Communication Support & its Ethics to Improve Patient_Centred Health Care

The health care domain faces many important challenges in coming years. With the introduction and increasing interconnectedness of ICT systems in health care the question arises how to cope with ethical and societal aspects of those systems and the processes they support. Furthermore, accountability of these aspects will become increasingly important. Typically, the focus during the development of complex ICT systems is on technical aspects, costs and functionalities. These systems, however, are built to achieve objectives that often involve conflicts of interest and raise moral issues, especially issues concerning access, privacy, accountability, liability and property. It is therefore essential to take the values of stakeholders and related moral issues explicitly into account at the time of designing the system.

In this research we would like to investigate how we can take into account these values at design time of systems that support the communication in health care. This means that we have to be able to:

  • Make explicit the ethical and societal aspects involved
  • Model them through the use of a formal language
  • How to encompass these interests in a multi-agent system (e.g. within all agents, within certain specific agents, through constraints or mechanisms in inter-agent communication and interaction)
  • How to use “humans in the loop” as a mechanism to enhance the incorporation of values in decision making processes?
  • Develop, implement and test these systems, which raises a last important question:
  • How to evaluate to what extent these ethical and societal aspects have been met / taken into account (measurability and accountability)

There are many aspects that one can think of: ethics, security, privacy, patient centered health care, efficiency, effectiveness, etc. To give an example: efficiency of health care processes is currently only known as a measure on the level of the health care provider. How many waiting hours there are for patients is not in any way taken into account. For society in general, this should of course be taken into account, as we already do with traffic jams. For traffic jams, we can calculate a societal “cost” involved, with as a result a lot of focus on trying to solve the problem of traffic jams. “Patient centered” is another interesting example. Currently, politicians and health care providers talk about patient centered health care. But what does that mean, and how can we say that we are really working in a “patient centered” way? If we cannot define it, politicians will never be able to account for the result of their policies.

The reason that we want to investigate how to incorporate humans in the system is that many trade-offs and issues are not that explicit and not easily quantifiable. By using the human actor in a certain role, it might be possible to cope with moral aspects in an accountable way without introducing too much complexity at the multi-agent level. In this project, the preferences, values and interests of the humans in the system will play a crucial role in the technical realisation of a communication support system that is capable of suggesting solutions that respect those preferences and interests where possible, and that clarifies conflicts of interest.

The realization of such software systems will require a dialogue between philosophers, sociologists, engineers and health practitioners. This project will deliver an approach for engineering complex software systems that takes stakeholder values explicitly into account at design time. A proof of concept will be realized within an actual health care context.