<s>
Health	B-General_Concept
data	I-General_Concept
isany	O
data	O
"	O
relatedtohealth	O
conditions	O
,	O
reproductive	O
outcomes	O
,	O
causes	B-Application
of	I-Application
death	I-Application
,	O
and	O
quality	O
of	O
life	O
"	O
for	O
an	O
individual	O
or	O
population	O
.	O
</s>
<s>
Health	B-General_Concept
data	I-General_Concept
includes	O
clinical	O
metrics	O
along	O
with	O
environmental	O
,	O
socioeconomic	O
,	O
and	O
behavioral	O
information	O
pertinent	O
to	O
health	O
and	O
wellness	O
.	O
</s>
<s>
A	O
plurality	O
of	O
health	B-General_Concept
data	I-General_Concept
are	O
collected	O
and	O
used	O
when	O
individuals	O
interact	O
with	O
health	O
care	O
systems	O
.	O
</s>
<s>
Historically	O
,	O
most	O
health	B-General_Concept
data	I-General_Concept
has	O
been	O
sourced	O
from	O
this	O
framework	O
.	O
</s>
<s>
The	O
advent	O
of	O
eHealth	B-Application
and	O
advances	O
in	O
health	O
information	B-General_Concept
technology	I-General_Concept
,	O
however	O
,	O
have	O
expanded	O
the	O
collection	O
and	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
—	O
but	O
have	O
also	O
engendered	O
new	O
security	O
,	O
privacy	O
,	O
and	O
ethical	O
concerns	O
.	O
</s>
<s>
The	O
increasing	O
collection	O
and	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
by	O
patients	O
is	O
a	O
major	O
component	O
of	O
digital	B-Application
health	I-Application
.	O
</s>
<s>
Health	B-General_Concept
data	I-General_Concept
are	O
classified	O
as	O
either	O
structured	O
or	O
unstructured	O
.	O
</s>
<s>
Structured	O
health	B-General_Concept
data	I-General_Concept
is	O
standardized	O
and	O
easily	O
transferable	O
between	O
health	O
information	O
systems	O
.	O
</s>
<s>
Unstructured	O
health	B-General_Concept
data	I-General_Concept
,	O
unlike	O
structured	O
data	O
,	O
is	O
not	O
standardized	O
.	O
</s>
<s>
Emails	O
,	O
audio	O
recordings	O
,	O
or	O
physician	O
notes	O
about	O
a	O
patient	O
are	O
examples	O
of	O
unstructured	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
While	O
advances	O
in	O
health	O
information	B-General_Concept
technology	I-General_Concept
have	O
expanded	O
collection	O
and	O
use	O
,	O
the	O
complexity	O
of	O
health	B-General_Concept
data	I-General_Concept
has	O
hindered	O
standardization	O
in	O
the	O
health	O
care	O
industry	O
.	O
</s>
<s>
As	O
of	O
2013	O
,	O
it	O
was	O
estimated	O
that	O
approximately	O
60%	O
of	O
health	B-General_Concept
data	I-General_Concept
in	O
the	O
United	O
States	O
were	O
unstructured	O
.	O
</s>
<s>
Health	O
informatics	O
,	O
a	O
field	O
of	O
health	B-General_Concept
data	I-General_Concept
management	O
,	O
superseded	O
medical	O
informatics	O
in	O
the	O
1970s	O
.	O
</s>
<s>
Health	O
informatics	O
,	O
which	O
is	O
broadly	O
defined	O
as	O
the	O
collection	O
,	O
storage	O
,	O
distribution	O
,	O
and	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
,	O
differs	O
from	O
medical	O
informatics	O
in	O
its	O
use	O
of	O
information	B-General_Concept
technology	I-General_Concept
.	O
</s>
<s>
Individuals	O
are	O
the	O
origin	O
of	O
all	O
health	B-General_Concept
data	I-General_Concept
,	O
yet	O
the	O
most	O
direct	O
if	O
often	O
overlooked	O
is	O
the	O
informal	O
personal	O
collection	O
of	O
data	O
.	O
</s>
<s>
Prior	O
to	O
recent	O
technological	O
advances	O
,	O
most	O
health	B-General_Concept
data	I-General_Concept
were	O
collected	O
within	O
health	O
care	O
systems	O
.	O
</s>
<s>
This	O
information	O
,	O
once	O
recorded	O
,	O
becomes	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
Recent	O
advances	O
in	O
health	O
information	B-General_Concept
technology	I-General_Concept
have	O
expanded	O
the	O
scope	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
Advances	O
in	O
health	O
information	B-General_Concept
technology	I-General_Concept
have	O
fostered	O
the	O
eHealth	B-Application
paradigm	O
,	O
which	O
has	O
expanded	O
the	O
collection	O
,	O
use	O
,	O
and	O
philosophy	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
EHealth	B-Application
,	O
a	O
term	O
coined	O
in	O
the	O
health	O
information	B-General_Concept
technology	I-General_Concept
industry	I-General_Concept
,	O
has	O
been	O
described	O
in	O
academia	O
as	O
an	O
emerging	O
field	O
 [ at ] 	O
the	O
intersection	O
of	O
medical	O
informatics	O
,	O
public	O
health	O
and	O
business	O
,	O
referring	O
to	O
health	O
services	O
and	O
information	O
delivered	O
or	O
enhanced	O
through	O
the	O
Internet	O
and	O
related	O
technologies	O
.	O
</s>
<s>
In	O
a	O
broader	O
sense	O
,	O
the	O
term	O
characterizes	O
not	O
only	O
a	O
technical	O
development	O
,	O
but	O
also	O
a	O
state-of-mind	O
,	O
a	O
way	O
of	O
thinking	O
,	O
an	O
attitude	O
,	O
and	O
a	O
commitment	O
for	O
networked	O
,	O
global	O
thinking	O
,	O
to	O
improve	O
health	O
care	O
...	O
using	O
information	O
and	O
communication	O
technology.From	O
the	O
confluence	O
of	O
eHealth	B-Application
and	O
mobile	O
technology	O
emerged	O
mHealth	B-Device
,	O
which	O
is	O
considered	O
a	O
subsector	O
of	O
eHealth	B-Application
.	O
</s>
<s>
mHealth	B-Device
has	O
been	O
defined	O
asmedical	O
and	O
public	O
health	O
practice	O
supported	O
by	O
mobile	O
devices	O
...	O
.	O
</s>
<s>
mHealth	B-Device
involves	O
the	O
use	O
and	O
capitalization	O
on	O
a	O
mobile	O
phone	O
's	O
core	O
utility	O
of	O
voice	O
and	O
short	O
messaging	O
service	O
(	O
SMS	O
)	O
as	O
well	O
as	O
more	O
complex	O
functionalities	O
and	O
applications	O
including	O
general	O
packet	O
radio	O
service	O
(	O
GPRS	O
)	O
,	O
third	O
and	O
fourth	O
generation	O
mobile	O
telecommunications	O
(	O
3G	O
and	O
4G	O
systems	O
)	O
,	O
global	O
positioning	O
system	O
(	O
GPS	O
)	O
,	O
and	O
Bluetooth	O
technology.The	O
emergence	O
of	O
eHealth	B-Application
and	O
mHealth	B-Device
have	O
expanded	O
the	O
definition	O
of	O
health	B-General_Concept
data	I-General_Concept
by	O
creating	O
new	O
opportunities	O
for	O
patient-generated	O
health	B-General_Concept
data	I-General_Concept
(	O
PGHD	O
)	O
.	O
</s>
<s>
MHealth	B-Device
allows	O
patients	O
to	O
monitor	O
and	O
report	O
PGHD	O
outside	O
of	O
a	O
clinical	O
setting	O
.	O
</s>
<s>
PGHD	O
,	O
mHealth	B-Device
,	O
eHealth	B-Application
,	O
and	O
other	O
technological	O
development	O
such	O
as	O
telemedicine	O
,	O
constitute	O
a	O
new	O
digital	B-Application
health	I-Application
paradigm	O
.	O
</s>
<s>
Digital	B-Application
health	I-Application
describes	O
a	O
patient-centric	O
health	O
care	O
system	O
in	O
which	O
patients	O
manage	O
their	O
own	O
health	O
and	O
wellness	O
with	O
new	O
technologies	O
that	O
will	O
gather	O
and	O
assess	O
their	O
data	O
.	O
</s>
<s>
Data	O
has	O
become	O
increasingly	O
valuable	O
in	O
the	O
21st	O
century	O
and	O
new	O
economies	O
have	O
been	O
shaped	O
by	O
who	O
controls	O
it	O
—	O
health	B-General_Concept
data	I-General_Concept
and	O
the	O
health	O
care	O
industry	O
are	O
unlikely	O
to	O
be	O
an	O
exception	O
.	O
</s>
<s>
Health	B-General_Concept
data	I-General_Concept
can	O
be	O
used	O
to	O
benefit	O
individuals	O
,	O
public	O
health	O
,	O
and	O
medical	O
research	O
and	O
development	O
.	O
</s>
<s>
The	O
uses	O
of	O
health	B-General_Concept
data	I-General_Concept
are	O
classified	O
as	O
either	O
primary	O
or	O
secondary	O
.	O
</s>
<s>
Primary	O
use	O
is	O
when	O
health	B-General_Concept
data	I-General_Concept
is	O
used	O
to	O
deliver	O
health	O
care	O
to	O
the	O
individual	O
from	O
whom	O
it	O
was	O
collected	O
.	O
</s>
<s>
Secondary	O
use	O
is	O
when	O
health	B-General_Concept
data	I-General_Concept
is	O
used	O
outside	O
of	O
health	O
care	O
delivery	O
for	O
that	O
individual	O
.	O
</s>
<s>
Digitization	O
and	O
health	O
information	B-General_Concept
technology	I-General_Concept
have	O
expanded	O
the	O
primary	O
and	O
secondary	O
uses	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
Over	O
the	O
last	O
decade	O
the	O
U.S.	O
health	O
care	O
system	O
widely	O
adopted	O
electronic	B-Application
health	I-Application
records	I-Application
(	O
EHRs	B-Application
)	O
—	O
an	O
inevitable	O
shift	O
given	O
EHR	O
benefits	O
over	O
paper	O
systems	O
.	O
</s>
<s>
EHRs	B-Application
have	O
expanded	O
the	O
secondary	O
uses	O
of	O
health	B-General_Concept
data	I-General_Concept
for	O
quality	O
assurance	O
,	O
clinical	O
research	O
,	O
medical	O
research	O
and	O
development	O
,	O
public	O
health	O
,	O
and	O
big	B-Application
data	I-Application
health	B-General_Concept
analytics	I-General_Concept
,	O
among	O
other	O
fields	O
.	O
</s>
<s>
Personal	O
health	O
records	O
(	O
PHRs	O
)	O
,	O
while	O
less	O
popular	O
than	O
EHRs	B-Application
,	O
have	O
expanded	O
the	O
primary	O
uses	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
PHRs	O
can	O
incorporate	O
both	O
patient	O
-	O
and	O
provider-reported	O
health	B-General_Concept
data	I-General_Concept
,	O
but	O
are	O
managed	O
by	O
patients	O
.	O
</s>
<s>
Integrated	O
EHR-PHR	O
systems	O
expand	O
the	O
primary	O
uses	O
of	O
health	B-General_Concept
data	I-General_Concept
by	O
giving	O
individuals	O
greater	O
access	O
to	O
their	O
health	B-General_Concept
data	I-General_Concept
—	O
which	O
can	O
help	O
them	O
monitor	O
,	O
evaluate	O
,	O
and	O
improve	O
their	O
own	O
health	O
.	O
</s>
<s>
This	O
is	O
an	O
important	O
aspect	O
of	O
the	O
digital	B-Application
health	I-Application
paradigm	O
.	O
</s>
<s>
In	O
the	O
United	O
States	O
,	O
prior	O
to	O
the	O
Health	O
Insurance	O
Portability	O
and	O
Accountability	O
Act	O
(	O
HIPAA	O
)	O
of	O
1996	O
,	O
there	O
were	O
no	O
comprehensive	O
federal	O
policies	O
that	O
regulated	O
the	O
security	O
or	O
privacy	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
While	O
HIPAA	O
established	O
health	B-General_Concept
data	I-General_Concept
security	O
and	O
privacy	O
in	O
the	O
U.S.	O
,	O
gaps	O
in	O
protection	O
persisted	O
.	O
</s>
<s>
The	O
emergence	O
of	O
new	O
health	O
information	B-General_Concept
technologies	I-General_Concept
exacerbated	O
these	O
gaps	O
.	O
</s>
<s>
In	O
2009	O
,	O
the	O
Health	O
Information	B-General_Concept
Technology	I-General_Concept
for	O
Economic	O
and	O
Clinical	O
Health	O
Act	O
was	O
passed	O
.	O
</s>
<s>
The	O
legislation	O
aimed	O
to	O
close	O
the	O
existing	O
gaps	O
in	O
HIPAA	O
by	O
expanding	O
HIPAA	O
regulations	O
to	O
more	O
entities	O
,	O
including	O
business	O
associates	O
or	O
subcontractors	O
which	O
store	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
There	O
are	O
important	O
ethical	O
considerations	O
for	O
the	O
collection	O
and	O
secondary	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
.	O
</s>
<s>
While	O
discussions	O
on	O
the	O
ethical	O
collection	O
and	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
typically	O
focus	O
on	O
research	O
,	O
it	O
is	O
important	O
not	O
to	O
overlook	O
potential	O
data	O
misuse	O
by	O
non-research	O
organizations	O
.	O
</s>
<s>
It	O
has	O
been	O
argued	O
that	O
the	O
collection	O
and	O
use	O
of	O
health	B-General_Concept
data	I-General_Concept
for	O
any	O
non-clinical	O
purpose	O
,	O
"	O
is	O
ethically	O
sound	O
only	O
if	O
there	O
is	O
(	O
or	O
could	O
reasonably	O
arise	O
)	O
a	O
question	O
to	O
be	O
answered	O
;	O
the	O
methodology	O
(	O
design	O
,	O
data	O
collected	O
,	O
etc	O
)	O
will	O
answer	O
the	O
question	O
;	O
and	O
the	O
costs	O
,	O
including	O
both	O
communal	O
health	O
care	O
resources	O
and	O
any	O
risks	O
and	O
burden	O
imposed	O
on	O
the	O
participants	O
,	O
justify	O
the	O
benefits	O
to	O
society.	O
"	O
</s>
<s>
Many	O
public	O
health	O
experts	O
have	O
been	O
advocating	O
that	O
health	B-General_Concept
data	I-General_Concept
collection	O
may	O
be	O
the	O
best	O
way	O
to	O
analyse	O
information	O
on	O
a	O
large-scale	O
.	O
</s>
<s>
There	O
are	O
important	O
and	O
growing	O
opportunities	O
to	O
use	O
health	B-General_Concept
data	I-General_Concept
for	O
improving	O
healthcare	O
quality	O
,	O
surveillance	O
,	O
health	O
system	O
management	O
and	O
research	O
.	O
</s>
<s>
At	O
the	O
global	O
level	O
,	O
a	O
strategy	O
on	O
digital	B-Application
health	I-Application
was	O
drafted	O
at	O
the	O
71st	O
World	O
Health	O
Assembly	O
,	O
in	O
May	O
2018	O
,	O
in	O
close	O
consultation	O
with	O
Member	O
States	O
and	O
with	O
inputs	O
from	O
stakeholders	O
.	O
</s>
<s>
The	O
framework	O
for	O
action	O
also	O
proposes	O
the	O
creation	O
of	O
an	O
international	O
convening	O
mechanism	O
for	O
validation	O
of	O
artificial	O
intelligence	O
and	O
digital	B-Application
health	I-Application
solutions	O
.	O
</s>
<s>
This	O
mechanism	O
will	O
enshrine	O
the	O
value	O
of	O
health	B-General_Concept
data	I-General_Concept
and	O
associated	O
digital	B-Application
health	I-Application
products	O
as	O
a	O
global	O
public	O
health	O
good	O
and	O
call	O
for	O
action	O
to	O
safeguard	O
the	O
anonymity	O
of	O
health	B-General_Concept
data	I-General_Concept
providers	O
,	O
mitigate	O
challenges	O
and	O
ensure	O
universal	O
access	O
to	O
digital	B-Application
health	I-Application
products	O
and	O
technology	O
.	O
</s>
<s>
The	O
European	O
Health	B-General_Concept
Data	I-General_Concept
&	O
Evidence	O
Network	O
,	O
,	O
is	O
building	O
a	O
data	O
network	O
to	O
perform	O
fast	O
,	O
scalable	O
and	O
highly	O
reproducible	O
research	O
.	O
</s>
