Transparency of Health Informatics Processes as the Condition of Healthcare Professionals' and Patients' Trust and Adoption: the Rise of Ethical Requirements

Ethical predicaments and countermeasures in nursing informatics

With the increasing use of technology in nursing, how nurses perform practice care has changed, inevitably leading to ethical concerns that differ from original ethical norms in nursing. Studies have focused on ethical issues in health informatics from clinicians' or patients' perspectives, while nurses' perspective is needed. This paper conducts a theoretical study on ethical predicaments that arise in nursing informatics from nurses' perspectives. Why and how these predicaments emerge are elaborated. Also, this paper offers countermeasures in realistic contexts from technique, education, and leadership aspects. Collaborations between governments, administrators, educators, technicians, and nurses are needed to step out of these predicaments.

A survey of pregnant patients' perspectives on the implementation of artificial intelligence in clinical care

OBJECTIVE

To evaluate and understand pregnant patients' perspectives on the implementation of artificial intelligence (AI) in clinical care with a focus on opportunities to improve healthcare technologies and healthcare delivery.

MATERIALS AND METHODS

We developed an anonymous survey and enrolled patients presenting to the labor and delivery unit at a tertiary care center September 2019-June 2020. We investigated the role and interplay of patient demographic factors, healthcare literacy, understanding of AI, comfort levels with various AI scenarios, and preferences for AI use in clinical care.

RESULTS

Of the 349 parturients, 57.6% were between the ages of 25-34 years, 90.1% reported college or graduate education and 69.2% believed the benefits of AI use in clinical care outweighed the risks. Cluster analysis revealed 2 distinct groups: patients more comfortable with clinical AI use (Pro-AI) and those who preferred physician presence (AI-Cautious). Pro-AI patients had a higher degree of education, were more knowledgeable about AI use in their daily lives and saw AI use as a significant advancement in medicine. AI-Cautious patients reported a lack of human qualities and low trust in the technology as detriments to AI use.

DISCUSSION

Patient trust and the preservation of the human physician-patient relationship are critical in moving forward with AI implementation in healthcare. Pregnant individuals are cautiously optimistic about AI use in their care.

CONCLUSION

Our findings provide insights into the status of AI use in perinatal care and provide a platform for driving patient-centered innovations.

Attitudes of Mental Health Service Users Toward Storage and Use of Electronic Health Records

OBJECTIVE

Electronic health records (EHRs) are used for both clinical practice and research. Because mental health service users' views are underrepresented in perspectives on EHR use, the authors examined service users' awareness, attitudes, and opinions about EHR data storage and sharing.

METHODS

A mixed-methods, cross-sectional design was used to examine attitudes of 253 Norwegian mental health service users who were recruited online to complete a quantitative and qualitative (free-text) survey about EHR utilization.

RESULTS

Most participants were aware that EHRs were stored (95%) and shared (58%). Most thought that patients benefited from EHR storage (84%), trusted authorities with EHR sharing (71%), were willing to share their EHRs to help others (75%), felt they benefited from EHR sharing (75%), and thought EHR sharing was ethical for health care and research (71%). Fewer were aware of EHR sharing for research (36%), and 62% were aware that shared data were anonymized. Of the participants, 69% recognized privacy risks associated with sharing. Lack of transparency and skepticism about anonymization and misuse of EHR data were concerns and perceived risks. Mental health service users thought that EHRs should be shared for policy development (81%), education and training (85%), improving care quality (89%), research (91%), and clinical decision support (81%).

CONCLUSIONS

Participants were aware of and supported EHR sharing for research and clinical care. They supported sharing to help others and were willing to fully participate in clinical care and research, as well as to share EHR information for their own care, research, and the care of others.

Management of Medico-Legal Risks in Digital Health Era: A Scoping Review

Artificial intelligence needs big data to develop reliable predictions. Therefore, storing and processing health data is essential for the new diagnostic and decisional technologies but, at the same time, represents a risk for privacy protection. This scoping review is aimed at underlying the medico-legal and ethical implications of the main artificial intelligence applications to healthcare, also focusing on the issues of the COVID-19 era. Starting from a summary of the United States (US) and European Union (EU) regulatory frameworks, the current medico-legal and ethical challenges are discussed in general terms before focusing on the specific issues regarding informed consent, medical malpractice/cognitive biases, automation and interconnectedness of medical devices, diagnostic algorithms and telemedicine. We aim at underlying that education of physicians on the management of this (new) kind of clinical risks can enhance compliance with regulations and avoid legal risks for the healthcare professionals and institutions.

Health Data, Information, and Knowledge Sharing for Addressing the COVID-19

OBJECTIVES

To introduce the 2021 International Medical Informatics Association (IMIA) Yearbook by the editors.

METHODS

The editorial provides an introduction and overview to the 2021 IMIA Yearbook whose special topic is "Managing Pandemics with Health Informatics - Successes and Challenges". The Special Topic, the keynote paper, and survey papers are discussed. The IMIA President's statement and the IMIA dialogue with the World Health Organization are introduced. The sections' changes in the Yearbook Editorial Committee are also described.

RESULTS

Health informatics, in the context of a global pandemic, led to the development of ways to collect, standardize, disseminate and reuse data worldwide: public health data but also information from social networks and scientific literature. Fact checking methods were mostly based on artificial intelligence and natural language processing. The pandemic also introduced new challenges for telehealth support in times of critical response. Next generation sequencing in bioinformatics helped in decoding the sequence of the virus and the development of messenger ribonucleic acid (mRNA) vaccines.

CONCLUSIONS

The Corona Virus Disease 2019 (COVID-19) pandemic shows the need for timely, reliable, open, and globally available information to support decision making and efficiently control outbreaks. Applying Findable, Accessible, Interoperable, and Reusable (FAIR) requirements for data is a key success factor while challenging ethical issues have to be considered.