Analysing Ethical Issues of a Patient Information Systems Using the PAPA Model

Analysing Ethical Issues of a Patient Information Systems Using the PAPA Model

Sam Goundar (The University of the South Pacific, Fiji), Alvish Pillai (The University of the South Pacific, Fiji) and Akashdeep Bhardwaj (University of Petroleum and Energy Studies, India)
DOI: 10.4018/978-1-7998-2367-4.ch006


Healthcare is a vital portion of today's medical environment, and it is necessary for medical providers to do their work in an efficient and effective manner. Everyday, hundreds of thousands of patients visit medical amenities stimulating the administration to run smoothly. Almost all hospitals and the health centers in Fiji are now heavily dependent on a patient information system (PATISplus) that helps the employees to manage all the medical and administrative information. In this chapter, the authors analyse the ethical issues of a patient information systems (PATIS) using the PAPA model. This is in terms of privacy, accessibility, accuracy, and property. This chapter reviews current policies within the Ministry of Health and Medical Services in Fiji and also if there is a need of development of standard operating procedures in view of the PAPA model.
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Hospital information system (HIS) is an element of health informatics that provide a common source of information about a patient’s health history. These systems enhance the ability of health care professionals to coordinate care by providing a patient health information and visit history at the place and time that it is needed.

The need to strengthen Fiji’s health information system (HIS) has been an ongoing issue for many years as highlighted in several assessment reports [FHSIP/HIMMA 1999; 2005;]. HIS at MoHMS had been receiving support from their partners such as AusAid and JICA during last decade and the data was collected from the sources due to lots of previous work. However policies were developed and information usage got less attention.

Health information system in Fiji is multipart and consolidated with wide data collection. Although the system was able to grab and gather information, it is limited to analysis, corroboration and comment on processes that would convert data into useful decision making information. Fiji’s health information through PATISPlus flow at the moment supports information requirements of upper management and is designed to stream data for the annual reporting needs of the Ministry. (Health Information Unit, MoH: 2009).

This research will be conducted at the Colonial War Memorial hospital (CWMH) one of the three largest hospital in the country. It is a referral hospital which also caters for referrals from the pacific neighboring countries. The research will focus on finding out the linkage, if any between the currently used CWMH PATIS system and the PAPA model introduced by Mason which is the four most crucial ethical issues of the information era on 1986 which is Privacy, Accuracy, Property and Accessibility abbreviated to PAPA.

This research will find out if there are any ethical issues in the current patient information systems using the PAPA model. This is to be undertaken to find out if the four concepts of PAPA model (Privacy, Accessibility, Accuracy and Property) are being considered in view of how patient information is collected, analyzed, managed, disseminated and used at the CWMH. In doing this, the study will also attempt to see if there are existing policies and procedures available to guide the use of PATIS ethically within CWMH and if so, what are the gaps and areas of improvement needed to strengthen the system.

The paper is important as results of the study will highlight the strengths and weaknesses of the current PATIS system at CWMH and furthermore, it will inform decision makers of relevant areas of improvement in terms of policies and procedures and also inform or raise awareness to the owners of the information (the patients) on important aspects to consider and be mindful of in terms of their health information, in as far as how they can access it or how it is used by the secondary users.

Now days anyone can access information from phones, desktops, internet etc. while previously the public gets to know things when published in the papers or announced in the radios. But in today’s era with the different forums of social medial these information is no longer confidential. Thus it is important that at operational level people are aware of what they are doing and also on the other hand raise awareness to the patients on their rights in terms of information and also in terms of what they can do when they think their rights have been violated when it comes to usage of their personal health information or medical records.

This research will be using quantitative method whereby interviews will be taken by devising a set of questionnaires based on the PAPA model. A desktop review will also be undertaken to see what is there in place taking into account the use of PAPA model. The contribution will be giving guidance to the internal uses and also the patients on ways of improvement once the gaps have been identified.

PATIS user access is provided by the Ministry’s Information Technology department with access restricted to users for their domains. PATIS reports is used to improve reporting systems on services such as number of patients and to quantify medicine usage. Additionally, privacy is ensured through user passwords and usernames and selective access is provided to senior managers for editing of information on PATIS.

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