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AMIA: Why The “Hold Harmless” Clause In EMR Contracts Is Unethical

Last Friday the board of the American Medical Informatics Association (AMIA) published a position paper in its journal saying that the “hold harmless” clause is unethical. One of the paper’s authors is Dr. Danny Sands, currently President of the Society for Participatory Medicine. I hope to write more about it this week, after attending the AMIA conference in DC, but here’s the basic issue:

— For ages, makers of electronic medical record systems (EMR) have insisted on a “hold harmless” clause in the contracts a system buyer must sign. It says, in essence, that if any harm comes to anyone because of a system problem, the buyer (the hospital) will hold the manufacturer harmless.

— In other words, if anything goes wrong with the system and someone gets hurt, it’s not the manufacturer’s fault. The reasoning has been: “Hey, you doctors are smart. If our system displays a wrong value, you’re supposed to notice it.”

I’m told this policy has been one big impediment to adoption of EMR systems, because it removes all motivation for vendors to fix things that make their product hard to use: If there’s a bug or the system slows someone down, and a patient gets hurt, the hospital gets sued, not the vendor.

If you were a hospital, wouldn’t that make you eager to buy? What would that do to your trust of the vendor? Patients, how do you feel about that? Providers? Read more »

*This blog post was originally published at e-Patients.net*

How ePatients Can Help Heal Healthcare

ePatient Dave, who shared his story (video below) with my students in the “Internet in Medicine” course this semester, is about to publish his own book: “Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer.”

Now three of his friends have written essays about this important issue:

We who’ve worked on it hope it will provoke thought about how healthcare is changing because of what e-patients can contribute, empowered as individuals and enabled by the Internet. To start that process, we’re publishing the introduction.

Three friends and mentors generously offered introductory essays. These essays they have little to do with my story, and everything to do with how e-patients can help heal healthcare:

 

My message to @Berci’s Medicine 2.0 course, March 25 2010 from e-Patient Dave deBronkart on Vimeo.

*This blog post was originally published at ScienceRoll*

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I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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