Improving routine health information systems in the European Region

Routine health information systems (RHISs) have the potential to dramatically improve decision-making among health-care professionals in the WHO European Region. However, a new study in the International Journal of Environmental Research and Public Health has identified challenges which make staff reluctant to adopt new technology that may help improve patient outcomes.

The study, “Routine health information systems in the European context: a systematic review of systematic reviews”, analyses 20 reviews published between 2007 and 2020 in 12 journals, covering between 3 and 14 countries.

To take full advantage of the potential of RHISs, an international strategy is required. WHO/Europe has identified behavioural and cultural insights that can help us to understand the drivers of and barriers to the uptake of health information systems and digital health. Behavioural and cultural insights and digital health are 2 of the 4 flagships of the European Programme of Work 2020–2025, and are helping to shape the future of health in the Region.

Strategies for improvement

The authors of the study identified challenges such as the lack of a strategy for RHIS implementation and evaluation, as well as insufficient equipment and financial and human resources. These conditions make it impossible to collect data capable of providing the best results, which may in turn discourage health workers from using the technology.

The authors used the PRISM framework to suggest strategies for improvement according to 3 determinants: technical, organizational and behavioural.

To improve technical strategies, records must be simplified to make data entry easy. Ideally, this is done by creating intuitive software that increases user acceptance and improves data availability in a usable format. Moreover, interoperability between RHISs should be enabled. 5G technology is a helpful solution to connectivity and bandwidth problems.

In terms of organizational strategies, it is important to manage financial and human resources effectively. A protocol that includes monitoring and evaluation, particularly during implementation, is essential. Here, leadership plays a role in guiding and resolving any issues that team members may encounter.

Finally, behavioural strategies are fundamental to RHIS implementation, as these systems rely on acceptance by potential users such as health-care professionals and the general public. Such strategies seek to strengthen staff members’ ability to collect, extract and use data effectively.

The review suggests that physicians should also receive training in digital skills, for example, to accurately input data into electronic health records, as well as transformational leadership and management. It is also important to incorporate professionals’ opinions on the timing of RHIS implementation.

Adapting to emerging trends

RHISs represent major cultural changes for health-care professionals and the general public. They are becoming effective instruments within organizations and health-care policies to promote citizen empowerment. Consequently, an expansion of social research into the health, organizational and policy impacts of RHIS use is recommended.

Big data and data-driven management are great opportunities for RHISs. More accurate and robust information allows for better management of acute situations such as the coronavirus pandemic, as well as disease prevention and expense reduction.

The combination of RHISs and big data is especially useful for analysing and evaluating the health problems of, and policies for, vulnerable groups. During a transition period when many people, including older people, continue to seek traditional services, RHISs can be useful for adapting information technology to specific needs.

Furthermore, issues of privacy, confidentiality and security of the data used in RHISs are vital.

Strengthening RHISs has become a global priority for tracking and achieving national health goals. Even if they present initial problems, RHISs can help to strengthen policy decision-making in local health systems, especially in low-income countries. It is therefore necessary to develop a suitable strategy based on the digitization of data processing, which can lead to a modern data-use structure and, ultimately, better health outcomes.

To facilitate the work of those assessing RHIS resources, an Excel file of Annex 2 of WHO/Europe’s support tool to strengthen health information systems is available for download via the link below.