Integration of Health and Social Care Patient Records: Challenges and Opportunities

Integrating health and social care, patient records are becoming increasingly essential for improving patient outcomes and enhancing the efficiency of healthcare delivery. As the World Health Organization (WHO) defines oral health as “the state of the mouth, teeth, and orofacial structures that enable individuals to perform essential functions,” it becomes clear that oral health is intrinsically linked to overall health and well-being. This understanding underscores integrating patient records across different healthcare domains to provide comprehensive care. Dr. Aarthi Shanmugavel and Professor Dr. Kenneth Eaton, from the World Federation of Public Health Associations, WFPHA Oral Health Working Group, discuss this further. 

The Current State of Patient Data Integration

In healthcare, patient-related data are collected, stored, managed, and analyzed to ensure the best care possible. However, integrating these data across different healthcare providers—such as dentists and general medical practitioners—remains a significant challenge. According to the Healthcare Information and Management Systems Society (HIMSS), interoperability is the system’s ability to access, exchange, integrate, and cooperatively use data across various boundaries. This level of interoperability is crucial for providing timely and seamless care, yet many healthcare systems worldwide still struggle to achieve it.

Challenges in Integrating Health and Social Care Records

A recent global survey by the WFPHA and the FDI World Dental Federation (FDI) identified several barriers to integrating electronic medical and dental records by over 100 participants from 50 countries. The survey participants included 75% dentists and 25% other health professionals, including physicians, nurses, and allied health professionals, with over 70 participants with more than 20 years of experience.

Key challenges include:

– Political and Economic Factors: Resistance to change, concerns over the cost of integration, and the influence of political factors can slow down the process of integrating health records.

– Technical Integration: The complexity of data, terminologies, and systems presents a significant hurdle. Achieving seamless integration requires standardized data formats and robust technical infrastructure.

– Data Protection Concerns: Ensuring patient privacy and the security of sensitive health information is a critical issue that needs to be addressed when integrating records.

– Decentralized Healthcare Systems: In countries with decentralized healthcare systems, the lack of a unified approach complicates the integration process.

– Patient Consent and Access: Patient consent and the ability to access their own records are also challenging, with some countries offering more access than others.

Opportunities for Enhanced Patient Care

Despite these challenges, there is a strong consensus on integrating medical and dental health records. The potential benefits of integration include:

– Improved Patient Outcomes: Integrated records provide healthcare providers with a comprehensive view of a patient’s health, leading to better diagnosis, treatment, and follow-up care.

– Increased Efficiency: By eliminating the need for repeated tests and procedures, integrated records can reduce costs and make the healthcare system more efficient.

– Better Patient Experience: Patients can expect more coordinated care with integrated records, reducing provider delays and miscommunication.

– Global Success Stories: Estonia, for example, has implemented a centralized healthcare system with integrated patient records at the national level, contributing to better overall health outcomes and increased life expectancy.

The Path Forward

Integrating health and social care patient records is essential for achieving patient-centered healthcare. The ultimate goal should be to develop a system that integrates electronic health and dental records and connects with personal devices, educational institutions, clinical research sectors, and global public health surveillance systems.

As healthcare systems worldwide continue to adopt more advanced health information systems, it is crucial to address the integration challenges. By fostering political will, advancing technology, and prioritizing patient-centered care, we can overcome these obstacles and create a more efficient, effective, and equitable healthcare system.

To read the full survey results, click here. 

Further references

Rajkumar NMR, Muzoora MR, Thun S. Dentistry and Interoperability. J Dent Res. 2022  Oct;101(11):1258-1262. doi: 10.1177/00220345221100175. Epub 2022 Jun 10.  PMID: 35689387; PMCID: PMC9516603. 

Powell, V., Din, F., Acharya, A. (2012). Integration of medical and dental care and patient data, 1st Edition. London: Springer. 

Professor Raman Bedi Appointed as Vice President-President-Elect of the World Federation of Public Health Associations (WFPHA)

In a significant milestone for global public health, Professor Raman Bedi has been appointed as the new Vice President-president-elect for the World Federation of Public Health Associations (WFPHA). His election on May 26, 2024, marks a historic moment as he becomes the first dentist and UK representative in over 50 years to hold this prestigious position. Professor Bedi, an Emeritus Professor at King’s College London and former Chief Dental Officer of England, is poised to bring his extensive experience in public health to the global stage.

A Glimpse into the WFPHA’s Mission and Vision

Founded in May 1967, the WFPHA represents a powerful collective of national public health associations from 104 countries, encompassing 139 member associations and nearly 5 million public health professionals worldwide. With a strong relationship with the World Health Organization (WHO) since 1971, the WFPHA has been critical in shaping global health policies and initiatives.

As Professor Bedi explains, the WFPHA is not just an organization but a vital agenda-setting entity that leads numerous global public health projects. These include initiatives like Global Public Health Week, Young WFPHA, and the biennial World Congress on Public Health. The WFPHA also collaborates with the WHO, United Nations, UNICEF, and other key international bodies to drive impactful change in public health.

First dentist as WFPHA President

Professor Bedi was elected with nearly 65% of countries voting in his favor. Reflecting on the outcome, Professor Bedi shared, “No dentist has ever been elected to this position, and it has been over 50 years since the UK had a president. The support I received, especially from the UK Faculty of Public Health, was instrumental in my nomination and election.”

Motivations and Priorities for Global Public Health

Professor Bedi’s motivation to run for this global leadership role stems from a deep-seated commitment to addressing pressing public health issues. He emphasizes the importance of preparing for future pandemics, tackling the global shortage of healthcare professionals, and addressing oral health as a public health concern.

“Oral health is a global issue that requires a broader public health approach,” Professor Bedi notes. He also highlights his dedication to promoting vaccination, particularly the HPV vaccine and supporting initiatives like Australia’s campaign to eradicate cervical cancer.

Challenges and Opportunities in Public Health

In his new role, Professor Bedi acknowledges the significant challenges facing public health today, including conflicts, workforce and funding shortages, misinformation, and the rapid development of emerging technologies like Artificial Intelligence (AI). He emphasizes strong leadership and supportive networks to navigate these challenges effectively.

To this end, Professor Bedi plans to create a global network focused on diversity and inclusion, ensuring that public health professionals have the skills and capacity to adopt and integrate innovative solutions into health services.

Strengthening National Public Health Associations

One of Professor Bedi’s key goals is to foster collaboration among national public health associations, building a collective structure that promotes constructive interaction across national boundaries. He believes that a supportive and inclusive environment and professional development opportunities will be essential in achieving this aim.

Upcoming Initiatives and Projects

As Vice President, Professor Bedi will support the current WFPHA President, Emma Rawson, who is passionate about Indigenous health. He also plans to focus on securing the bid for London to host the 2030 World Congress on Public Health, a significant event that would bring over 5,000 public health professionals to the city.

A Commitment to Leadership and Inclusion

Reflecting on his career, Professor Bedi attributes his readiness for this leadership role to his resilience, relationship-building skills, and passion for creating supportive networks. His experience as Chief Dental Officer for England and his work with the Senior Dental Leadership program have shaped his global vision for advancing public health.

As he embarks on this new journey, Professor Bedi reassures WFPHA members and the wider public health community of his commitment to advancing global public health. “I am excited about the journey ahead and grateful for the opportunity to serve as Vice President and, eventually, as WFPHA President in 2026,” he concludes.

Professor Raman Bedi’s appointment as the new Vice President-president-elect of the WFPHA marks a pivotal moment for the organization and the global public health community. His leadership promises to bring innovative solutions and a renewed focus on addressing our time’s most pressing public health challenges.

This article was adapted from an original interview done by Nature.com.

Inequity in Sustainable Health Today: A Global Perspective

The global healthcare landscape is fraught with inequities, especially in achieving sustainable health outcomes. This article is brought to you by the Sustainable Health Equity Movement (SHEM), a coalition dedicated to advancing health equity globally. It includes contributions from Professor Luis Eugenio De Souza, Immediate Past President of the World Federation of Public Health Associations.

Inequity in Sustainable Health: The Global Context

The COVID-19 pandemic starkly highlighted global health inequities, disproportionately affecting socio-economically vulnerable communities. Disadvantaged populations faced higher infection and mortality risks, compounded by systemic inequities that treat health as a commodity. In high-income countries, overwhelmed healthcare systems foreshadowed dire challenges for low- and middle-income nations. The stockpiling and profiteering of wealthy nations led to a global outcry, prompting an open letter to the UN, supported by over 120 entities representing five million public health professionals. This letter called for ethical worldwide leadership and the establishment of a Global Health Equity Task Force within WHO to coordinate an equity-focused pandemic response.

The Birth of the Sustainable Health Equity Movement (SHEM)

Two years later, the Sustainable Health Equity Movement (SHEM) was founded, emphasizing the need to address social inequality and the climate crisis to achieve sustainable health equity. SHEM advocates for embedding health equity principles in all policies, highlighting how unequal power dynamics, economic disparity, environmental damage, and conflicts exacerbate health inequities through inadequate access to health services, environmental risks, and unmet educational needs. SHEM’s call for a globally binding framework promotes health equity and economic reforms, including fair taxation, worker protection, and environmental equity. The movement also proposes establishing a Sustainable Health Equity Commission with a UN Rapporteur to monitor progress.

SHEM’s Vision for the Future

Three years later, SHEM reiterated that sustainable health equity means achieving and maintaining equitable health outcomes for all people, including future generations. This vision encompasses three main actions: ensuring the right to health by providing access to comprehensive health services for all; creating conditions for a healthy life by addressing social and environmental determinants of health; and fulfilling all human rights, including economic, social, cultural, civil, and political rights.

The Urgency of SHEM’s Mission Today

Despite unprecedented advances in reducing mortality rates and increasing life expectancy over the past 60 years, health inequities persist. There are signs that global life expectancy could decrease due to the ongoing impact of climate change. Current global governance often prioritizes economic interests over human well-being, as evidenced by insufficient and delayed agreements such as the 2030 Agenda, the COP climate agreements, the UN Tax Treaty, and the recently failed Pandemic Treaty. The inaction against ongoing acts of genocide, such as in Gaza (Palestine) and Darfur (Sudan), further reveals a broken human deal.

A Call to Action

As founding members of SHEM, we, along with Prof. Luis Eugenio De Souza, Immediate Past President of the Brazilian Association of Collective Health, emphasize the need for a profound transformation of global, national, and local political, economic, and knowledge governance to uphold human democracy, peace, justice, and dignity. This transformation is essential to preserving human life in balance with other life forms on our shared planet.

The fight against inequity in sustainable health is far from over. SHEM must intensify its call for ethical principles of equity, ensuring everyone has access to the health services they need regardless of socioeconomic status. By addressing the root causes of health inequities, we can build a healthier, more equitable world for future generations. 

Please note that this article initially appeared in Science Direct.

Tackling Plastic Pollution: 4th Session of the Intergovernmental Negotiating Committee Insights

As the global plastic pollution crisis intensifies, the need for decisive action has never been more critical. Approximately 10 billion tonnes of plastic have been produced since the 1950s, but over 8 billion tonnes have turned into waste. Alarmingly, 10-15 million tonnes of this waste leak into the marine environment each year, a figure projected to triple by 2050. This growing environmental threat demands urgent, coordinated global efforts.

The Global Response to Marine Plastic Pollution

Recognizing the severity of plastic pollution, particularly in the marine environment, the United Nations Environment Assembly (UNEA) has been at the forefront of global efforts to combat this issue. UNEA Resolution 3/7, for instance, established an Ad Hoc Expert Group (AHEG) to explore various response options, ranging from innovative approaches to legally binding governance strategies.

The fourth Intergovernmental Negotiating Committee (INC-4) session took place in Ottawa, Canada, from April 23 to 29, 2024. This crucial gathering aimed to develop an international legally binding instrument (ILBI) on plastic pollution, with a significant focus on the marine environment. The event attracted over 2,500 participants, including representatives from governments, academia, civil society organizations, private sector entities, UN bodies, and international organizations. Many others participated virtually via webcast. Professor Peter Orris represented the World Federation of Public Health Associations (WFPHA) from its Environmental Health Working Group.

Key Discussions and Divergences at INC-4

Throughout the seven-day session, delegates engaged in intensive negotiations within five Subgroups, guided by a Revised Draft Text developed after INC-3. While some areas of convergence emerged—such as plastic waste management and just transition—sharp divergences remained. Contentious issues included the inclusion of primary plastic polymers, the treatment of chemicals and polymers, and the integration of existing processes.

Despite these challenges, delegates agreed to use the outcomes of INC-4 as a foundation for further negotiations at the upcoming INC-5, scheduled for November 2024 in Busan, Republic of Korea.

The Health Sector’s Role in the Plastics Treaty

The health sector’s relationship with plastic pollution was a significant focus during INC-4. WHO and various civil society health groups actively participated in discussions, addressing the proposal to exempt the health sector from the treaty due to its extensive use of plastic products. Health organizations, united in their stance, argued against this exemption, emphasizing the need for special consideration rather than a blanket exclusion.

A letter from Health Care Without Harm, endorsed by WHO and signed by over 600 clinicians and 18 international professional associations, including WFPHA, called for an ambitious and just treaty to tackle plastic pollution within the health sector. The letter highlighted the sector’s heavy reliance on plastics, particularly single-use items, and urged governments to explore programs that eliminate non-essential uses and promote reusable, non-toxic alternatives.

Looking Ahead: The Road to INC-5

The negotiations at INC-4 made it clear that the road to an effective and comprehensive treaty on plastic pollution remains challenging. With the entire treaty still under discussion, decisions are only final once a consensus is reached. The upcoming INC-5 in Busan will be critical in these negotiations as the world watches to see how rapidly and effectively the international community can address the mounting plastic pollution crisis, particularly in our oceans.

As the journey towards a legally binding instrument continues, the global community remains hopeful that these efforts will lead to significant progress in protecting the marine environment from the devastating impacts of plastic pollution.

Tobacco Legislation Reform and Industry Response in Israel: A Comprehensive Overview

Israel has implemented progressive tobacco control legislation to curb the influence of tobacco and related products, including heated tobacco products and electronic cigarettes. The legislation, effective in phases from March 2019 to January 2020, encompasses three primary elements: advertising bans, point-of-sale display bans, and plain packaging requirements. This comprehensive effort aims to reduce tobacco consumption and mitigate public health risks associated with tobacco use.

Please note that the following is not a summary of the webinar but Professor Bar-Zeev’s academic paper on Tobacco legislation reform and industry response in Israel. Scroll to the bottom for the full webinar which was held on Thursday, July. 18, 2024 at 3 PM CEST. This is one of many webinars hosted by our Non-Communicable Disease Working Group. 

Key Elements of the Legislation

1. Advertising Bans:

– Prohibited in all media channels, including broadcast, outdoor, internet, and print media, except newspapers.

– Effective March 2019, this measure aims to reduce the visibility and attractiveness of tobacco products to the public.

2. Point-of-Sale Display Bans:

– Effective January 2020, this ban applies to all retail environments except specialized tobacco and alcohol outlets.

– This measure seeks to reduce impulse purchases and the normalization of tobacco products in everyday settings.

3. Plain Packaging:

– Also effective January 2020, this requirement mandates plain packaging for all tobacco products, including heated tobacco and electronic cigarettes, using the color Pantone 448 C.

– The packaging must include textual health warnings covering a significant portion of the package.

Industry Response and Tactics

During the initial implementation phase, the tobacco industry employed various tactics to circumvent the new regulations

– Print Media Loopholes: Industry advertisements included small branded elements and full-size previous packaging visuals to bypass plain packaging rules.

– QR Codes and Direct Advertisements: QR codes in advertisements led consumers to direct marketing content not covered by the legislation.

– Point-of-Sale Displays: Attractive, non-hermetically closed display cases allowed products to be partially visible, undermining the display ban.

– Branded Accessories: Distribution of branded tin cases and inclusion of branding inside packages to mitigate the impact of plain packaging.

– Coalition Efforts and Recommendations
A coalition of civil society and professional organizations from various disciplines, including public health and communications, actively communicated to counter these industry tactics. The coalition shared information and strategies on platforms like WhatsApp.

Key recommendations include:

– Enhanced Specificity: Legislation should be highly specific to prevent industry exploitation of loopholes.

– Complete Advertisement Bans: Avoid exemptions in advertising bans to ensure comprehensive coverage.

– Regulatory Oversight: Implement pre-publication requirements for industry advertisements and prohibit QR codes.

– Proactive Enforcement: Establish detailed implementation guidelines and enforcement plans to ensure compliance.

– National Authority for Tobacco Control: Create a dedicated body to oversee and enforce tobacco control measures, similar to the US FDA’s role.

– Legal Challenges and Future Directions The legislation faced legal challenges from entities like Juul Labs, which sought exemptions for vaping products. However, the Supreme Court upheld the law, validating the legislative process and highlighting the importance of transparent and regulated industry participation.

Conclusion

Israel’s experience underscores the importance of detailed legislation, proactive enforcement, and the need for mechanisms to address industry tactics quickly. By learning from these efforts, other countries can enhance their tobacco control measures to protect public health more effectively.