If patients die as a result of health information technology (HIT) defects, the clinicians will be liable—not the vendors. Hospital administrators have signed contracts with “hold harmless” clauses that protect their HIT vendors.
At the same time, like a Soviet-style Ministry of Information, the vendors demand secrecy about the defects. Some hospitals maintain lists of HIT defects, which might contain thousands of items, some of which pose considerable risks to patients. But they are contractually bound not to disclose them (Health Care Renewal 3/26/08).
“Enforced nonsharing of software problems is an industry norm,” write Ross Koppel and David Kreda, although anathema to improving patient care or to evidence-based medicine (JAMA 2009;301:1276-1278).
Vendors avoid liability by relying on the doctrine known as “learned intermediaries,” they note. Users are medical professionals with the expertise to recognize the errors and protect the patients from harm.
Though supposedly the panacea for correcting inefficiency and medical error, “implementations of HIT are massively complex and fraught with delays, errors, resistance, work process redesign, frustration, and outright failure,” they observe, citing numerous references.
There has been very little change in the difficulties with HIT over the past 35 years, writes Scot M. Silverstein, M.D., of Drexel University, College of Information Science and Technology. Those responsible for HIT are not held to the same standards of accountability as clinicians are, though both patient wellbeing and institutions’ financial resources are at risk. Dr. Silverstein has developed a website about “what has been shown best not to do.”
Additional information:
Government has no business in business. That includes medicine. The government’s only proper function is the protection of evry individuals rights to his life, liberty, property and the pursuit of his own individual happiness. Government has the gun. It is th sole authorized agent for the use of force and as Jefferson wrote in “The Declaration of Independence” “that to secure these rights governments are instituted among men deriving their just powers from the consent of the governed”. The patient’s and the physician’s mind is his only means of knowledge and guide to action. He must think in order to know what to do. He cannot act in reason by taking orders mindlessly. He requires facts that he evaluates by thinking to act rationally. He is not infallible but has the means to correct his errors by applying logic, the science of non contradictory identification. The government rquirement that doctors be deprived of information essential to rational action is evil. Ths solution to this and all consequences of goverment interferrence in medicine is clear. Leave us alone. We and our patients do not need you except to protect us from those who would force us to act against our rationally chosen actions.
The lack of this information (problems and risk with HIT) is feeding the health information technology propaganda that the solution for health care problems is an electronic medical record. Having watched the VA push full force into their electronic medical record over 8 yrs, I have seen that they are just now starting to try to collect errors made as a result of their electronic health record.
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