Skip to main content
SpringerLink
Log in

When Cutting Edge Technology Meets Clinical Practice: Ethical Dimensions of e-Health

  • Chapter
  • First Online:
Book cover Emerging Pervasive Information and Communication Technologies (PICT)

Part of the book series: Law, Governance and Technology Series ((LGTS,volume 11))

Abstract

The purpose of this chapter is to identify problems generated by electronic health (e-Health) and to explore their impact on ethical clinical conduct in order to identify ameliorative strategies. More generally the chapter is an exploration of how to deal with change and reaffirm what is fundamental in health care. Healthcare is primarily a moral enterprise in which action means values. The clinicians’ primary value commitment must always be to the patients’ welfare and best interests. Using a set of indicators as standards of performance for the sociotechnical e-Health system, including pervasive information and computing technology (PICT), the chapter explores the impact of technology performance, vendor and health-related entity management and law and regulation on clinical conduct.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abdelhak, Mervat, Sara Grostick, and Mary Alice Hanken. 2012. Health information: Management of a strategic resource. St. Louis: Elsevier Saunders.

    Google Scholar 

  • AHIMA. 2012a. Avoiding medical identity theft. My PHR. www.myphr.com/Privacy/medical_identity_theft.aspx. Accessed Mar 2012.

  • AHIMA. 2012b. Code of ethics. http://www.ahima.org/about/ethicscode.aspx. Accessed Mar 2012.

  • Allen, C., et al. 2006. Why machine ethics? IEEE Intelligent Systems 21(4): 12–17.

    Article  Google Scholar 

  • American Academy of Audiology. 2012. Update on communications between the American Academy of Audiology (AAA), the Academy of Doctors of Audiology (ADA) and United HealthCare (UHC)/hi HealthInnovations (HI). http://www.audiology.org/advocacy/Pages/Update_Comm_AAA_ADA_UHC_HI.aspx. Accessed 6 Apr 2012.

  • American Telemedicine Association. 2009. Telemedicine standards & guidelines: Policy and guidance for the establishment of telemedicine standards. http://www.americantelemed.org/i4a/pages/index.cfm?pageID=3311. Accessed Mar 2012.

  • Anderson, Michael, and Susan Leigh Anderson. 2007. Machine ethics: Creating an ethical intelligent agent. AI Magazine 28(4): 15–26.

    Google Scholar 

  • Andersora, Michael, Susan Leigh Anderson, and Chris Armera. 2006. MedEthEx: A prototype medical ethics advisor. Boston: American Association for Artificial Intelligence.

    Google Scholar 

  • Archer, N., U. Fevrier-Thomas, C. Lokker, K.A. McKibbon, and S.E. Straus. 2012. Personal health records: A scoping review. Journal of the American Medical Informatics Association 18(4): 515–522. doi:10.1136/amiajnl-2011-000105.

    Article  Google Scholar 

  • Arnrich, B., O. Mayora, J. Bardram, and G. Troster. 2010. Pervasive healthcare: Paving the way for a pervasive, user-centered and preventive healthcare model. Methods of Information in Medicine 49(1): 67–73.

    Google Scholar 

  • Battat, Brenda. 2012. HLAA’s comments on the United Healthcare direct-to-consumer hearing aid program. http://brendabattat.blogspot.com/. Accessed 2 Apr 2012.

  • Beauchamp, Tom L., and James F. Childress. 2009. Principles of biomedical ethics. New York: Oxford University Press.

    Google Scholar 

  • Bergeron, B.P. 2001. The wireless web and patient care. The Journal of Medical Practice Management 17(1): 39–43.

    MathSciNet  Google Scholar 

  • Bergeron, B. 2003. Telemedicine. MedGenMed 5(2): 43. doi:452996 [pii].

    Google Scholar 

  • Bergeron, Bryan P. 2004. Wireless local area network security. The Journal of Medical Practice Management 20(3): 138–142.

    MathSciNet  Google Scholar 

  • Bhaskar, R.K., and G. Somu. 2011. Adoption of Information Technology (IT) in healthcare delivery – experience at a tertiary level hospital. The Internet Journal of Medical Informatics 5(2). www.ispub.com.

  • Birmingham, William. 2008. Towards an understanding of artificial intelligence and its application to ethics. Pittsburgh: American Society for Engineering Education.

    Google Scholar 

  • Brennan, Patricia Flatley, Rupa Valdez, and A. Joy Rivera-Rodriguez. 2011. Consumer health information technology in the home a guide for human factors design considerations. http://www.nap.edu/catalog.php?record_id=13205. Accessed Mar 2012.

  • Centers for Medicare & Medicaid Services. 2012. HHS proposes HIPAA standard for a unique health plan identifier. http://www.cms.gov. Accessed 9 Apr 2012.

  • Cheng, Michael. 2003. Medical device regulations: Global overview and guiding principles. Geneva: World Health Organization.

    Google Scholar 

  • De Moor, Georges, John O’Brien, Doug Fridsma, Carol Bean, Jos Devlies, Caitlin M. Cusack, Meryl Bloomrosen, Nancy Lorenzi, and Pascal Coorevits. 2011. Policy brief on the current status of certification of electronic health records in the US and Europe. In Transatlantic cooperation surrounding health related information and communication technology, Studies in health technology and informatics 170, ed. Georges J.E. de Moor, 83–106. Amsterdam: Ios Press.

    Google Scholar 

  • DeLone, W.H., and E.R. McLean. 2003. The DeLone and McLean model of information systems success: A ten-year update. Journal of Management Information Systems 19(4): 9–30.

    Google Scholar 

  • Duquenoy, Penny, George Carlisle, and Kimppa Kai. 2008. Ethical, legal, and social issues in medical informatics. Hershey: Medical Information Science Reference.

    Book  Google Scholar 

  • ECRI Institute. 2012. Worst medical technology dangers for 2012. http://www.ecri.org. Accessed Mar 2012.

  • ECRI Institute. 2012b. Worst medical technology dangers for 2012. http://www.medscape.com/features/slideshow/tech-dangers?src=mp&spon=3812. Accessed.

  • EHR: Experience from the Field. 2011. EHR & EMR insights industry updates. http://ehrinsights.srssoft.com/2011/06/ehr-experience-from-the-field/. Accessed Mar 2012.

  • European Commission. 2012. The right prescription for Europe’s ehealth. http://www.europa.eu. Accessed Mar 2012.

  • Falas, T., G. Papadopoulos, and A. Stafylopatis. 2003. A review of decision support systems in telecare. Journal of Medical Systems 27(4): 347–356.

    Article  Google Scholar 

  • Gearon, Christopher J., and California HealthCare Foundation. 2007. Perspectives on the future of personal health records. San Francisco: California HealthCare Foundation.

    Google Scholar 

  • Goodman, K.W., E.S. Berner, M.A. Dente, B. Kaplan, R. Koppel, D. Rucker, D.Z. Sands, and P. Winkelstein. 2010. 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 Association 18(1): 77–81.

    Article  Google Scholar 

  • Haghenbeck, K.T. 2005. Critical care nurses’ experiences when technology malfunctions. The Journal of the New York State Nurses' Association 36(1): 13–19.

    Google Scholar 

  • Harman, Laurinda B. 2006. Ethical challenges in the management of health information. Sudbury: Jones and Bartlett Publishers.

    Google Scholar 

  • Harrison, M.I., R. Koppel, and S. Bar-Lev. 2007. Unintended consequences of information technologies in health care–an interactive sociotechnical analysis. Journal of the American Medical Informatics Association 14(5): 542–549. doi:10.1197/jamia.M2384.

    Article  Google Scholar 

  • Haux, Reinhold. 2006. Individualization, globalization and health – About sustainable information technologies and the aim of medical informatics. International Journal of Medical Informatics 75(12): 795–808.

    Article  Google Scholar 

  • Health IT Policy Committee. 2009. “Meaningful use: A definition” recommendations from the meaningful use workgroup to the health IT policy committee June 16, 2009. Washington, DC: Department of Health and Human Services.

    Google Scholar 

  • Honarvar, Ali Reza, and Nasser Ghasem-Aghaee. 2009. An artificial neural network approach for creating an ethical artificial agent. Daejeon: Institute of Electrical and Electronics Engineers Inc.

    Google Scholar 

  • Hosmer, Larue Tone. 1995. Trust: The connecting link between organizational theory and philosophical ethics. Academy of Management Review 20: 379+.

    MathSciNet  Google Scholar 

  • Hsieh, T.C., G.J. Kuperman, T. Jaggi, P. Hojnowski-Diaz, J. Fiskio, D.H. Williams, D.W. Bates, and T.K. Gandhi. 2004. Characteristics and consequences of drug allergy alert overrides in a computerized physician order entry system. Journal of the American Medical Informatics Association 11(6): 482–491. doi:10.1197/jamia.M1556.

    Article  Google Scholar 

  • Institute of Medicine (U.S.) Committee on Planning a Continuing Health Care Professional Education Institute. 2010. Redesigning continuing education in the health professions. Washington, DC: National Academies Press.

    Google Scholar 

  • Institute of Medicine (U.S.). Committee on Patient Safety and Health Information Technology. 2012. Health IT and patient safety: Building safer systems for better care. Washington, DC: National Academies Press.

    Google Scholar 

  • Institute of Medicine (U.S.). Committee on the Public Health Effectiveness of the FDA 510(k) Clearance Process. 2011. Medical devices and the public’s health the FDA 510(k) clearance process at 35 years. vol 2011. Washington, DC: National Academies Press (Orig. Pub.).

    Google Scholar 

  • Iserson, K.V. 2000. Telemedicine: A proposal for an ethical code. Cambridge Quarterly of Healthcare Ethics 9(3): 404–406.

    Google Scholar 

  • Jasanoff, Sheila. 1995. Handbook of science and technology studies. Thousand Oaks: Sage Publications.

    Google Scholar 

  • John and Mary R. Markle Foundation., Robert Wood Johnson Foundation., & Connecting for Health (Organization). 2004. Connecting Americans to their healthcare: final report, working group on policies for electronic information sharing between doctors and patients. New York, MY.: Markle Foundation: Robert Wood Johnson Foundation.

    Google Scholar 

  • Johnson, S.B., and R.A. Friedman. 2007. Bridging the gap between biological and clinical informatics in a graduate training program. Journal of Biomedical Informatics 40(1): 59–66.

    Article  Google Scholar 

  • Johnson, Deborah G., and Keith Miller. 2009. Computer ethics: Analyzing information technology. Upper Saddle River: Prentice Hall.

    Google Scholar 

  • Karulf, Eric. 2008. Body area networks (BAN). St. Louis: Washington University.

    Google Scholar 

  • Kluge, E.H. 2007. The need for global certification in the field of health informatics: Some ethical issues. Medinfo. MEDINFO 12(Pt 1): 233–236.

    Google Scholar 

  • Kluge, E.H. 2011. Ethical and legal challenges for health telematics in a global world: Telehealth and the technological imperative. International Journal of Medical Informatics 80(2): e1–e5.

    Article  Google Scholar 

  • Koppel, Ross, and David Kreda. 2009. Health care information technology vendors’ “hold harmless” clause: Implications for patients and clinicians. The Journal of the American Medical Association 301(12): 1276–1278.

    Article  Google Scholar 

  • Kraemer, F., K. van Overveld, and M. Peterson. 2011. Is there an ethics algorithm? Ethics and Information Technology 13(3):251–260. doi:10.1007/s10676-010-9233-7.

  • Landro, Laura. 2008. For patients, a list of hospital hazards. Wall Street Journal – Eastern Edition 252(148): D2.

    Google Scholar 

  • Layman, E. 2003. Health informatics: Ethical issues. The Health Care Manager 22(1): 2–15.

    Google Scholar 

  • Lee, Sharon. 2010. Contemporary issues of ethical e-therapy. Journal of Ethics in Mental Health 5(1). http://www.jemh.ca/issues/v5n1/documents/JEMH_Vol5_No1_Contemporary_Issues_of_Ethical_E-Therapy.pdf.

  • Leviss, J. 2010. H.I.T. or miss lessons learned from health information technology implementations. Bethesda: American health Information Management Association Press.

    Google Scholar 

  • Manders-Huits, N. 2011. What values in design? The challenge of incorporating moral values into design. Science and Engineering Ethics 17(2): 271–287. doi:10.1007/s11948-010-9198-2.

    Article  Google Scholar 

  • mHealth Regulatory Coalition. n.d. http://mhealthregulatorycoalition.org/. Accessed Mar 2012.

  • Michalowski, W., R. Slowinski, S. Wilk, K.J. Farion, J. Pike, and S. Rubin. 2005. Design and development of a mobile system for supporting emergency triage. Methods of Information in Medicine 44(1): 14–24.

    Google Scholar 

  • Miller, R.H. 2012. Satisfying patient-consumer principles for health information exchange: Evidence from California case studies. Health Affairs (Millwood) 31(3): 537–547. doi:10.1377/hlthaff.2011.0531.

    Article  Google Scholar 

  • Nickel, P.J. 2011. Ethics in e-trust and e-trustworthiness: The case of direct computer-patient interfaces. Ethics and Information Technology 13(4): 355–363.

    Article  MathSciNet  Google Scholar 

  • Oregon Health & Science University. 2011. CPOE.org computerized physician/provider order entry. http://www.cpoe.org/. Accessed Feb 2012.

  • Pearson, Dave. 2011. Beware the ghost in the machine: Software-related recalls on the rise. Healthcare Technology Management 1(6). http://www.healthcaretechnology.com/index.php?option=com_articles&view=article&id=30568:beware-the-ghost-in-the-machine-software-related-recalls-on-the-rise.

  • Kelly, D. 2012. Pittsburgh Post-Gazette. Tech distractions a worry for hospitals. 5 Apr 2012.

    Google Scholar 

  • Poon, E.G., A.K. Jha, M. Christino, M.M. Honour, R. Fernandopulle, B. Middleton, J. Newhouse, et al. 2006. Assessing the level of healthcare information technology adoption in the United States: A snapshot. BMC Medical Informatics and Decision Making 6: 1.

    Article  Google Scholar 

  • Rybynok, V.O., P.A. Kyriacou, J. Binnersley, and A. Woodcock. 2010. Development of a personal electronic health record card in the United Kingdom. Conference Proceedings – IEEE Engineering in Medicine and Biology Society 2010: 4431–4435. doi:10.1109/IEMBS.2010.5626004.

    Google Scholar 

  • Schopp, L.H., J.W. Hales, G.D. Brown, and J.L. Quetsch. 2003. A rationale and training agenda for rehabilitation informatics: Roadmap for an emerging discipline. NeuroRehabilitation 18(2): 159–170.

    Google Scholar 

  • SearchHealthIT.com. 2010. How the HITECH act changes HIPAA compliance. http://searchhealthit.techtarget.com/tip/How-the-HITECH-Act-changes-HIPAA-compliance. Accessed June 2012.

  • Seelman, Katherine D. 2013. Health information management and rehabilitation: moving toward an adequate ethical framework for telerehabilitation. In Telerehabilitation, ed. Sajeesh Kumar and Ellen R. Cohn. London: Springer.

    Google Scholar 

  • Sidorov, Jan, and Disease Management Care Blog. 2011. More on the impact of health information technology on medical practice: Errors of omission. Disease management care blog. http://diseasemanagementcareblog.blogspot.com/2011/07/more-on-impact-of-health-information.html. Accessed 11 Feb 2012.

  • Simborg, D.W. 2009. The limits of free speech: The PHR problem. Journal of the American Medical Informatics Association 16(3): 282–283. doi:10.1197/jamia.M3069.

    Article  Google Scholar 

  • Simpson, Jenifer. 2010a. CMS on ‘Meaningful use’ in regard to electronic health records, ed. Centers for Medicare & Medicaid Services. Washington, DC: American Association of People with Disabilities.

    Google Scholar 

  • Simpson, Jenifer. 2010b. To HHS on certification criteria for health record technology, ed. Office of the National Coordinator for Health Information Technology. Washington, DC: American Association of People with Disabilities.

    Google Scholar 

  • Singer, Peter. 1991. A companion to ethics. Blackwell companions to philosophy. Oxford/ Cambridge, MA: Blackwell Reference.

    Google Scholar 

  • Sittig, D.F., and H. Singh. 2011. Defining health information technology-related errors: New developments since to err is human. Archives of Internal Medicine 171(14): 1281–1284.

    Article  Google Scholar 

  • Snyder, L. 2012. American college of physicians ethics manual: Sixth edition. Annals of Internal Medicine 156(1 Pt 2): 73–104. doi:156/1_Part_2/73 [pii] 10.1059/0003-4819-156-1-201201031-00001.

    Article  Google Scholar 

  • Stahl, Bernd Carsten. 2004. Information, ethics, and computers: The problem of autonomous moral agents. Minds and Machines 14(1): 67–83.

    Article  Google Scholar 

  • The Joint Commission. 2012. Joint commission topic library. http://www.jointcommission.org/topics/default.aspx?y=2012&ps=25. Accessed Feb 2012.

  • Tonkens, Ryan. 2009. A challenge for machine ethics. Minds and Machines 19(3): 421–438.

    Article  Google Scholar 

  • U.S. Department of Health & Human Services. 2010. Health information technology: Initial set of standards, implementation specifications, and certification criteria for electronic health record technology; Final rule, ed. Office of the Secretary. Washington, DC: U.S. Department of Health & Human Services.

    Google Scholar 

  • U.S. Department of Health & Human Services. 2012. Medicare and medicaid programs; electronic health record initiative program–stage 2, ed. Office of the Secretary. Washington, DC: U.S. Department of Health & Human Services.

    Google Scholar 

  • U.S. Department of Veterans Affairs. 2012. Blue button. http://www.va.gov/bluebutton/. Accessed Mar 2012.

  • U.S. Food and Drug Administration. 2010a. Health Information Technology (H-IT) Safety Issues.

    Google Scholar 

  • U.S. Food and Drug Administration. 2010b. Testimony of Jeffrey Shuren, Director of FDA’s Center for Devices and Radiological Health. In Health Information Technology (HIT) Policy Committee Adoption Certification Workgroup. Washington, DC. http://hcrenewal.blogspot.com/2010_02_01_archive.html.

  • U.S. National Council on Disability, 2009. The current state of health care for people with disabilities. Washington, DC: National Council on Disability.

    Google Scholar 

  • U.S. The Office of National Coordinator Health Information Technology. 2011. PHR model privacy notice. http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__draft_phr_model_notice/1176. Accessed Mar 2012.

  • UnitedHealth Group. 2011. UnitedHealth group business makes major breakthroughs in helping people assess, address hearing loss. http://www.multivu.com/mnr/51966-healthinnovations-unitedhealth-group-launch-suite-low-cost-hearing-devices. Accessed Mar 2012.

  • Vital Wave Consulting. 2009. mHealth for development: The opportunity of mobile technology for healthcare in the developing world. Washington, DC/Berkshire: UN Foundation – Vodafone Foundation Partnership.

    Google Scholar 

  • Wagner, P.J., S.M. Howard, D.R. Bentley, Y.H. Seol, and P. Sodomka. 2010. Incorporating patient perspectives into the personal health record: Implications for care and caring. Perspectives in Health Information Management 7: 1e.

    Google Scholar 

  • Waser, Mark R. 2009. A safe ethical system for intelligent machines. Arlington: American Association for Artificial Intelligence.

    Google Scholar 

  • Watson, Marcia L. 2005. Can there be just one trust? A cross-disciplinary identification of trust definitions and measurement. Coral Gables: University of Miami.

    Google Scholar 

  • Zhang, Joy Y., Claire Marris, and Nikolas Rose. 2011. The transnational governnance of synthetic biology: Scientific uncertainty, cross-borderness and the “art” of governance. In BIOS working paper. London: London School of Economics and Political Science.

    Google Scholar 

  • Zoubul, Carrie S. 2009. Healthcare institutional ethics: Broader than clinical ethics. In Health care ethics, ed. Eileen E. Morrison. Sudbury: Jones & Bartlett Publishers.

    Google Scholar 

Download references

Acknowledgments

Daihua Xie Yu designed Fig. 7.1, e-Health Model.

Dr. Valerie Watzlaf made invaluable contributions by her review of the chapter.

Author information

Authors and Affiliations

  1. School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA

    Katherine D. Seelman Ph.D.

  2. School of Health and Rehabilitation Sciences, Health Sciences Library System (HSLS), University of Pittsburgh, Pittsburgh, PA, USA

    Linda M. Hartman M.L.S

  3. Health & Rehabilitation Informatics Lab, University of Pittsburgh, Pittsburgh, PA, USA

    Daihua X. Yu M.S.

Authors
  1. Katherine D. Seelman Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda M. Hartman M.L.S
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daihua X. Yu M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katherine D. Seelman Ph.D. .

Editor information

Editors and Affiliations

  1. Poynter Center, Indiana University, Bloomington, Indiana, USA

    Kenneth D. Pimple

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media Dordrecht.

About this chapter

Cite this chapter

Seelman, K.D., Hartman, L.M., Yu, D.X. (2014). When Cutting Edge Technology Meets Clinical Practice: Ethical Dimensions of e-Health. In: Pimple, K. (eds) Emerging Pervasive Information and Communication Technologies (PICT). Law, Governance and Technology Series, vol 11. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6833-8_7

Download citation

  • DOI: https://doi.org/10.1007/978-94-007-6833-8_7

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-6832-1

  • Online ISBN: 978-94-007-6833-8

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation