Patient-Centred Health Care

Communication Support and its Ethics to Improve Patient-Centred Health Care

(duration: 08/2009 - 08-2013)

Project summary

In this research project Almende and 3TU investigate how we can take into account ethical values during the design time of systems that support the communication in health care. This means that we have to be able to:

* Make explicit the ethical and societal aspects involved;

* Model them through the use of a formal language.

Questions arise such as:

* how to encompass these interests in a multi-agent system (e.g. within all agents, within certain specific agents, through constraints or mechanisms in inter-agent communication and interaction)

* and how to use 'humans in the loop' as a mechanism to enhance the incorporation of values in decision making processes?

Additionally, we have to be able to develop, implement and test these systems, which raises a last important question:

* How to evaluate to what extent these ethical and societal aspects have been met / taken into account (measurability and accountability)?

There are many aspects that one can think of: ethics, security, privacy, patient centered health care, efficiency, effectiveness, etc. To give an example: efficiency of health care processes is currently only known as a measure on the level of the health care provider. How many waiting hours there are for patients is not in any way taken into account. For society in general, this should of course be taken into account, as we already do with traffic jams. For traffic jams, we can calculate a societal cost involved, with as a result a lot of focus on trying to solve the problem of traffic jams.

'Patient centered' is another interesting example. Currently, politicians and health care providers talk about patient centered health care. But what does that mean, and how can we say that we are really working in a 'patient centered' way? If we cannot define it, politicians will never be able to account for the result of their policies.

The reason that we want to investigate how to incorporate humans in the system is that many trade-offs and issues are not that explicit and not easily quantifiable. By using the human actor in a certain role, it might be possible to cope with moral aspects in an accountable way without introducing too much complexity at the multi-agent level. In this project, the preferences, values and interests of the humans in the system will play a crucial role in the technical realisation of a communication support system that is capable of suggesting solutions that respect those preferences and interests where possible, and that clarifies conflicts of interest.

The realization of such software systems will require a dialogue between philosophers, sociologists, engineers and health practitioners. This project will deliver an approach for engineering complex software systems that takes stakeholder values explicitly into account at design time. A proof of concept will be realized within an actual health care context.


3TU Center for Ethics and Technology Research 

Man Machine Interaction group Delft University of Technology

Christian Detweiler Profile Page


Catholijn Jonker (TU Delft / Almende)

Jeroen van den Hoven (3TU)

Koen Hindriks (TU Delft)

Alfons Salden (Almende)


3TUTU Delft