Accountability, the use of advanced medical images and the design of hospital picture archive systems

Research of the medical imaging group of Professor Reiber at LUMC (a Dutch hospital) specializes in the development of software which automatically segments, measures, and classifies medical images. With the help of these applications researchers and clinicians can conduct quantitative analyses of medical images.

The technology has not yet been fully integrated in clinical practice and is mainly used in scientific research. That situation is likely to change in the future. The imaging techniques and applications are invaluable tools in helping surgeons to plan surgery, conduct surgery, and to choose from a panoply of available tools, materials and prosthetic artefacts, such as stents for insertion in arteries. Also from the point of view of controlling cost in health care, quality control and accountability, these systems are valuable tools.

Designing, developing and implementing a health care work station which makes this type of new knowledge available to users in a variety of health care contexts requires among other things an ethically sound information architecture. An ethically sound information architecture is based upon a normative characterization of the Hospital Information Environment in which the envisaged system will be used. In order to provide such a normative characterization the following questions should be answered: who should have access to enhanced medical images and their quantitative interpretations, why, where and when, on which conditions, and with which responsibilities?

The required normative characterization implies the articulation of a) the needs to know, b) required know-how, c) the responsibilities, d) accountabilities and e) liabilities of all users involved. The research-project has two deliverables: (i) a proposal for an ethically sound information architecture, and (ii) a methodological characterisation of how in general ethically sound information architectures should be developed.

More information: