Jani Koskinen

Sensemaking in the personal health space

Purpose – Service alignment between health service provider and patient is changing. Instead of placing responsibilities into the hands of a provider, new forms of co-operation are emerging in which patients are regarded as a resource and a partner. In order to see this vision come to life, mechanisms that: first, support patient’s health decision making; and second, integrate matters of health into a wider ensemble that is health space; the overarching state of health-related affairs, are needed. In the following, these kinds of mechanisms are investigated and their applicability is discussed in relation to a national project. The paper aims to discuss these issues. Design/methodology/approach – The work is exploratory and conceptual, focussing more on people than on technology. In the work, findings related to a concept of a health navigator; an artefact of personal health decision support, are assembled into a framework that bases on key sociological theories. The empirical elements focus on observatio...

A Viewpoint for More Ethical Approach in Healthcare Information System Development and Procurement: The Four Principles

Healthcare is a field where the influence of ethics needs to be strong. It should also cover the area of information system development in healthcare. Great amounts or research about ethics, healthcare and information system development and combinations of those can be found. However, the actual development of healthcare information systems has a serious lack of understanding of ethical codes of healthcare and it seems that financial values may bypass ethical ones. Several examples of the consequences to healthcare information systems, in which financial values in conjunction with technological determinism are controlling the decisions, are presented and critiqued.

The concept of Datenherrschaft of patient information from a Lockean perspective

Purpose – The purpose of this paper is to analyse the current status of ownership of patient information from a Lockean perspective and then present Datenherrschaft (German for “mastery over information”) as a new model for patient ownership of patient information. Design/methodology/approach – This paper is theoretical in approach. It is based on arguments derived from Locke’s Two Treatises of Government. Legal examples of the current situation are derived from Finnish, UK and Swedish legislation. Findings – Current legislation concerning patient information is not clearly formulated and so recognising a new right on the part of the patient, Datenherrschaft, would be an ethically justifiable way of remedying the issue. Research limitations/implications – The legal analysis was limited to Finland, the UK and Sweden, and so other legislation should be looked at in future research. Datenherrschaft is used as an example of an ethically justified way of regulating patient information ownership and should be a...

Where is patient in EHR project

In this paper, we do a literature review on electronic health records (EHR) and patient involvement. It seems that patients are not included as much as one would presume. After our analysis of both literature and ethical nature, we suggest that research on why this is so and whether they should be included needs to be done.

PHR, We’ve Had a Problem Here

Personal health records (PHRs) have been a global trend in recent decade. It has been seen as a concept and tool that could help patients maintaining health, improving their well-being, and supporting communication with healthcare professional etc. Despite the great amount of research about PHR there is no consensus what a PHR actually means in academic literature or other arenas. There are multiple terms in use and multiple definitions which set challenges for rational discourse between citizens/patient, healthcare providers, system developers and policy makers. Especially, when citizens—as key stakeholder—should also be able to understand what those systems are we need clear and understandable definition for PHR’s. In the paper, we conduct a brief survey for different definitions and show the problems that arise with the incoherent use of the term “PHR”.

Need for eHealth Ethics

The healthcare is an area where ethics has justifiably gained a central position, and this fact has acted as a safeguard for people and society. However, the increasing use of information technology has brought forth new kind of situations that the traditional medical ethics approach has not faced before. There is need for a new approach of eHealth ethics that covers the needs for modern healthcare to ensure that the ethicality will be ensured today and future likewise. We argue that a fruitful approach for this is the synthesis of traditional medical ethics and IS-ethics. In this article we look the four principles of medical ethics together with IS-ethics approaches by Moor and Brey to see what kind of values should be protected and what are the needs for justified use of information technology in healthcare.

An Unclear Question: Who Owns Patient Information?

Patient information systems are critical instruments in modern healthcare; thus, modern healthcare systems cannot function properly without them. While there are countless varieties of information systems used in healthcare, there is one overarching commonality among them – they all contain information about patients. Different groups involved in healthcare have an interest in patients’ information for different reasons. However, in many countries, it remains unclear who exactly owns the data. This issue thus needs to be resolved. As ethics is critical in determining the justifiable owner of patient information, any legislative solution to competing interests ought to be ethically well justified. In this paper, we argue that an ethically acceptable formulation of the ownership of patient data has already been suggested and that it can be further justified also through the Kantian tradition.

Problem Limiting the Public Domain -Rawls’s Veil of Ignorance and Time

Information, ideas and new inventions are crucial parts of modern society. Accumulated knowledge is a huge possibility for mankind and information technology has especially made it possible to share resources with all mankind. Nevertheless, the current situation where strong intellectual property rights exists the public domain has been limited and thus the possibilities to use that knowledge is limited especially for people lacking adequate income or property. It seems that the current situation is not well justified because current intellectual property rights are against the two Principles of Justice presented by Rawls. In addition intellectual property rights are a source of inequity towards the people of the future and would not be implemented behind Veil of Ignorance which is the core way to define whether a society is just according to Rawls. This paper shows examples which emphasize the view that new legislation for intellectual property is needed.

Information Technology – The Unredeemed Opportunity to Reduce Cultural and Social Capital Gaps between Citizens and Professionals in Healthcare

Patient empowerment and involvement are significant aims in long-term diseases, but short appointments give only little room for conversations. However, the patients need various information and support from healthcare professionals. So, there are pressures to develop new, effective ways for reciprocal communication in addition to the traditional ones.