Taiwan's National Health Insurance Research Database (NHIRD): in the Era of Artificial Intelligence, Causal...

Area of Science:

• Health Informatics
• Real-World Evidence Generation
• Artificial Intelligence in Healthcare

Background:

• Taiwan's National Health Insurance Research Database (NHIRD) is a vital resource for generating real-world evidence.
• The NHIRD is undergoing a reassessment on the 30th anniversary of Taiwan's National Health Insurance program.
• Key areas for review include the database's development, challenges, and future trajectory.

Purpose of the Study:

• To provide an updated review of the NHIRD.

Main Methods:

• A narrative review was conducted, synthesizing studies, reports, and policy documents from 2019-2024.
• Developments in database infrastructure, data collection, validation, linkage, governance, and interoperability were summarized.
• Focus was placed on implications for real-world evidence and AI-driven research.

Main Results:

• The NHIRD now includes structured laboratory and medical imaging data, enhancing research scope.
• Validation studies confirm the reliability of ICD-10-CM codes for epidemiological research.
• Challenges include data standardization, cybersecurity, and privacy concerns, prompting initiatives like FHIR-based infrastructure development for AI readiness and ethical governance.

Conclusions:

• Continuous investment in data quality, privacy, and interoperability is crucial for the NHIRD's evolution.
• Sustained reforms position the NHIRD as a leading resource for real-world evidence and global health contributions.
• The NHIRD is adapting to balance ethical governance with scientific innovation for digital medicine advancement.