Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators
Background The rapid digitisation of healthcare has resulted in the capture of a vast amount of health data, which are increasingly being used for secondary purposes, such as quality improvement and performance management.Objectives This study examined the legal and ethical considerations that affec...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-04-01
|
| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/2/e003309.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849315673765838848 |
|---|---|
| author | Tim Shaw Kevin Leow Ian Kerridge Cameron Stewart Anna Janssen Kavisha Shah |
| author_facet | Tim Shaw Kevin Leow Ian Kerridge Cameron Stewart Anna Janssen Kavisha Shah |
| author_sort | Tim Shaw |
| collection | DOAJ |
| description | Background The rapid digitisation of healthcare has resulted in the capture of a vast amount of health data, which are increasingly being used for secondary purposes, such as quality improvement and performance management.Objectives This study examined the legal and ethical considerations that affect if and how health professionals and administrators implement and use their performance data from the perspective of these stakeholder groups.Eligibility criteria The search strategy focused on the use of health data (1) for quality improvement and performance management, (2) by health professionals and (3) discussion of ethicolegal concerns.Sources of evidence A scoping review was conducted of three medical databases (Medline, Scopus and Embase) in April 2023, updated in June 2024.Charting methods Included articles were first charted against 12 descriptive variables and then thematically analysed against the 16 substantive and procedural values of the Ethics Framework for Big Data in Health and Research (the Framework).Results We identified 16 articles that explored 5/7 procedural and 8/9 substantive values of the Framework. Health professionals were mostly concerned with the fairness of data comparisons defined as the use of accurate and risk-adjusted datasets and the contextualisation of performance data against clinical experiences. Health administrators additionally emphasised the importance of good governance and data stewardship to improving professional engagement with performance data, but privacy remains a key barrier.Conclusions The growing interest in using health data for quality improvement and performance management requires health services to address barriers to utilisation of performance data. Legal and ethical concerns must be balanced and prioritised in collaboration with end users for performance data to be accepted as a valid form of quality and performance assessment. Although privacy remains a key issue, these fears can be effectively managed by restricting public reporting on performance to only what is essential for public assurance. |
| format | Article |
| id | doaj-art-4ea21905140e401ab61fc36d3907cfad |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-4ea21905140e401ab61fc36d3907cfad2025-08-20T03:52:04ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-04-0114210.1136/bmjoq-2025-003309Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administratorsTim Shaw0Kevin Leow1Ian Kerridge2Cameron Stewart3Anna Janssen4Kavisha Shah5The University of Sydney Charles Perkins Centre, Sydney, New South Wales, AustraliaThe University of Sydney, Centre for Kidney Research, School of Public Health, Sydney Medical School, Children’s Hospital at Westmead, New South Wales, Australia3 Marie Bashir Institute for Emerging Infectious Disease and Biosecurity, University of Sydney, Sydney, New South Wales, AustraliaCentre for Health Governance, Law and Ethics, Sydney Law School, University of Sydney, AustraliaFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, AustraliaFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, AustraliaBackground The rapid digitisation of healthcare has resulted in the capture of a vast amount of health data, which are increasingly being used for secondary purposes, such as quality improvement and performance management.Objectives This study examined the legal and ethical considerations that affect if and how health professionals and administrators implement and use their performance data from the perspective of these stakeholder groups.Eligibility criteria The search strategy focused on the use of health data (1) for quality improvement and performance management, (2) by health professionals and (3) discussion of ethicolegal concerns.Sources of evidence A scoping review was conducted of three medical databases (Medline, Scopus and Embase) in April 2023, updated in June 2024.Charting methods Included articles were first charted against 12 descriptive variables and then thematically analysed against the 16 substantive and procedural values of the Ethics Framework for Big Data in Health and Research (the Framework).Results We identified 16 articles that explored 5/7 procedural and 8/9 substantive values of the Framework. Health professionals were mostly concerned with the fairness of data comparisons defined as the use of accurate and risk-adjusted datasets and the contextualisation of performance data against clinical experiences. Health administrators additionally emphasised the importance of good governance and data stewardship to improving professional engagement with performance data, but privacy remains a key barrier.Conclusions The growing interest in using health data for quality improvement and performance management requires health services to address barriers to utilisation of performance data. Legal and ethical concerns must be balanced and prioritised in collaboration with end users for performance data to be accepted as a valid form of quality and performance assessment. Although privacy remains a key issue, these fears can be effectively managed by restricting public reporting on performance to only what is essential for public assurance.https://bmjopenquality.bmj.com/content/14/2/e003309.full |
| spellingShingle | Tim Shaw Kevin Leow Ian Kerridge Cameron Stewart Anna Janssen Kavisha Shah Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators BMJ Open Quality |
| title | Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators |
| title_full | Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators |
| title_fullStr | Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators |
| title_full_unstemmed | Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators |
| title_short | Ethical and legal considerations governing use of health data for quality improvement and performance management: a scoping review of the perspectives of health professionals and administrators |
| title_sort | ethical and legal considerations governing use of health data for quality improvement and performance management a scoping review of the perspectives of health professionals and administrators |
| url | https://bmjopenquality.bmj.com/content/14/2/e003309.full |
| work_keys_str_mv | AT timshaw ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators AT kevinleow ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators AT iankerridge ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators AT cameronstewart ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators AT annajanssen ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators AT kavishashah ethicalandlegalconsiderationsgoverninguseofhealthdataforqualityimprovementandperformancemanagementascopingreviewoftheperspectivesofhealthprofessionalsandadministrators |