Appendix 4: Questionnaire 2: Designed to Study the Realization and Characteristics of the IS Tool, to be used by the Designer of the IS and to the “Internal” Users – Medical Information Systems Ethics

Appendix 4
Questionnaire 2: Designed to Study the Realization and Characteristics of the IS Tool, to be used by the Designer of the IS and to the “Internal” Users

Table A4.1. Questionnaire 2, designed to study the realization and characteristics of the IS tool, to be used by the designer of the IS and the “internal” users

Tick the box that corresponds to your answer
Regarding the information systems used by your structureYES, absolutelyYES, partlyNO, not reallyNO, not at all
1-1. Are good professional practice protocols integrated into the establishment’s computer system?
1-2. Has the number of medical errors decreased since the installation of your IS?
2-1. Does your IS help to improve the qualitative performance of your patient care?
2-2. Since the implementation of your IS, have you noticed an improvement in the means of internal quality management of the medical information given to the patient?
3-1. Have you often received compliments from your patients or from patients’ associations about the quality of your IS?
3-2. After quality of care, are cost management and productivity among the primary objectives of your IS?
4-1. Does your IS have a sharing platform where the patient can access medical information relevant to him or her?
4-2. Is the sharing and pooling of medical information with the patient on the primary objectives of your IS?
5-1. Have you surveyed your patients regarding their satisfaction with the quality and choice of the information disseminated?
5-2. Does your IS have a monitoring device to check that the information it is transmitting is not erroneous or deteriorated by usage?
6-1. Does your IS enable the patient to be kept informed (within a relatively short period) of medical results pertaining to him or her, via the doctor?
6-2. Does your IS facilitate exchanges and communication between the doctors and the other providers of healthcare services?
7-1. Within your healthcare structure, is medical information easily transferrable from one department to another via your internal connection or network?
7-2. Does your computer system show good transversality between the different healthcare activities?
8-1. Have you enacted structural changes or new actions within your organization after analyzing data collected by the IS?
8-2. Does your IS have a monitoring device to alert the manager when a situation or activity is abnormal?
9-1. Have you applied a piloting policy for your establishment on the basis of your existing IS?
9-2. Does your IS have a significant impact on the “decisional” departments for the management of your establishment?
10-1. Does your IS feed back to the State and the Ministry the information necessary to determine the political objectives, the strategy to be implemented in order to cater for the expectations of all actors involved in the healthcare chain?
10-2. Does your IS transmit medical information to the State or its subsidiaries so that they can plan any changes to the national healthcare system?
11-1. Does your IS establish legitimacy of the patients’ right to information?
11-2. Does your IS establish legitimacy of the information processing for the patient?
12-1. Have you clearly identified all the issues and risks linked to data security via your IS (deterioration, loss, theft, identity fraud, etc.)?
12-2. Have you properly applied all methods and tools to secure data exchanges, such as identification, authentication, encryption, electronic signatures, certification, technical specifications for the computer system and the backup systems?
13-1. Has your IS helped you to gain time in your contacts or exchanges with a healthcare actor outside your establishment?
13-2. Since the installation of your IS, have you had more regular contacts with other healthcare actors day to day?
14-1. Has your computer system enabled the healthcare professionals to have more frequent and regular contact with patients?
14-2. Do you believe your IS has helped improve the availability of the healthcare actors in your structure?
15-1. Does your IS help correct the social imbalances in terms of accessibility to medical information for your patients?
15-2. Does your IS have specific regulations concerning the nature of professional status among your staff and the possibility of access to a certain piece of medical information?
16-1. Does your IS have specific regulations as to the way in which medical information is distributed?
16-2. Have you received comments from healthcare users regarding unfairness in the acquisition of medical information?
17-1. Have you adjusted the workload of the healthcare staff, on the basis of their user profiles on the IS?
17-2. Have you drawn up a breakdown of the advantages and disadvantages of using the IS in terms of their daily workload?
18-1. Does your IS transmit the same information to all the healthcare professionals involved in the patient’s healthcare circuit within your structure?
18-2. Does your IS represent the same decision-support tool for all the healthcare professionals involved in the patient’s healthcare circuit within your structure?
19-1. Is the information output by your IS clearly understood by your patients?
19-2. Do your patients complain about the inaccuracy of the information divulged by your IS?
20-1. Are the medical data that feed into your IS used for statistical studies?
20-2. Have the medical data that feed into your IS been used for epidemiological studies?
21-1. Do you believe that your IS gives the healthcare user more responsibility toward the collective?
21-2. Is increasing the patients’ own responsibility by offering them greater independence in the making of the medical decision one of the aims of your IS?
22-1. Does your IS support the strategic objectives defined in the overall ambition of your structure?
22-2. Has your IS contributed to the development of actions involving all the staff at your structure?
23-1. Have you been the subject of a lawsuit brought by a healthcare user because of erroneous medical information given to him or her?
23-2. Has your IS helped you to avoid or reduce harm done to your patients because of improper distribution of the medical information?
24-1. Since your IS has been operating, have your patients had more of an influence on the medical decisions that affect them?
24-2. Does your IS provide patients with fuller and more reactive information?
25-1. Are your patients aware of the nature of the use that is made of their medical data?
25-2. Do your patients know the form in which their medical data will be constructed, distributed and stored?
26-1. Does your IS have settings to anonymize patients for which the medical information is associated?
26-2. Does your IS handle information relating to your patients’ private life that you deem indispensable in order for that system to work?
27-1. Is your IS fully compliant with the law on “ICT and Freedom”?
27-2. Does your IS respect your patients’ right to prior information?
28-1. Does your IS have a system to check the quality of the stored medical data?
28-2. Does your IS have a maintenance system that keeps it operational 24/7?
29-1. Is your IS subject to individual usage?
29-2. Is your IS subject to collective usage?
30-1. Does your healthcare establishment clearly explain to the patients the rules concerning access to data pertaining to their health (see France’s law of August 4, 2002; patient information; direct access to the medical file; shared medical information)?
30-2. Does your IS help reduce the informational imbalance between the doctor and the patient?
31-1. Does your IS obey all the regulations in force (DICOM and HL7) regarding medical data?
31-2. Does your IS have the ability to evolve on the basis of the adjustments imposed by the legislation in force?
32-1. Does your IS obey the rules concerning storage and hosting as enacted by the CNIL?
32-2. Does your IS obey the rules concerning the distribution of medical information as enacted by the CNIL?
33-1. Does your IS contribute to the advancement of organizational efficiency in the use of the medical information?
33-2. Have you adapted the organization of your structure to improve the use of the medical information?
34-1. Has your establishment agreed to devote a financial and/or human effort in the evolution of the IS?
34-2. Does your IS have good flexibility of implementation within your structure?
35-1. Has your organization undertaken the writing of guidelines for the use of the IS?
35-2. When your IS was installed, was there a real policy of monitoring the change in order to adapt your establishment to the new modes of information management?
36-1. Does your IS have good computer integration and functional interoperability?
36-2. Does an IS enhance cooperation with the other applications and computerized devices used in the different departments?
37-1. Have you received requests for training from your staff to better grasp and understand the tool?
37-2. Within your structure, have you noticed mistakes in the way your staff use the IS?
38-1. Are the resources used appropriate for the desired objectives for your IS?
38-2. Have you carried out a retrospective study regarding the evolution of the resources mobilized in relation to the objectives initially envisaged?
39-1. Does your establishment have an analysis of the issues and ranked risks for the IS?
39-2. Has your establishment developed a policy of prevention and precaution regarding the possible consequences of the operation of your IS?
40-1. Are the main objectives of your IS primarily oriented toward the patient’s interest?
40-2. Is the computer system consistent in its construction and technical assembly?