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International Efforts

Health information technology use in the United States and the United Kingdom

Health information technology use is growing in both the United States and the United Kingdom. 

On January 23, 2014, the U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and the U.K. Secretary of State for Health Jeremy Hunt signed a bi-lateral agreement for the use and sharing of health IT information and tools. The agreement strengthens efforts to cultivate and increase the use of health IT tools and information designed to help improve the quality and efficiency of the delivery of health care in both countries. The two Secretaries of Health signed the agreement at the Annual Meeting of the HHS Office of the National Coordinator for Health IT. 

The agreement signals a formal commitment by both countries to collaborate to advance the applications of data and technology to improve health.

Originally identified at the June 5, 2013, bilateral summit meeting between the United States and United Kingdom, the collaboration focuses on four key areas for health IT and innovation.

  • Sharing Quality Indicators – This collaboration reviewed existing quality indicators and selected depression symptom screening and knee and hip patient-reported quality indicators.  Building on this initial work, this collaboration sought to further alignment across existing British and American clinical repositories to identify best practices in the design and use of quality indicators. This work leverages technical experts and data, and works toward a standardized approach to quality indicator development.  Initial efforts have resulted in: 
    • 2015 – Focusing on patient-reported outcome measures (PROM) for patients undergoing knee replacements, the US and UK identified national registries currently using the same PRO survey tools to compare surgical outcomes by Body Mass Index (BMI) for each country’s national joint replacement program. Data showed improvements in pain and function in all patients with results as good if not better in morbidly obese patients and demonstrated that it is feasible to measure quality indicators across the US and UK.
    • April 2016 – ONC, CMS and iOutcomes, part of the technology transfer company for the University of Oxford signed an MoU providing for:
      • royalty-free use of the Oxford Hip and Knee Scores to participants in CMS quality reporting programs
      • a web-based portal for access to the tools, scoring guides and other supporting materials
      • ONC assistance to Oxford in enabling the use of these scores using relevant health IT quality reporting standards
      Read the MOU [PDF - 193KB]
    • Alignment of these PROMs across the two countries will promote data sharing to allow comparisons of quality outcomes by providers, patients, regions and other characteristics.
  • Liberating Data and Putting It to Work – HHS and the United States and National Health Service England will discuss and find areas of collaboration around:
    • Open data and safe and secure data transparency of secondary stored data, with the consent of patients to allow for the two countries to further assess the quality of preventive interventions and health care delivery;  
    • Interoperability standards for improvement of data sharing and clinical care respectively, with a focus on consumer/patients accessing and sharing their data, such as Blue Button in the United States;
  • Adopting Digital Health Record Systems –  Both organizations will work to maximize successful adoption of digital records across the health care spectrum and support the development of a robust health IT workforce; and
  • Priming the Health IT Market – Both organizations will work to support the Health IT Marketplace by identifying barriers to innovation, sharing individual certification approaches for patients and clinician-facing applications, and strategies to support small and medium enterprises/start-ups.