Realizing the promise of big data: how Taiwan can help the world reduce medical errors and advance precision medicine

Abstract

Purpose – The study explores how Taiwan’s electronic health data systems can be used to build algorithms that reduce or eliminate medical errors and to advance precision medicine. Design/methodology/approach – This study is a narrative review of the literature. Findings – The body of medical knowledge has grown far too large for human clinicians to parse. In theory, electronic health records could augment clinical decision-making with electronic clinical decision support systems (CDSSs). However, computer scientists and clinicians have made remarkably little progress in building CDSSs, because health data tend to be siloed across many different systems that are not interoperable and cannot be linked using common identifiers. As a result, medicine in the USA is often practiced inconsistently with poor adherence to the best preventive and clinical practices. Poor information technology infrastructure contributes to medical errors and waste, resulting in suboptimal care and tens of thousands of premature deaths every year. Taiwan’s national health system, in contrast, is underpinned by a coordinated system of electronic data systems but remains underutilized. In this paper, the authors present a theoretical path toward developing artificial intelligence (AI)-driven CDSS systems using Taiwan’s National Health Insurance Research Database. Such a system could in theory not only optimize care and prevent clinical errors but also empower patients to track their progress in achieving their personal health goals. Originality/value – While research teams have previously built AI systems with limited applications, this study provides a framework for building global AI-based CDSS systems using one of the world’s few unified electronic health data systems.