Study Set Content:
The expansion of evidence-based medicine and of managed care places a high premium on the tools of
health informatics
helps clinicians, administrators, third-party payers, governments, researchers, and other parties to collect, store, retrieve, analyze, and scrutinize vast amounts of data.
Health informatics
he practice of medicine or nursing is not exclusively and clearly scientific, statistical, or procedural, and hence is not, so far, computationally tractable. This is not to make a hoary appeal to the “art and science
Miller and Goodman, 1998:
If computers, databases, and networks can improve physician–patient or nurse–patient relationships, perhaps by improving (), then we shall have achieved a happy result.
communication
“If reliance on computers impedes the abilities of health professionals to establish trust and to communicate compassionately, however, or further contributes to the dehumanization of patients, then we may have paid too dearly for our use of these machines”
Shortliffe, 1994
CONSUMER HEALTH INFORMATICS
1. Consumer health informatics
2. Technologies focused on patients as the primary users
3. Makes vast amounts of information available to patients.
ISSUES USING WWW
PEER REVIEW
2.ONLINE CONSULTATIONS
SUPPORT GROUPS
How and by whom is the quality of a Web site to be evaluated? Who is responsible for the accuracy of information communicated to patients?
PEER REVIEW
Internet support groups can provide succor and advice to the sick, but there is a chance that someone who might benefit from seeing a physician will not do so because of comforts and information otherwise attained, and that her not doing so will lead to bad consequences. How should this problem be addressed?
SUPPORT GROUPS
There is yet no standard of care for online medical consultations. What risks do physicians and nurses run by giving advice to patients whom they have not met or examined? This question is especially important in the context of telemedicine or remote-presence health care, the use of video teleconferencing, image transmission, and other technologies that allow clinicians to evaluate and treat patients in other than face-to-face situations
ONLINE CONSULTATIONS
INFORMATICS, like other health technologies, will thrive if our enthusiasm is open to greater() and is wed to deep reflection on ()
evidence, human value
apply in attempts to determine what is good or meritorious and which behaviors are desirable or correct in accordance with higher principles
Ethical considerations
are generally derived from ethical ones but deal with the practical regulation of morality or behaviors and activities.
Legal principles
offers conceptual tools to evaluate and guide moral decision making.
ETHICS
directly tell us how to behave (or not to behave) under various specific circumstances and prescribe remedies or punishments for individuals who do not comply with the law
LAWS
Major legal issues related to the use of software applications in clinical practice and in biomedical research include
1. Liability under tort law 2. Potential use of computer applications as expert witnesses in the courtroom 3. Legislation governing privacy and confidentiality 4. Copyrights, patents, and intellectual property issue.
is an act or omission, other than a breach of contract, which gives rise to injury or harm to another, and amounts to a civil wrong for which courts impose liability.
TORT
In other words, a wrong has been committed and the remedy is
money
In the United States and in many other nations, principles of tort law govern situations in which harm or injuries result from the manufacture and sale of goods and services
Miller et al., 1985
Two ideas from tort law potentially apply to the clinical use of software systems:
the negligence theory, and
2. strict product liability
