Inter-institutional Communication Research Articles

Rise of long-distance urology transfer during the COVID-19 pandemic: Identifying factors to enhance transfers of care efficiency and clinical outcomes.

The objective of this study is to identify variables associated with clinical outcomes after urologic transfers before and during the COVID pandemic. After IRB approval, a retrospective chart review was performed on adult patients transferred to our institution from 01/01/2018 to 12/31/2019 ("pre-COVID") and from 01/02/2020 to 12/31/2022 ("COVID"). We identified demographics, origin hospitals, ICD-10 pre- and post-transfer diagnoses, distance of transfer, and post-transfer CPT codes. During the study period, our adult urology service accepted 160 transfers with a mean patient age of 71 years. A total of 49/160 (30%) of subjects made up the "pre-COVID" cohort and 111/160 (70%) made up the "COVID" cohort. There were 11/111 (10%) transfers of >100 miles in the COVID period but 0/49 in the pre-COVID period (p = 0.02). Patients from the COVID period waited on average 1.2 days longer for a procedure after transfer compared to pre-COVID period (p = 0.03). The time until a patient's surgical procedure after transfer was a significant predictor of length of stay > 5 days (OR 1.91, CI 1.43 - 2.58, p < 0.01). Different diagnosis upon re-evaluation after transfer was associated with a decreased rate of subsequent readmission (OR 0.30, CI 0.09-0.97, p = 0.05). Long-distance transfer, even >100 miles (which we termed "mega-transfers"), was a new pandemic-related phenomenon at our institution. Delays in definitive care and changes in diagnoses after transfer were associated with readmission and length of stay. Our findings illustrate the importance of inter-institutional communication, diagnostic accuracy, and post discharge planning when managing transfer patients.

“Collateral beauty.” Experiences and needs of professionals caring for parents continuing pregnancy after a life-limiting prenatal diagnosis: A grounded theory study

Background: Caring for parents continuing pregnancy after learning about a severe life-limiting condition in their unborn is challenging. Most existing studies focus on affected families, whereas research on the subjective experience of care professionals is scarce. Aim: We aimed to (1) explore experiences and needs of involved care professionals, (2) obtain information about existing care structures, and (3) identify requirements for a structured perinatal palliative care program. Design: Grounded Theory study using theoretical sampling. Data was collected by semi-structured interviews and analyzed following the principles of grounded theory coding and situational analysis. Setting: A total of 18 professionals from 12 different services in Munich and surroundings participated in the study: 8 physicians, 3 midwives, 2 nurses, 1 each pregnancy counselor, grief counselor, chaplain, clinical psychologist, and undertaker. Results: Several organizations provide support for affected parents, but inter-institutional communication is scarce. Due to the lack of a dedicated perinatal palliative care program, professionals make immense and partly unpaid efforts to support concerned parents. Providers experience “collateral beauty” in their work despite all the suffering and grief. This includes the development of a humble attitude and feelings of gratitude toward life, the feeling of having a meaningful task and professional as well as personal growth. Requirements for a structured perinatal palliative care program include: fostering peer support, ensuring regular supervision, and enhancing interdisciplinary exchange. Conclusions: Perinatal palliative care demands a high level of personal engagement but is experienced as highly rewarding by care professionals.

Inter-Institutional Communication Model for Online Learning for Elementary School Students

This study seeks to understand various communication events in the learning process holistically. The communication events in this paper include communication from the interpersonal level, computer-mediated communication, to organizational communication. This study explains the communication process from the human aspect (non-technical) and human relations with learning media technology (technical). This study seeks to answer how daily communication and communication media technology is vital in implementing online education for elementary school students. This study aims to offer an inter-institutional communication model that can be used to provide online education for students in elementary schools during disaster emergencies such as the Covid-19 pandemic. This study uses a focus group discussion (FGD) methodology with data collection techniques in interviews, field observations, and literature studies. This study uses data analysis in three-stage coding: open, axial, and selective. The subjects in this study were providers of elementary school (Sekolah Dasar) in Subdistrict (Kelurahan) Teluk Pucung, Kota Bekasi. This study finds that there is a need for intensification of communication from the daily level involving local stakeholders to resolve non-technical problems. The government needs to improve the communication media technology infrastructure and innovation in learning media technology for students who take online learning at the elementary level.

PENERAPAN MEKANISME MEDIASI DALAM PROSES PENYELESAIAN SENGKETA KEWENANGAN BADAN PERMUSYARAWATAN DESA DAN KEPALA DESA BERDASARKAN UNDANG-UNDANG NOMOR 6 TAHUN 2014 TENTANG DESA (STUDI KASUS DI DESA JENGGALA, KECAMATAN TANJUNG KABUPATEN LOMBOK UTARA)

That the potential for overlap in the authority of the BPD and the Head as a form of normative application of Law Number 6 of 2014 is very large, especially if we look at aspects of implementing the functions of the BPD Institution which will coincide with the function of the village head as executor of government in the village. The formulation of the problem in this research is first, How is the Mediation Mechanism Implemented in the Dispute Resolution Process over the Authority of the Village Consultative Body and the Village Head Based on Law Number 6 of 2014 on Village Neighborhoods? And secondly, what are the alternative forms of mediation that can be implemented in the Dispute Resolution Process over the Authority of the Village Consultative Body and the Village Head Based on Law Number 6 of 2014 on Village Neighbors (Case Study in Jenggala Village, Tanjung District, North Lombok Regency) The results of the research conducted by the author show that firstly, the application of a mediation mechanism in resolving authority disputes between the BPD and the Village Head can be carried out on a normative basis contained in the provisions of Article 112 in Article 115 of Law Number 6 of 2014 concerning Villages. Second, alternative forms of mediation in resolving disputes between the Village Head and BPD in Jenggala Village can be implemented in 2 (two) forms, namely, formal mediation and informal mediation. Formal mediation is mediation carried out by the KLU DP2KBPMD Service who acts as the mediator. Meanwhile, informal mediation can be carried out through, firstly, the Village Inter-Institutional Communication Forum (FKAKD), the formation of which was initiated by the BPD based on the provisions of Article 62 of North Lombok Regency Regional Regulation Number 3 of 2019 concerning BPD, and secondly through the Village Krama Council based on North Lombok Regent Regulation Number 20 2017 concerning MKD Guidelines.

Leveraging Electronic Health Records to Address Breast Cancer Disparities.

Purpose of ReviewBreast cancer is the most commonly diagnosed cancer in women, and the leading cause of cancer death. However, racial and ethnic minority groups, as well as rural and underserved populations, face disparities that limit their access to specialty care for breast cancer. To address these disparities, health care providers can leverage an electronic health record (EHR).Recent FindingsFew studies have evaluated the potential benefits of using EHRs to address breast cancer disparities, and none of them outlines a standard approach for this effort. However, these studies outline that EHRs can be used to identify and notify patients at risk for breast cancer. These systems can also automate referrals and scheduling for screening and genetic testing, as well as recruit eligible patients for clinical trials. EHRs can also provide educational materials to reduce risks associated with modifiable risk factors, such as physical activity, obesity, and smoking. These systems can also support telemedicine visits and centralize inter-institutional communication to improve treatment adherence and the quality of care.SummaryEHRs have tremendous potential to increase accessibility and communication for patients with breast cancer by augmenting patient engagement, improving communication between patients and providers, and strengthening communication among providers. These efforts can reduce breast cancer disparities by increasing breast cancer screening, improving treatment adherence, expanding access to specialty care, and promoting risk-reducing habits among racial and ethnic minority groups and other underserved populations.

Kapadokya Bölge Turizminin Sorunlarına ve Çözüm Önerilerine Yönelik Bir Değerlendirme

The aim of this study is to put forth how much of the ongoing tourism problems in the Cappadocia Region could be solved by in-depth analysis or what steps can be taken to solve them. From this point of view, by using the qualitative research approach, the single-case embedded design was used in the study. In this context, the outputs of meetings such as conferences, seminars, and workshops held so far to identify the problems that prevent tourism development in the destination have been examined by document analysis. Regarding the tourism of the Cappadocia region, lack of promotion, vocational/in-service training, and qualified workforce, poor working conditions, insufficient incentives for the sector, failure to manage crises, unplanned construction in the region, security problems, not adopting the concept of sustainability, inability to activate alternative tourism types, standard service quality and inadequate supervision, lack of historical and cultural inventory, transportation problems and many problems regarding inter-institutional communication and cooperation have been revealed. Based on the research results, possible solutions for the problems experienced in the tourism sector in the region are presented. Since there has been limited research in terms of addressing the current problems of the tourism sector in the Cappadocia Region, It is expected that the findings of this study will contribute to the field and provide practical benefits by creating a resource for subsequent research and offering suggestions.

Barriers and solutions to developing and maintaining research networks during a pandemic: An example from the iELEVATE perinatal network.

To improve maternal health outcomes, increased diversity is needed among pregnant people in research studies and community surveillance. To expand the pool, we sought to develop a network encompassing academic and community obstetrics clinics. Typical challenges in developing a network include site identification, contracting, onboarding sites, staff engagement, participant recruitment, funding, and institutional review board approvals. While not insurmountable, these challenges became magnified as we built a research network during a global pandemic. Our objective is to describe the framework utilized to resolve pandemic-related issues. We developed a framework for site-specific adaptation of the generalized study protocol. Twice monthly video meetings were held between the lead academic sites to identify local challenges and to generate ideas for solutions. We identified site and participant recruitment challenges and then implemented solutions tailored to the local workflow. These solutions included the use of an electronic consent and videoconferences with local clinic leadership and staff. The processes for network development and maintenance changed to address issues related to the COVID-19 pandemic. However, aspects of the sample processing/storage and data collection elements were held constant between sites. Adapting our consenting approach enabled maintaining study enrollment during the pandemic. The pandemic amplified issues related to contracting, onboarding, and IRB approval. Maintaining continuity in sample management and clinical data collection allowed for pooling of information between sites. Adaptability is key to maintaining network sites. Rapidly changing guidelines for beginning and continuing research during the pandemic required frequent intra- and inter-institutional communication to navigate.

On the Aspects of Social Work Support for Adoptive Parents in the Process of Adoption

The article represents a part of a master thesis research project carried out at Klaipeda university. Concepts of biological, emotional, and procedural parenting obligations were utilised to analyse the issues of social work support for adoptive families. Procedural and emotional components were found to raise the biggest challenges. Although fostering and adoption mean raising a child deprived of parental care and usually needing additional help, social work support is mostly oriented towards fostering families. Therefore, social work support for adoptive parents while rather intensive in preparing the necessary documentation, initial training and matching of a family and a child, basically stops after the child arrives in a family. After that support remains purely voluntary and occasional. Research results show that the adoption process needs to be improved by revising training programmes, enhancing inter-institutional communication, and enriching the information provided for adoptive parents. The current procedures are seen as inefficient by social workers and adoptive parents.

REGULATION OF OFFENCES AGAINST PUBLIC SECURITY IN THE CRIMINAL CODE OF ROMANIA

The aim of this article is to highlight the place the Romanian lawmaker has given to criminal offences against public security in the criminal law. At the same time, we seek to delineate the legal object of crimes against public security from that of crimes that affect relations of social coexistence, especially those protecting public order and peace. Knowledge of the legal object contributes to a better understanding of the concepts of public security and social order that are interdependent with law and human capital. Also, through the method of documentation we aimed to highlight, in the context of the pandemic: some legislative changes that had an impact on the activities carried out in the field of public security; the main measures taken to ensure the safety of the person and the observance of health measures in criminal proceedings; the activities that were carried out online in the judicial proceedings and the manner in which the intra-institutional communication or inter-institutional communication took place; the main changes brought by the legislator in the matter of criminal offences against public security (safety).

Assessing University and Programme Experiences: Towards an Integrated Asia Pacific Approach

Effective assessment of university experiences is critical for quality assurance/enhancement but fragmented across the Pacific-Asian universities. A shared conceptual and measurement foundation for understanding student experiences is a necessary first step for inter-institutional communication across the region. The current study is a first step toward such a foundation, uniting two of the most internationally and locally prominent instruments: Chinese College Student Survey (university engagement; Mainland China) and Student Learning Experience Questionnaire (programme engagement; Hong Kong). The survey was completed by students from one research-intensive Hong Kong university (n = 539). Random, split-half CFA, latent-reliability, pair-wise correlations, ANOVA (gender) and MANOVA (faculty) were conducted. Factor-structure (good CFA fit for the test/retest) and scale reliability (0.07 &amp;gt; Raykov’s Rho) suggested a robust, short (63-items) survey resulted. Intra-/inter-survey relationships were consistent with the existing Student Engagement and Student Approaches to Learning theory. ANOVA indicated small differences for gender for a few latent constructs, but MANOVA revealed substantial differences across the 10 faculties. This study resulted in a robust Pacific-Asian intra-/inter-institutional student experience instrument which brings together two equally important perspectives on the student experience. This comprehensive student engagement instrument stands ready for cross-national and longitudinal tests. The new instrument’s benefits extend to theoretical connections to student experience assessment in the United States, Australia, and the United Kingdom enabling international connections to be made.

Referral Process for Surgical Management of Tuberculosis in Lima: A Qualitative Study

BackgroundLung resection surgery can be a complementary therapy for managing tuberculosis (TB) complications, but access is lacking in high-burden areas. The referral process for surgical evaluation is not well described. This study aimed to elucidate the TB surgery referral process in Peru. MethodsA qualitative study was conducted using focus groups and interviews of health care providers from the Peruvian National TB Program. A semi-structured interview guide was developed with local partners. Focus groups and individual interviews were recorded and transcribed. Thematic analysis was used to reconstruct the referral process and identify barriers as well as areas for improvement. ResultsA total of 12 sessions were recorded (7 interviews and 5 focus groups; 36 participants total). The main themes identified were: (1) Surgical referral workflow, (2) Unstandardized selection criteria for surgery, (3) Limited inter-institutional communication, and (4) Material barriers to surgical management. ConclusionHealth care providers involved in the referral process of surgical management of tuberculosis in Lima reported a hierarchical referral workflow. Interinstitutional communication may be a critical interventional point to improve a patient's quality of care during the referral process.

Hidden Aspects of Social and Historical Development of Islamic Community in Sisak, Croatia

Abstract This article presents the efforts of the Islamic community in Sisak, Croatia, to achieve better social status and recognition in the local environment from the 1960s until today. By applying anthropological perspectives, we present the Islamic community’s long-lasting efforts of building a mosque, presenting their personal experience related to cultural identity and belonging. The aim is to present aspirations of the Islamic community during and after socialism focusing on inter-institutional communication and diverse integration strategies. We approach the Islamic community from an ethnographic perspective, conducting interviews with community members and searching documents in archives.

Ukrainian Historical Issues in Polish Media in the Context of a Hybrid War: Between Myths and Post-Truth

Ukrainian-Polish relations have been rather controversial in terms of historical policy lately, and it has a negative impact on interstate relations. On the one hand, in the foreign policy discourse Poland is considered to be one of the leading advocates of Ukraine in the collective West, along with Lithuania, and on the other hand problems of historical and humanitarian character permanently arise in bilateral relations, which form a negative background, become a subject to manipulation by third countries, and exacerbate relations both at the interpersonal and inter-institutional communication levels. The additional factor that complicates the understanding of historical policy issues is media of both countries, where the old and new myths, elements of post-truth and emotional subjective evaluations of the non-professional level penetrate beyond the historical corporate society. Populist politicians of the left and right ideological flanks try to take advantage of it, but it becomes an obstacle to political understanding, and complicates the investment development of a large subregion of the countries of Central, Southeastern Europe and the Baltic States. Historical policy has become a part of an information security, and some third countries, in our case it’s the Russian Federation, use this factor during the implementation of hybrid war tasks against Ukraine and the countries of the European Union. The article assumes that only the change of political rhetoric, the avoidance of populism regarding historical relations of two neighboring nations, the strengthening of corporate responsibility of national media in matters of historical policy’s coverage are able to neutralize the influence of radical political trends inside the countries, and outside - the influence of other states which are not interested in overcoming the tragic plume of history in Poland and Ukraine. Authors of the article do not aim to study or compare purely historical positions. This is about media tools and their role in the historical policy discourse.

Implementation of Tanzania’s National Cancer Treatment Guidelines: A Qualitative Approach to Clinical Systems

PURPOSE In response to the increasing burden of cancer in Tanzania, the Tanzanian Ministry of Health Community Development, Gender, Elderly, and Children plans to launch their first National Cancer Treatment Guidelines. These guidelines will provide an opportunity to improve and standardize care at Ocean Road Cancer Institute (ORCI), the national cancer center, where previous data suggest that patients do not consistently receive standard treatment. A theory-informed implementation strategy will be conducted to facilitate the routine use of guidelines among health care providers at ORCI. As part of the needs assessment for this effort, this study explored the barriers to and facilitators of guideline-concordant care at ORCI. METHODS We conducted three focus groups with participants stratified by profession, which included oncologists, radiotherapists, oncology residents, and nurses. A discussion guide was used to generate discussion about multiple aspects of current clinical processes at ORCI. Audio recordings were transcribed and translated to English, and data were analyzed using the framework method. RESULTS A total of 21 participants helped identify institutional and systemic factors that were internal and external to the clinical systems at ORCI that may affect guideline-concordant care. These can be categorized into the following: strengths and facilitators, barriers, and suggestions for improvement. Internal facilitators include multidisciplinary patient management, government-sponsored free cancer care, community engagement, and providers’ motivation for continuous learning and improvement. Internal barriers include interdepartmental and interinstitutional communication gaps, resource limitations for specialized services, high patient volumes, and patient misconceptions and nonadherence. Participants offered many practical suggestions for improving clinical systems at ORCI. CONCLUSION Our results highlight several barriers and facilitators within and outside of the clinical systems at ORCI that may affect the uptake of the National Cancer Treatment Guidelines. Findings have been used to recommend quality improvement and environmental restructuring measures at ORCI that will inform the broader guideline implementation strategy.

Development and Utilization of a Rapid and Accurate Epidemic Investigation Support System for COVID-19.

ObjectivesIn this pandemic situation caused by a novel coronavirus disease in 2019 (COVID-19), an electronic support system that can rapidly and accurately perform epidemic investigations, is needed. It would systematically secure and analyze patients’ data (who have been confirmed to have the infection), location information, and credit card usage.MethodsThe “Infectious Disease Prevention and Control Act” in South Korea, established a legal basis for the securement, handling procedure, and disclosure of information required for epidemic investigations. The Epidemic Investigation Support System (EISS) was developed as an application platform on the Smart City data platform.ResultsThe EISS performed the function of inter-institutional communication which reduced the processing period of patients’ data in comparison to other methods. This system automatically marked confirmed cases’ tracking data on a map and hot-spot analysis which lead to the prediction of areas where people may be vulnerable to infection.ConclusionThe EISS was designed and implemented for use during an epidemic investigation to prevent the spread of an infectious disease, by specifically tracking confirmed cases of infection.

Improving transitions in care for children with complex and medically fragile needs: a mixed methods study

BackgroundChildren with medical complexity are a small yet resource intensive population in the Canadian health care system. The process for discharging these children from hospital to home is not yet optimal. The overall goal of this project was to develop recommendations to be included in a provincial strategy to support transitions in care for children with complex and medically fragile needs.MethodsA wide assortment of stakeholders participated in this mixed method, multiphase project. During Phase 1, data was gathered from a range of sources to document families’ experiences transitioning from an inpatient hospital stay back to their home communities. In Phase 2, pediatricians, nurses, and health administrators participated in key stakeholder interviews to identify barriers and facilitators to a successful transition in care for children and families with complex care needs. A multi-sector consensus meeting was held during Phase 3 to discuss study findings and refine key recommendations for inclusion in a provincial strategy.ResultsSix case studies were developed involving children and families discharged home with a variety of complex care needs. Children ranged in age from 15 days to 9 years old. Nine telephone interviews were conducted in Phase 2 with pediatricians, nurses, and administrators from across the province. A variety of inter-institutional communication challenges were described as a major barrier to the transition process. A consistent message across all interviews was the need for improved coordination to facilitate transitions in care. The consensus meeting to review study findings included physicians, nurses, paramedics, senior administrators, and policy analysts from different health and government sectors and resulted in six recommendations for inclusion in a provincial strategy.ConclusionsThis project identified policy and practice gaps that currently exist related to transitions in care for children with complex and medically fragile needs and their families. Our collaborative patient-centred approach to understanding how children and families currently navigate transitions in care provided a foundation for developing recommendations for a provincial wide strategy.

Information from Earth Observation for the Management of Sustainable Land Use and Land Cover in Brazil: An Analysis of User Needs

Brazil has some of the world’s most important forest and natural ecosystem resources and their sustainability is of global importance. The expansion of agriculture for livestock, the extractive industries, illegal logging, land conflicts, fire and deforestation are pressures on land use and drivers of land use change in many regions of Brazil. While different institutions in Brazil have sought to use Earth Observation (EO) data to support better land use management and conservation projects, several problems remain at the national and state level in the implementation of EO to support environmental policies and services provided to Brazilian society. This paper presents the results of a systematic analysis of the key challenges in using EO data in land management in Brazil and summarises them in a conceptual model of the factors influencing EO data use for assessing sustainable land use and land cover in Brazil. The research was based on a series of in-depth, semi-structured interviews (43) and structured interviews (53) with key stakeholders who make use of EO data across different locations in Brazil. The major challenges identified in the complex and multifaceted aspects of using this information were associated with access to, and with the processing of, raw data into usable information. The analysis also revealed novel insights on a lack of inter-institutional communication, adequate office infrastructure and personnel, availability of the right type of EO data and funding restrictions, political instability and bureaucracy as factors that limit more effective use of EO data in Brazil at present. We close this analysis by considering how EO information for the sustainable management of land use and land cover can assist institutions as they respond to the varied political and economic instabilities affecting environmental governance and deforestation levels.

Elucidating challenges and solutions in the maternal healthcare, identified by medical doctors in northern South Africa: a qualitative study

Introductionas South Africa's maternal mortality ratio increased between 1990 and 2015, the country failed to reach the United Nations millennium development goal 5a. The maternal mortality ratio of Limpopo province is higher than the national average and previous studies report shortages of manpower and medical equipment in Limpopo province. The overall study aim was to elucidate views and experiences of medical doctors regarding maternal healthcare by identifying the challenges they experience and solutions they suggest.Methodsa qualitative interview-based study was performed with ten medical doctors as participants. Manifest content analysis was used to analyze the data.Resultsthe main findings were categorized as lack of material and human resources, feelings of experienced isolation and solution-focused expressions. The challenges identified included logistical issues, staffing issues, demographic characteristics of the patient population, poor interinstitutional communication and lack of support from the administration. The solutions included revision of resource allocation and improvement of the interinstitutional cooperation. For example, participants suggested that exchange programs between hospitals could be arranged, that the emergency medical service personnel could triage patients and that private practitioners could be contracted to work at public institutions.Conclusionmost identified challenges were related to a lack of resources. Based on their inside experience, the participants suggested several solutions. These firsthand accounts of the local medical doctors highlight the need for intervention and should be taken into account when it comes to improving the provincial healthcare and working toward achieving the healthcare-related sustainable development goals by 2030.

Listen to the Midwives in Limpopo Province South Africa: An Exploratory Study on Maternal Care

Background and Aim: South Africa is a middle-income country that did not reach the United Nations Millennium Development Goal 5 by 2015, because maternal mortality ratio increased between 1990 and 2015. Limpopo is a rural province, and its institutional maternal mortality ratio is higher than the national average. Studies reported that there is a shortage of midwives and medical equipment in the province. This study is part of a broader research program focusing on strengthening health systems for maternal care in Limpopo province, and it was aimed at exploring the experiences of Midwives prior to debriefing and training sessions conducted. Methods: Qualitative research was used whereby five focus group interviews were conducted with midwives from five districts to share experiences during the provision of maternal healthcare and to propose solutions thereof. Tesch’s open coding qualitative data analysis was used. Results: The findings revealed that there is a lack of resources, feelings of isolation, problems related to logistical issues, staffing issues, demographic characteristics of the population, interinstitutional communication, and lack of administrative support. Conclusion: Hospital managers must revise how they allocate resources, improve inter-institutional cooperation, and change of management attitude. This study concludes that the midwives identified numerous challenges that originate from a lack of resources. Revision for resource allocation is hoped that it will solve logistical problems, increased inter-institutional cooperation in terms of capacity building and patient assessment suggested with the hope to minimize the challenges of communication and staffing.

Building National and International Genomic Data Sharing Initiatives

Rapid and affordable molecular profiling has led to an explosion of clinical and genomic data to enhance the diagnosis, prognostication and treatment of cancer. Whereas institutions and groups functioning in relative isolation have contributed to bring genomic sequencing to the spotlight, the analysis and storage of annotated clinical and genomic information in unconnected silos significantly limit the collective benefit of data sharing. A globalised approach is needed to create an environment that fosters big data learning. In this presentation, national and international data sharing initiatives are highlighted with an emphasis on the establishment of information technology infrastructure that empowers intra- and inter-institutional communication. Multiple big data initiatives such as AACR’s GENIE, ASCO’s CancerLINQ, NCI’s Genomic Data Commons, etc., have emerged over the past few years. Quality assurance of the merged data and the careful collection of long-term outcomes are important considerations to ensure utility of such initiatives. The Global Alliance for Genomic Health (GA4GH), established with the goal to create a common framework of unifying approaches to enable the responsible, voluntary, and secure sharing of clinical and genomic data, has created many resources to help translate such goals into practice.