Shaping a Vision for 21st Century Health Statistics. International developments


International trends are favorable for the U.S. health statistics visioning process, with many countries engaged in parallel efforts to enhance their health information capacity. As in the U.S., these efforts are closely and explicitly tied to the goal of improving national health. Many of the same themes being addressed in the U.S., as reflected in this paper, are emerging in other countries’ efforts. There is also strong momentum toward collaboration and mutual learning in health information among countries. For example, the U.S. can learn a great deal from other countries about privacy protections. All of the countries described below have national privacy laws and data protection agencies.(17)

The United Kingdom, Australia, and Canada all provide valuable models and opportunities for collaboration.

  • England’s National Health Service (NHS) has been at work on its Health Care Model since the early 1980s, supported by a government that understands investment in information technology as essential overhead for health care. The NHS published its information strategy, Information for Health, in 1998.(18)
  • In Australia,(19) the Commonwealth, six states and two territories have signed a National Health Information Agreement that provides a cooperative framework for the collection, quality, and dissemination of national health information in that country. The agreement has produced a National Health Information Management Group and other bodies, as well as a national health information model, data dictionary, and knowledge base.
  • Canadians began a systematic examination of their health information needs in the early 1990s. This led in 1998 to a broad consultative process, coordinated by the Canadian Institute for Health Information and aimed at crafting a “National Health Information Roadmap” to support the country’s health objectives. (20) These activities have led to substantial new pilot funding from the Canadian government for implementation of the Roadmap. Despite the differences in health care delivery systems, Canada’s health statistics have developed much like those in the U.S., and they have similar inadequacies in terms of their completeness, compatibility, and usefulness. The consultations and theoretical work going into Canadian Roadmap development¾and the commitment to providing Canadians with accessible, useful information¾offer valuable models for our country’s visioning process and its products.
  • The European Union issued a Privacy Directive in 1998, intensifying the pressure on the U.S. to strengthen its own privacy protections. European nations have had a framework for addressing privacy since 1980, when the Organization for Economic Cooperation and Development (OECD) issued Guidelines on the Protection of Privacy and Transborder Flows of Personal Data. These guidelines cover such topics as limitations on data collection and use, specification of purpose, openness, and accountability.