Project

Decision support systems are contributing significantly to the digital transformation of healthcare. However, they raise important normative challenges in terms of responsibility, privacy, security and autonomy, as well as social challenges with regard to human-machine interaction, workflows, professional self-image and the doctor-patient relationship. These ethical and social implications of their use have not yet been sufficiently investigated.

The aim of this joint project was to explore ethical, social, professional and technical key aspects of digital decision support in healthcare by combining empirical and theoretical approaches, using three exemplary case studies – nephrology, surgery and nursing. In the initial phase of the project, the problems arising at the technical and procedural level were recorded for the three case studies. On this basis, an empirical and theoretical investigation of social, normative-ethical and professional aspects from the perspective of patients, health care professionals and the group of IT designers and providers was carried out. In addition, effects at the health system level were identified and analyzed. Various stakeholder groups were actively involved in the project and their perspectives and expertise were systematically taken into account.

• Fraunhofer ISI applied empirical methods (focus groups, interviews) to investigate the social impacts of IT-based decision support systems from the perspective of patients and relatives. Additionally, expected effects at the level of the German healthcare  system were captured.
• Hannover Medical School was responsible for conducting a qualitative interview study with future nurses and doctors and for aspects of participation (including conference organisation) and dissemination (including publications) of the project results.
• The Protestant University of Applied Sciences Rhineland-Westphalia-Lippe examined the normative-ethical aspects of responsibility. The methods used include literature research, analytical reconstruction of terms, analysis of the relata assignments in the case studies, and norm-background-related case study evaluation.
• The Institute for Medical Informatics at RWTH Aachen University applied an interdisciplinary set of methods to examine the use cases of nephrology, surgery and nursing with regard to the effects of digital artefacts and decision-support applications on the socio-technical system.

• Bratan, T., Schneider, D., Funer, F., Heyen, N., Klausen, A., Liedtke, W., Lipprandt, M., Salloch, S., Langanke, M. (2024). Unterstützung ärztlicher und pflegerischer Tätigkeit durch KI: Handlungsempfehlungen für eine verantwortbare Gestaltung und Nutzung. In: Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 67: 1039-1046. https://doi.org/10.1007/s00103-024-03918-1
• Funer, F.*, Schneider, D.*, Heyen, N.B., Aichinger, H., Klausen, A., Tinnemeyer, S., Salloch, S., Bratan, T. (2024). Impacts of Clinical Decision Support Systems on the Relationship, Communication and Shared Decision-Making Between Health Care Professionals and Patients. Multistakeholder Interview study. In: JMIR – Journal of Medical Internet Research 26: e55717. https://doi.org/10.2196/55717
• Funer, F., Liedtke, W., Klausen, A., Tinnemeyer, S., Schneider, D., Zacharias, H.U., Langanke, M., Salloch, S. (2023): Responsibility and Decision-Making Authority in Using Clinical Decision Support Systems: An Empirical-Ethical Exploration of German Prospective Professionals’ Preferences and Concerns. In: Journal of Medical Ethics. https://doi.org/10.1136/jme-2022-108814
• Heyen, N.B. & Salloch, S. (2021). The ethics of machine learning-based clinical decision support: an analysis through the lens of professionalisation theory. In: BMC Medical Ethics 19;22(1):112. https://doi.org/10.1186/s12910-021-00679-3

Tanja Bratan (Projektleitung)

Nils Heyen

Diana Schneider

Heike Aichinger (no longer at Fraunhofer ISI)

3/2020 – 8/2023

• Bundesministerium für Bildung und Forschung, DLR Projetträger

• Hannover Medical School MHH
• Protestant University of Applied Sciences Rhineland-Westphalia-Lippe
• Institute for Medical Informatics at RWTH Aachen University

DESIREE - Decision Support in Routine and Emergency Health Care