1-3 an introduction to current clinical informatics issues

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Section One: An Introduction to Clinical Informatics

Module 1-3 Challenges

Ethics Current Ethical Issues





Challenges in Clinical Informatics

•  Access to clean data •  Demand for skilled workers •  Sheer amount & availability of data •  Complex, time sensitive workflows •  De-personalization of physician-patient

interaction •  Lack of knowledge on “how” systems work •  Gap between EBM & Implementation of EBM





Challenges in Clinical Informatics

•  Interoperability •  Usability •  Patient Engagement •  Ubiquitous care





Professional Ethical Conduct

•  DO facilitate legal right to PHI •  DO safeguard PHI •  DO act respectfully, courteously, timely, and

professionally •  DO speak up about potential system issues •  DO lead by example •  DO follow ethicolegal mandates •  DO move clinical informatics forward •  DO encourage growth of clinical informatics





Professional Ethical Conduct

•  DON’T inappropriately disclose PHI •  DON’T mislead patients •  DON’T be afraid to speak up if your

employer’s actions, policies, or procedures violate ethical or legal obligations





Conflicts of Interest

If you make decisions or conduct affairs on behalf of a professional group – you may be

required to disclose potential conflicts of interest that affect your ability to make

unbiased decisions





Consumer Rights

•  FTC’s Fair Information Practice – Provides recommendations for fair and

adequate information privacy •  Notice/awareness •  Choice/consent •  Access/participation •  Integrity/Security •  Enforcement/Redress





Basic Ethical Concepts

Autonomy The freedom from external control or influence






Beneficence/Nonmaleficence Action that is done for the benefit of others An obligation not to inflict intentional harm






Best Interest Standard Determining the best interest of an individual who cannot make decisions for themselves






Fidelity Faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and

support






Justice Just behavior and treatment to all people






Rights An entitlement or claim others are obliged to

respect






Veracity Habitual truthfulness





Ethical Theories

•  Utilitarianism •  Deontology •  Egoism

•  Care Ethics •  Virtue Ethics





Current Bioethical Issues

•  Beginning of life – Family Planning

•  Contraception, Artificial Insemination, IVF, Surrogates

– Abortion •  Natural, Therapeutic, Elective, Fetus Development,

Role of Politics in Abortion

– Perinatal Ethics •  Prenatal Testing, Genetic Testing, Prenatal Surgery






•  Quality of life – Genetic Science

•  Stem Cell Research, Human Genome Project, Home Genetic Testing, Genetic Discrimination, Gene Therapy

– Organ Transplants •  Supply/Demand, Organ Donation Awareness, Competition

for Organs, Artificial Organ Creation – Communicable Diseases

•  Needle Exchange Programs, Condom Distribution, Anonymous/Confidential/Mandatory/Voluntary Testing, Stigmatization and Discrimination, Mandatory Disclosure






•  Death and Dying – End of Life Planning

•  Advance Directives, Living Wills, Power of Attorney for Healthcare

– Withdrawing & Withholding Care •  Right to Die, Vulnerable Patients, Disagreement on

Treatment for Incapacitated Patients – Euthanasia

•  Passive Euthanasia (DNR/no-code), Active Euthanasia (Rxs, supplying, or administering a means resulting in death)





Review Questions

1.  Failing to notify an employer of a possible PHI breach would violate the code of professional ethical conduct

1.  True 2.  False





Review Questions 1.  Failing to notify an employer of a possible PHI breach

would violate the code of professional ethical conduct 1.  True 2.  False

The AMIA code of professional and ethical conduct says that professionals should act in accordance with ethicolegal

mandates and patient rights when employer actions, policies, or procedures would violate legal or ethical obligations or

agreements made with patients.

Failing to report a breach would violate HIPAA’s breach notification rule….but more on that later.





Review Questions

1.  Veracity is best described as: 1.  Habitual Truthfulness 2.  Faithfulness to a person, cause, or belief,

demonstrated by continuing loyalty and support

3.  An entitlement or claim others are obliged to respect

4.  The study of the nature of duty and obligation





Review Questions

1.  Veracity is best described as: 1.  Habitual Truthfulness 2.  Faithfulness to a person, cause, or belief,

demonstrated by continuing loyalty and support (fidelity)

3.  An entitlement or claim others are obliged to respect (rights)

4.  The study of the nature of duty and obligation (deontology)

1-3 an introduction to current clinical informatics issues

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