Abstract
Negotiating health information technology contracts can improve patient safety, but they are often signed with minimal review and negotiation. Taking the time to negotiate these agreements can help assure that the vendor is actually committed to provide the features and functions that the customer believes are being provided. These include protection against lost or inaccurate data, the ability to adjust clinical alerts to avoid “alert fatigue,” and the exact functionality of clinical decision support. Equally important is the effort a customer should make to uncover any of its own assumptions about how the product will function so that they can be addressed in the agreement.
Although the chapter does not provide legal advice, it discusses revising typical non-disclosure provisions so the customer can report problems that may best be described using screenshots or detailed functionality. Indemnification clauses are also reviewed in the context of equitable risk allocation so that the vendor retains an incentive to provide a safe product. While contract review and negotiation may be challenging, these efforts should help avoid unintended consequences and improve patient safety.
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References
Joint Commission Sentinel Event Alert 42. Available at http://www.jointcommission.org/sentinel_event_alert_issue_42_safely_implementing_health_information_and_converging_technologies/. Joint Commission Sentinel Event Alert 54. Available at http://www.jointcommission.org/sea_issue54/. Accessed 13 June 2016.
SAFER guides. Available at https://www.healthit.gov/safer/safer-guides. Accessed 3 July 2016.
Sittig DF, Singh S. Defining health information technology-related errors. Arch Intern Med. 2011;171(14):1281–4.
Sittig DF, Campbell E, Guappone K, Dykstra R, Ash JS. Recommendations for monitoring and evaluation of in-patient computer-based provider order entry systems: results of a delphi survey. AMIA 2007 Symposium Proceedings. p. 671–675.
The Electronic Health Record (EHR) Association has published the EHR Developer Code of Conduct in support of patient safety and other issues. Its principles include notice to customers if software issues are identified that could materially affect patient safety. See http://www.himssehra.org/ASP/codeofconduct.asp. Accessed 3 July 2016. If the vendor in question has adopted the Code of Conduct, it may be more willing to negotiate access to information about errors and other points.
Goodman KW, Berner ES, Dente MA, Kaplan B, Koppel R, Rucker D, et al. Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: a report of an AMIA special task force. J Am Med Inform Assoc. 2011;18:77–81.
Koppel R, Kreda D. Health care information technology vendors’ “hold harmless” clause: implications for patients and clinicians. JAMA. 2009;301:1276–8.
Harrington L. Safety issues related to the electronic medical record (EMR): synthesis of the literature from the last decade, 2000–2009. J Healthc Manag. 2011;56(1):31–44.
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Lamar, M. (2016). Managing HIT Contract Process for Patient Safety. In: Agrawal, A. (eds) Safety of Health IT. Springer, Cham. https://doi.org/10.1007/978-3-319-31123-4_18
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DOI: https://doi.org/10.1007/978-3-319-31123-4_18
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