Clinical Information Systems - Seen through the Ethics Lens.

Area of Science:

• Health Informatics
• Bioethics
• Sociotechnical Systems

Background:

• Clinical information systems (CIS) are increasingly used beyond traditional healthcare settings, extending to patients and citizens.
• This expansion amplifies both potential benefits and inherent risks, necessitating a closer examination of ethical considerations.

Purpose of the Study:

• To explore ethical debates arising from smart CIS extending to patients and citizens.
• To investigate the ethical competencies and education required for the appropriate use of these advanced systems.

Main Methods:

• A literature review was conducted on ethics topics related to clinical and health information systems, decision support, health information exchange, and mobile technologies.
• Searches focused on MEDLINE database articles from 2016-2019, with a specific emphasis on 2018-2019, and included a secondary search combining keywords with 'education'.

Main Results:

• Privacy, confidentiality, and informed consent were dominant ethical concerns, alongside the impact on the provider-patient relationship.
• The opacity of algorithms and lack of result explicability present significant challenges.
• Many studies highlighted the need for sociotechnical ethics education for both providers and patients, though few detailed specific ethical competencies.

Conclusions:

• Ethical values are not yet robustly integrated into empirical health technology evaluations.
• Sociotechnical ethics competencies require more detailed specification.
• Gaps in empirical evaluation and competency definition warrant further research at the intersection of CIS and ethics.