Evaluations and Ethics

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A range of ethical issues must be considered in an HIT system implementation. Ethical issues can be related to the appropriate use of decision support systems, privacy and confidentiality, consent for the use of clinical information, and accountability errors. By being aware of potential ethical issues, nurse informaticists may generate evaluation plans that circumvent or address ethical concerns before these concerns hinder a system implementation.

In this Discussion, you analyze potential concerns or issues that could arise during an evaluation, and consider strategies for addressing those concerns.

To prepare:

  • Select one of the following areas, and consider potential ethical issues a nurse informaticist may encounter:
    • appropriate uses and users of decision support systems
    • privacy and confidentiality
    • consent for secondary use of clinical and genetic information in databases
    • accountability or responsibility for errors
  • Using this week’s Learning Resources and at least one additional resource from the Walden Library, identify key concerns within the area you selected.
  • Consider strategies for using evaluations to address these ethical concerns.

Required Readings

 

Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.

  • Chapter 12, “Proposing and Communicating the Results of Evaluation Studies: Ethical, Legal, and Regulatory Issues” (pp. 338–361)

This chapter covers both how to write a proposal to conduct an evaluation and how to present the findings. It highlights the importance of conforming to legal, regulatory, and ethical standards in the evaluation and write-up.

Berner, E. S. (2008). Ethical and legal issues in the use of health information technology to improve patient safety. HEC Forum20(3), 243–258.

Retrieved from the Walden Library databases.

In this article, the author outlines key ethical and legal issues that need to be considered when using health information technology. These include issues with the establishment of a standard of care, increased availability of patient information, accuracy of information, the effectiveness of user training, and the fulfillment of informed consent obligations.

 

Goldstein, M. M. (2010). Health information technology and the idea of informed consent. Journal of Law, Medicine & Ethics38(1), 27–35.

Retrieved from the Walden Library databases.

This article details the reasons behind the policy of informed consent and the challenges posed to providing privacy by electronic health records and the ease of gaining access to confidential patient information.

Goodman, K. W. (2010). Ethics, information technology, and public health: New challenges for the clinician-patient relationship. Journal of Law, Medicine & Ethics38(1), 58–63.

Retrieved from the Walden Library databases.

The focus of this article is the challenge facing health care personnel in balancing the privacy of patients and the need to perform research on public health issues. The author discusses whether there is a moral obligation for patients and clinicians to be willing to share information for the “greater good.”

Goodman, K. W., Berner, E. S., Dente, M. A., Kaplan, B., Koppel, R., Rucker, D., et al. (2011). Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: A report of an AMIA special task force. Journal of the American Medical Informatics Association18(1), 77–81.

Retrieved from the Walden Library databases.

This article highlights recommendations by an AMIA special task force that analyzed ethical and safety issues dealing with the increased use of HIT systems. The recommendations covered such areas as the need for HIT regulation, the ability to provide ethics training to vendors, and organizational commitment to placing patient safety as the highest priority.

Nykänen, P., Brender, J., Talmon, J., de Keizer, N., Rigby, M., Beuscart-Zephir, M. C., & Ammenwerth. E. (2011). Guideline for good evaluation practice in health informatics (GEP-HI). International Journal of Medical Informatics, 80(12), 815–827.

Retrieved from the Walden Library databases.

In this article, the authors highlight their efforts to develop a good practice guideline to plan and perform evaluation studies in health informatics. The authors put forth a list of sixty issues to function as a guideline for good evaluation practices.

Rothstein, M. A. (2011). Currents in contemporary bioethics: Physicians’ duty to inform patients of new medical discoveries: The effect of health information technology. Journal of Law, Medicine & Ethics39(4), 690–693.

Retrieved from the Walden Library databases.

The authors of this article analyze the duty of physicians to inform patients of relevant medical developments following their episode of care. Additionally, the authors make recommendations for promoting recognition of physicians’ duty to notify patients of new medical discoveries applicable to their health.

Rothstein, M. A. (2010). The Hippocratic bargain and health information technology. Journal of Law, Medicine & Ethics38(1), 7–13.

Retrieved from the Walden Library databases.

This article highlights the sensitive nature of much of the information contained in Electronic Health Records and its current availability to a wide range of individuals. The author calls for the development of policy to protect the privacy of patients. He suggests allowing the segmentation of patient information so that the majority of sensitive information is difficult to access.

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