Meta-consent for the secondary use of health data within a learning health system: a qualitative study of the public’s perspective

BMC Medical Ethics

Jean-François Ethier¹  Annabelle Cumyn¹  Anne-Marie Cloutier¹  Nissrine Safa¹  Roxanne Dault¹  Adrien Barton² 

[1] Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l’Université, J1K 2R1, Sherbrooke, QC, Canada;Groupe de Recherche Interdisciplinaire en Informatique de la Santé (GRIIS), Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 2500 Boulevard de l’Université, J1K 2R1, Sherbrooke, QC, Canada;Centre National de la Recherche Scientifique (CNRS) - Institut de Recherche en Informatique de Toulouse (IRIT), 29 rue Jeanne Marvig, 31055, Toulouse, France;

关键词: Learning healthcare system;    Meta-consent;    Health data;    Public opinion;    Focus groups;   

DOI  :  10.1186/s12910-021-00647-x

来源: Springer

【 摘 要 】

BackgroundThe advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agility and transparency required to obtain consent from all involved, especially the citizens. Therefore, a new approach to consent is needed. Previous work identified the meta-consent model as a promising alternative to fulfill the requirements of LHSs, particularly large-scale deployments. We elicited the public’s attitude toward the meta-consent model to evaluate if the model could be understood by the citizens and would be deemed acceptable to prepare for its possible implementation in Quebec.MethodsEight focus groups, with a total of 63 members of the general public from various backgrounds were conducted in Quebec, Canada, in 2019. Explicit attention was given to literacy levels, language spoken at home and rural vs urban settings. We assessed attitudes, concerns and facilitators regarding key components of the meta-consent model: predefined categories to personalized consent requests, a dynamic web-based infrastructure to record meta-consent, and default settings. To analyse the discussions, a thematic content analysis was performed using a qualitative software.ResultsOur findings showed that participants were supportive of this new approach of consent as it promotes transparency and offers autonomy for the management of their health data. Key facilitators were identified to be considered in the implementation of a meta-consent model in the Quebec LHSs: information and transparency, awareness campaigns, development of educational tools, collaboration of front-line healthcare professionals, default settings deemed acceptable by the society as well as close partnerships with recognized and trusted institutions.ConclusionsThis qualitative study reveals the openness of a sample of the Quebec population regarding the meta-consent model for secondary use of health data for research. This first exploratory study conducted with the public is an important step in guiding decision-makers in the next phases of implementing the various strategies to support access and use of health data in Quebec.

【 授权许可】

CC BY