Ethical Applications of Informatics
rESEarCh BrIEF
Using an online survey of 1,227 randomly selected respondents, Bodkin and Miaoulis (2007) sought to describe the characteristics of information seekers on e-health websites, the types of information they seek, and their perceptions of the quality and ethics of the websites. Of the respondents, 74% had sought health in- formation on the Web, with women accounting for 55.8% of the health informa- tion seekers. A total of 50% of the seekers were between 35 and 54 years of age. Nearly two thirds of the users began their searches using a general search engine rather than a health-specific site, unless they were seeking information related to symptoms or diseases. Top reasons for seeking information were related to dis- eases or symptoms of medical conditions, medication information, health news, health insurance, locating a doctor, and Medicare or Medicaid information. The level of education of information seekers was related to the ratings of website quality, in that more educated seekers found health information websites more understandable, but were more likely to perceive bias in the website information. The researchers also found that the ethical codes for e-health websites seem to be increasing consumers’ trust in the safety and quality of information found on the Web, but that most consumers are not comfortable purchasing health products or services online.
The full article appears in Bodkin, C., & Miaoulis, G. (2007). eHealth information quality and ethics issues: An exploratory study of consumer perceptions. International Journal of Pharmaceuti- cal and Healthcare Marketing, 1(1), 27–42. Retrieved from ABI/INFORM Global (Document ID: 1515583081).
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practices are sometimes more harmful than beneficial). A case in point is the long-standing practice of instilling endotracheal tubes with normal saline before suctioning (O’Neal, Grap, Thompson, & Dudley, 2001). Based on the evidence gathered through several studies, the potentially deleterious effects of this practice have become widely recognized. Conceivably, a meta-analysis approach to clinical studies will be expedited by convergence of large clinical data repositories across care settings, thereby making available to practitioners the collective contribu- tions of health professionals and longitudinal outcomes for individuals, families, and populations.
Nurses need to be engaged in the design of CIS tools that support access to and the generation of nursing knowledge. As we have emphasized, the adoption of clini- cal data standards is of particular importance to the future design of CIS tools. We are also beginning to see the development and use of expert systems that implement knowledge automatically without human intervention. For example, an insulin pump that senses the patient’s blood glucose level and administers insulin based on those data is a form of expert system. The expert system differs from decision support tools in that the decision support tools require the human to act on the information pro- vided, whereas the expert system intervenes automatically based on an algorithm that directs the intervention. Consider that as CISs are widely implemented, as standards for nursing documentation and reporting are adopted, and as healthcare IT solutions continue to evolve, the synthesis of findings from a variety of methods and world- views becomes much more feasible.
BOX 6-3 CaSE STuDy: CaSTINg TO ThE FuTurE
In the year 2025, nursing practice enabled by technology has created a profes- sional culture of reflection, critical inquiry, and interprofessional collaboration. Nurses use technology at the point of care in all clinical settings (e.g., primary care, acute care, community, and long-term care) to inform their clinical deci- sions and effect the best possible outcomes for their clients. Information is gath- ered and retrieved via human–technology biometric interfaces including voice, visual, sensory, gustatory, and auditory interfaces, which continuously monitor physiologic parameters for potentially harmful imbalances. Longitudinal records are maintained for all citizens from their initial prenatal assessment to death; all lifelong records are aggregated into the knowledge bases of expert systems. These systems provide the basis of the artificial intelligence being embedded in emerging technologies. Smart technologies and invisible computing are ubiqui- tous in all sectors where care is delivered. Clients and families are empowered to review and contribute actively to their record of health and wellness. Invasive diagnostic techniques are obsolete, nanotechnology therapeutics are the norm, and robotics supplement or replace much of the traditional work of all health professions. Nurses provide expertise to citizens to help them effectively manage their health and wellness life plans, and navigate access to appropriate informa- tion and services.