In this second episode of season 2 we discuss an international perspective of using RWD to evaluate country healthcare systems and their information systems with Jillian Oderkirk, Senior Economist, Health Division at the Organisation for Economic Cooperation and Development (OECD), an intergovernmental economic organisation with 38 member countries founded in 1961. Jillian provides a unique perspective from her global position on the health agenda of the OECD, and in particular the need to utilise data at scale to better understand healthcare systems, their impact at a national and international level with regards to quality evaluation, while assisting governments to improve their healthcare systems. Jillian has very relevant, prior experience in Canada, and with the OECD since 2010 in working with governments on assessing how they are transitioning from 20th century models of care provision and systems implementation to a 21st century, data-driven, learning healthcare system goal. In the conversation, we explore some of the more advanced countries, such as France, Finland, Denmark and South Korea with regards to realising this goal, as well as some deeper insights into countries like the Netherlands in OECD's most recent audit report (link). The COVID-19 pandemic has acted as a lens on the problems everyone has with ensuring there is health data and information that is accessible and interoperable, with analytical interoperability, but also a catalyst for governments to prioritise improvements and policy responses to the persistent information deficit. Within the discussion there is less emphasis on technical and methodological aspects of working with data, but more about governance, control and protection of health data, challenged by more nihilistic approaches to not utilising it in research to avoid perceived risks. Political and technocratic hurdles issues, such as parochial planning at local level, and the emphasis on reinventing versus copying best practice illustrate how the OECD is responding to this, such as with their 2016 recommendations on data governance (link). Fitness for purpose of information systems remains a key challenge, albeit with some pockets of improvement. In the latter aspect of the episode we discuss future trends, and indeed hope for the 21st century goal Jillian has, demonstrated in programmes like EHDEN, and global open science collaborations such as OHDSI, based on transparency, reproducibility, collaboration and verifiable data interoperability. The views expressed by the participants are personal and not necessarily reflective of their organisations.