Background
Evaluating and researching health information systems are interventions of their kind and might lead to ethical complexities and challenges. Most of those challenges are inherited from the more general fields of research and evaluation, health studies, and information systems studies. Beyond those challenges, this field has its particular traits, regarding the involved stakeholders, required values or qualities, or the process which can raise field-specific or context-specific ethical challenges.
Objectives
This paper reports and discusses some of the challenges of evaluating and researching health information systems by taking a systematic approach in finding, postulating, and analyzing them.
Method
Through a scoping review, a set of ethical challenges, regarding the evaluation and research of health information systems, were extracted. From the same set of articles, the acting entities, including stakeholders and artefacts, were identified. From a sample of seven cases of health information systems, a set of demanded impact qualities were extracted. From the literature, the evaluation stages were elicited. The acting entities, required qualities, and the evaluation stages were combined to create a three-dimensional space. The space contained the ethical challenges extracted from the scoping review and helped to postulate more items.
Results
The final list of identified items contains 20 possible ethical challenges that can be caused or raised by evaluating or researching health information systems and technologies. The ethical challenges are discussed, based on their probable stage of occurrence. The three-dimensional space and the method of populating it is proposed as an effective method in similar cases of discovering ethical challenges.
Conclusion
Evaluating or researching health information systems can raise ethical challenges, that we have identified 20 of them in this article. All the challenges were discussed, such as the actual value of evaluation, breach of privacy, risks for safety, problems with usability and accessibility, conflict of interests, problems with the informed consent, and miscommunication. The novel approach for elicitation of the ethical challenges introduced in this article might be applied in other similar studies.