Medical Information Systems Ethics

The exponential digitization of medical data has led to a transformation of the practice of medicine. This change notably raises a new complexity of issues surrounding health IT. The proper use of these communication tools, such as telemedicine, e-health, m-health the big medical data, should improve the quality of monitoring and care of patients for an information system to "human face".

Faced with these challenges, the author analyses in an ethical angle the patient-physician relationship, sharing, transmission and storage of medical information, setting pins to an ethic for the digitization of medical information. Drawing on good practice recommendations closely associated with values, this model is developing tools for reflection and present the keys to understanding the decision-making issues that reflect both the technological constraints and the complex nature of human reality in medicine .

Economist and health manager,Jerome Beranger is a senior consultant and associate researcher (PhD) for Keosys society. His research focuses on ethics and sociology of information systems for e-health, m-health and big data.

INTRODUCTION  ix

CHAPTER 1. THE EMERGENCE OF MEDICAL INFORMATION IN THE FACE OF PERSONAL AND SOCIETAL ETHICAL CHALLENGES  1

1.1. An information-consuming society  2

1.2. e-Health, m-health, the Quantified Self and Big Data 5

1.3. Medical secrecy in the face of the computerization of healthcare data  18

1.3.1. Regulatory characteristics of medical secrecy 19

1.3.2. Protection of healthcare data 24

1.4. Cultural evolution of mentalities surrounding legitimacy of information 28

1.5. Processing of personal data in law 30

1.5.1. European regulations concerning the processing of medical data 32

1.5.2. American legal framework surrounding personal healthcare data 39

1.5.3. Laws pertaining to personal data in Asia  42

CHAPTER 2. ETHICAL MODELING: FROM THE DESIGN TO THE USE OF AN INFORMATION SYSTEM 45

2.1. Info-ethics: data on practical wisdom 47

2.1.1. Epistemological illumination around the pyramid of knowledge 48

2.1.2. From data to knowledge through an information system 52

2.1.3. Quality and choice of medical information 56

2.2. Identification of method used to develop the ethical analysis model 61

2.3. Development of the ethical analysis space 68

2.4. Presentation of the ethical model  74

2.4.1. Ethical cube of an accepted contingency 75

2.4.2. Ethical model of information system in the doctorpatient relationship 78

2.4.3. Ethical modeling of medical communication 88

2.4.4. Process of creation of practical wisdom via neo-Platonic systemic ethical modeling 95

2.4.5. Ethical inductive algorithmic governance (;;, G, ;;) 108

2.4.6. Toward a selective ranking of medical data 113

CHAPTER 3. USES OF THIS ETHICAL MODEL 119

3.1. Implementing the ethical model  119

3.1.1. Implementing the model on the major aims of an information system 121

3.1.2. Implementation of the model in the general creation of an information system 131

3.2. Presentation of the studys questionnaires  131

3.3. Necessary environmental changes for healthcare information systems: recommendations and actions 134

3.3.1. From a structural and technological perspective  137

3.3.2. From a strategic and methodological perspective 141

3.3.3. From an organizational and regulatory perspective  146

3.3.4. From a relational and cultural perspective 153

3.4. Creating an ethical charter on the ideal computational tool for a healthcare establishment 158

3.4.1. Missions and areas of action  158

3.4.2. Contents  160

CHAPTER 4. ETHICS-ORIENTED PERSONALIZED MEDICINE 165

4.1. The evolution of society toward an ethical ideal based on information  166

4.2. The doctorpatientIS triangulation 174

4.2.1. Manmachine interface  175

4.2.2. Data compression  178

4.2.3. Flexibility and technical adaptation to the users  180

4.2.4. Shared knowledge engineering  182

4.3. Ethical use of an information system in healthcare  184

4.4. Ethics-oriented personalized medicine 189

4.4.1. Value of management 190

4.4.2. Ethical management  191

4.5. Tool for the establishment and constant improvement of information systems for ethical practice in hospitals 194

4.5.1. Construction of the dashboards  195

4.5.2. Methodology of implementation and use 212

CONCLUSIONS 221

APPENDIX 1 225

APPENDIX 2 229

APPENDIX 3 233

APPENDIX 4 235

APPENDIX 5 243

APPENDIX 6 245

BIBLIOGRAPHY 247

INDEX 261