The potential of digital health records for public health research, policy, and practice: the case of the Lombardy Region Data Warehouse

Main Article Content

Lorenzo Blandi
Alessandro Amorosi
Olivia Leoni
Timo Clemens
Helmut Brand
Anna Odone


Big data, data linkage, data quality, privacy, electronic health records


Digital health records can provide advantages to healthcare practice, policy, and research. Several countries have established population-based digitalised data collection, integrated through data linkage techniques. In Lombardy (Italy), a regional population-based registry was established in the 2000s. It collects data from the social and health sector, anonymised immediately after their acquisition and restructured in a single repository. Data can be used for public health interest, planning, monitoring, services evaluation, and research. Indeed, data can also be provided to universities and other scientific institutes. The availability of such data enables to explore the epidemiology of infectious, chronic, and rare diseases. Thus, epidemiological research can support policymakers to tackle public health threats. However, analysis of electronic health records comes along with several challenges, including data inaccuracy, incompleteness, and biases. Researchers should take into consideration limits and barriers related to quality of data. Moreover, health data use must adhere to the national and European privacy legislation, at times limiting the potential of data integration. Therefore, even if big data drives innovation and scientific knowledge, ethical issues regarding privacy should be considered in public debate.


Download data is not yet available.
Abstract 60 | PDF Downloads 32


1. Solomon J N, Gavin M C, Gore, M L. Detecting and understanding non-compliance with conservation rules. Biol Conserv. 2015, 189, 1-4. doi: 10.1016/j.biocon.2015.04.028.
2. Essler S, Christner N, Becher T, Paulus M. The ontogenetic emergence of normativity: How action imitation relates to infants’ norm enforcement. J Exp Child Psychol. 2023 Mar;227:105591. doi: 10.1016/j.jecp.2022.105591.
3. Boyd R, Richerson P J, Henrich J. The cultural niche: Why social learning is essential for human adaptation. Proc Natl Acad Sci U S A. 2011 Jun 28;108 Suppl 2(Suppl 2):10918-25. doi: 10.1073/pnas.1100290108.
4. Legare C H, Harris P L. The ontogeny of cultural learning. Child Dev. 2016 May;87(3):633-42. doi: 10.1111/cdev.12542.
5. Over H, Carpenter M. The social side of imitation. Child Dev Perspect. 2013, 7(1), 6-11. doi: 10.1111/cdep.12006.
6. Van Kleef G A, Wanders F, Stamkou E, Homan A C. The social dynamics of breaking the rules: Antecedents and consequences of norm-violating behavior. Current Opinion in Psychology. 2015, 6, 25-31. doi: 10.1016/j.copsyc.2015.03.013.
7. Travaglino G A, Moon C. Compliance and self-reporting during the COVID-19 pandemic: a cross-cultural study of trust and self-conscious emotions in the United States, Italy, and South Korea. Front Psychol. 2021 Mar 16;12:565845. doi: 10.3389/fpsyg.2021.565845.
8. Redford P. Self-construal and anger action tendencies in Hong Kong and the United Kingdom. In Merging past, present, and future in cross-cultural psychology 2020 (pp. 367- 386). Garland Science. doi: 10.4324/9781003077473-45
9. Boiger M, Deyne S D, Mesquita B. Emotions in “the world”: cultural practices, products, and meanings of anger and shame in two individualist cultures. Front Psychol. 2013 Dec 5;4:867. doi: 10.3389/fpsyg.2013.00867.
10. Thibaut J, Friedland N, Walker L. Compliance with rules: Some social determinants. Journal of Personality and Social Psychology. 1974, 30(6), 792. doi: 10.1037/h0037535.
11. Reynolds S J, Dang C T, Yam K C, Leavitt K. The role of moral knowledge in everyday immorality: What does it matter if I know what is right? Organizational Behavior and Human Decision Processes. 2014, 123(2), 124-137. doi: 10.1016/j.obhdp.2013.10.008.
12. Bicchieri C, Dimant E, Gächter S. Observability, social proximity, and the erosion of norm compliance. SSRN Electronic Journal. 2020. doi: 10.2139/ssrn.3576289
13. Percy S V, Sandholtz W. Why norms rarely die. European Journal of International Relations. 2022, 28(4), 934-954. doi: 10.1177/13540661221126018.
14. Turiel E. The development of social concepts: Mores, customs, and conventions 1975.
15. Berti A E, Guarnaccia V, Lattuada R. Lo sviluppo della nozione di norma giuridica. Scuola e Città, 1997 (12), 532-545.
16. McKenzie-Mohr D, Lee N R, Kotler P, Schultz P W. Social marketing to protect the environment: What works. SAGE publications. 2011. doi: 10.4135/9781483349466.
17. Arias A. Understanding and managing compliance in the nature conservation context. J Environ Manage. 2015 Apr 15;153:134-43. doi: 10.1016/j.jenvman.2015.02.013.
18. Gore M L, Knuth B A, Scherer C W, Curtis P D. Evaluating a conservation investment designed to reduce human–wildlife conflict. Conservation Letters. 2008, 1(3), 136-145. doi: 10.1111/j.1755-263X.2008.00017.x.
19. Pollnac R, Christie P, Cinner J E, et al. Marine reserves as linked social–ecological systems. Proc Natl Acad Sci U S A. 2010 Oct 26;107(43):18262-5. doi: 10.1073/pnas.0908266107.
20. Howse R, Teitel R. Beyond compliance: Rethinking why international law really matters. Global Policy. 2010, 1(2), 127-136. doi: 10.1111/j.1758-5899.2010.00035.x.
21. Tyler T R. Why people obey the law. In Why People Obey the Law 2021. Princeton university press. 2021.
22. Signorelli C, Scognamiglio T, Odone A. COVID-19 in Italy: impact of containment measures and prevalence estimates of infection in the general population. Acta Biomed. 2020 Apr 10;91(3-S):175-179. doi: 10.23750/abm.v91i3-S.9511.
23. Choi J, Kim K-H. The Differential Consequences of Fear, Anger, and Depression in Response to COVID-19 in South Korea. Int J Environ Res Public Health. 2022 May 31;19(11):6723. doi: 10.3390/ijerph19116723.
24. Demirtaş-Madran H A. Accepting restrictions and compliance with recommended preventive behaviors for COVID-19: a discussion based on the key approaches and current research on fear appeals. Front Psychol. 2021 Jun 7;12:558437. doi: 10.3389/fpsyg.2021.558437.
25. Travaini G, Caruso P, Dickson M M, Espa G, Merzagora I. Is obedience still a virtue? An Italian research during COVID-19 pandemic. Rassegna Italiana Di Criminologia. 2022, (4), 283-289. doi: 10.7347/RIC-042022-p283.
26. Jørgensen F, Bor A, Petersen M B. Compliance without fear: Individual-level protective behaviour during the first wave of the COVID-19 pandemic. Br J Health Psychol. 2021 May;26(2):679-696. doi: 10.1111/bjhp.12519.
27. Ruiu G, Ruiu M L. Violation of lockdown norms and peaks in daily number of positive cases to COVID-19 in Italy. Emerald Open Research. 2020 May 13;2:25. doi: 10.35241/emeraldopenres.13699.1.
28. Briscese G, Lacetera N, Macis M, Tonin M. Compliance with covid-19 social- distancing measures in Italy: the role of expectations and duration (Vol. 27). Cambridge, MA, USA: National Bureau of Economic Research 2020.
29. Badman R P, Wang A X, Skrodzki M, et al. Trust in Institutions, Not in Political Leaders, Determines Compliance in COVID-19 Prevention Measures within Societies across the Globe. Behav Sci (Basel). 2022 May 30;12(6):170. doi: 10.3390/bs12060170.
30. Han Q, Zheng B, Cristea M, et al. Trust in government regarding COVID-19 and its associations with preventive health behaviour and prosocial behaviour during the pandemic: a cross-sectional and longitudinal study. Psychol Med. 2021 Mar 26:1-11. doi: 10.1017/S0033291721001306.
31. Blandi L, Sabbatucci M, Dallagiacoma G, Alberti F, ­Bertuccio P, Odone A. Digital Information Approach through Social Media among Gen Z and Millennials: The Global Scenario during the COVID-19 Pandemic. Vaccines (Basel). 2022 Oct 28;10(11):1822. doi: 10.3390/vaccines10111822.

Most read articles by the same author(s)

1 2 3 4 5 6 7 > >>