Yearb Med Inform 2017; 26(01): 59-67
DOI: 10.15265/IY-2017-010
Special Section: Learning from Experience: Secondary Use of Patient Data
Working Group Contributions
Georg Thieme Verlag KG Stuttgart

Evaluation Considerations for Secondary Uses of Clinical Data: Principles for an Evidence-based Approach to Policy and Implementation of Secondary Analysis

A Position Paper from the IMIA Technology Assessment & Quality Development in Health Informatics Working GroupP. J. Scott1, M. Rigby2, E. Ammenwerth3, J. Brender McNair4, A. Georgiou5, H. Hyppönen6, N. de Keizer7, F. Magrabi5, P. Nykänen8, W. T. Gude7, W. Hackl3
  • 1University of Portsmouth, Centre for Healthcare Modelling and Informatics, Portsmouth, United Kingdom
  • 2Keele University, School of Social Science and Public Policy, Keele, United Kingdom
  • 3UMIT, University for Health Sciences, Medical Informatics and Technology, Institute of Medical Informatics, Hall in Tyrol, Austria
  • 4Aalborg University, Department of Health Science & Technology, Aalborg, Denmark
  • 5Macquarie University, Australian Institute of Health Innovation, Sydney, Australia
  • 6National Institute for Health and Welfare, Information Department, Helsinki, Finland
  • 7Academic Medical Center, Department of Medical Informatics, Amsterdam, The Netherlands
  • 8University of Tampere, School of Information Sciences, Tampere, Finland
Further Information

Publication History

Publication Date:
11 September 2017 (online)


Objectives: To set the scientific context and then suggest principles for an evidence-based approach to secondary uses of clinical data, covering both evaluation of the secondary uses of data and evaluation of health systems and services based upon secondary uses of data.

Method: Working Group review of selected literature and policy approaches.

Results: We present important considerations in the evaluation of secondary uses of clinical data from the angles of governance and trust, theory, semantics, and policy. We make the case for a multi-level and multi-factorial approach to the evaluation of secondary uses of clinical data and describe a methodological framework for best practice. We emphasise the importance of evaluating the governance of secondary uses of health data in maintaining trust, which is essential for such uses. We also offer examples of the re-use of routine health data to demonstrate how it can support evaluation of clinical performance and optimize health IT system design.

Conclusions: Great expectations are resting upon “Big Data” and innovative analytics. However, to build and maintain public trust, improve data reliability, and assure the validity of analytic inferences, there must be independent and transparent evaluation. A mature and evidence-based approach needs not merely data science, but must be guided by the broader concerns of applied health informatics.