data access for translational research: a pilot implementation

Background

Translational researchers need robust IT solutions to access a range of data types, varying from public data sets to pseudonymised patient information with restricted access, provided on a case by case basis. The reason for this complication is that managing access policies to sensitive human data must consider issues of data confidentiality, identifiability, extent of consent, and data usage agreements. All these ethical, social and legal aspects must be incorporated into a differential management of restricted access to sensitive data.

Methods

In this paper we present a pilot system that uses several common open source software components in a novel combination to coordinate access to heterogeneous biomedical data repositories containing open data (open access) as well as sensitive data (restricted access) in the domain of biobanking and biosample research. Our approach is based on a digital identity federation and software to manage resource access entitlements.

Results

Open source software components were assembled and configured in such a way that they allow for different ways of restricted access according to the protection needs of the data. We have tested the resulting pilot infrastructure and assessed its performance, feasibility and reproducibility.

Conclusions

Common open source software components are sufficient to allow for the creation of a secure system for differential access to sensitive data. The implementation of this system is exemplary for researchers facing similar requirements for restricted access data. Here we report experience and lessons learnt of our pilot implementation, which may be useful for similar use cases. Furthermore, we discuss possible extensions for more complex scenarios.