摘要

All technologists and vendors involved in health information technology (HIT) have an ethical responsibility to design and build software applications and architecture that ensure patients' health information is accurate and protected and to use decision support to promote delivery of high-value care to the patient. This goal is difficult to achieve for many reasons, but it is possible for those who know how to proceed. As a whole, ethical principles indicate that HIT should focus on increasing value to patients (a) by protecting their privacy and making them the owners of their protected health information (PHI); (b) by educating patients and giving them an informed say in healthcare decisions; and (c) by enabling providers to collaborate, share PHI securely, gain useful information that supports their decisions; and (d) by promoting standards-based interoperability with other third-party systems to promote ease-of-access and to facilitate the sharing of information across multiple providers. Herein, we describe ethical criteria for judging HIT systems, and we show that ignoring ethical principles results in HIT systems that fail to increase value to the patient. We discuss how ethical HIT deployment is the only way to transform healthcare for the better, and we describe the components of an ethical HIT system that supports an ethical value chain focused on patient privacy and control, as well as improving care efficiency, effectiveness, affordability, and safety.