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Abstract
Objectives: Study the initial expectations and the final realization of Information system (IS) with health professionals. Methods: Our study is done from two questionnaires includes 40 items (Q1 and Q2) based on modeling ethics. This model is constructed using four universal ethical principles: autonomy-beneficence–non-maleficence-justice we meet with environmental parameters of the real: structural and technological-policy and procedural-organizational and regulatory-cultural and relationship. We interviewed 26 players consisting of 14 designers IS and 4 respectively responsible for consulting firms, publishers of IS and hosting of medical data. A score ethics unit/100 were used to assess the ethical expectations (Q1) of the actors and the achievement ethic (Q2) for the SI. Results: The score ethical expectations unit (Q1: 78.7) of IS is higher than that of the realization (Q2: 63.7) of SI (p<0.001). The subscores ethical expectations belong in order of importance to ethical principles: beneficence (84.9)-autonomy (78.9)-non-maleficence (77.2)-justice (73.9). Subscores ethical achieving a mean SI (in order of importance) the following ethical principles: autonomy (67.3)-beneficence (63.0)-non-maleficence (62.1)-justice (58 6). The score ethical expectations unit (Q1) is higher than that of the realization (Q2) to all categories of protagonists (except the hosts of health data). Gives the same results if we study all the subscores principle by principle. Offer Ethics (Q2) of the editors of SI is still below expectations ethical (Q1) of actors involved in contracting owner (MOA) of an IS healthy. Offer Ethics (Q2) of the hosts of health data is always higher ethical expectations of the actors involved in the entire MOA of an IS. Conclusions: The application of our modeling ethics for study of the expectations and achieving a health IS results in the coherent set according to the nature of the principles and stakeholders. This reflects a degree of accuracy of the assessment tool for health IS healthy. There is a double confrontation, on the one hand, between autonomy and beneficence, and also between non-maleficence and justice, according to the expectations and the realization of IS with the protagonists. By highlighting this model based on ethical principles and environmental parameters of reality, our work contribute to make the initial foundation of the architecture ethics of a health IS.
Highlights
The organization of health systems is going through several years of difficulties multifactorial
From the questionnaire 1 (Q1) and questionnaire 2 (Q2), we have respectively set up a score ethics unit expectations and the achievement ethic of an Information Systems (IS) on all the 26 actors who participated in the study with a high internal consistency (α> 0.9)
We obtain the same trend for each sub-scores of ethical principles in Q1 compared to Q2
Summary
The organization of health systems is going through several years of difficulties multifactorial (disruption of mentality, clashes of views on policies to control health care costs). Our health systems and in general our societies returned to an era of questioning. In this article we focus on questions concerning the potential part of these Information Systems (IS) and ethical issues they should consider [2]. The handling and use of medical information that IS we can find in constant balance between confidentiality (heart of medicine discipline) and transparency (heart of the public sphere) [3]. Given these facts, how should we think about the implementation of coherent information system and what ethical dimensions have to comply?
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