This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Informatics/ Internet in Medicine  • Informatics, Other  • Medical Practice  • Law and Medicine  • Quality of Care  • Patient Safety/ Medical Error  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their Commentary, Dr Koppel and Mr Kreda¹ made clear the problems associated with applying the customs and traditions of business software contracting and sales (where "hold harmless" and "keep defects secret" clauses are commonplace) to health care information technology (HIT) as if they are the same. I believe that ignoring their differences has likely created an epidemic of violations of hospital governing body responsibilities and Joint Commission standards for health care organization leadership.

For example, Joint Commission leadership standard LD.01.03.01² states, "The governing body is ultimately accountable for the safety and quality of care, treatment, and services." The rationale for this standard states:

The governing body's ultimate responsibility for safety and quality derives from their legal responsibility and operational authority for [organization] performance. In this context, the governing body provides for internal structures and resources, including staff, that support safety and quality.²

Scot Silverstein, MD
scot.silverstein@ischool.drexel.edu
College of Information Science and Technology
Drexel University
Philadelphia, Pennsylvania

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Health Care Information Technology Vendors' "Hold Harmless" Clause: Implications for Patients and Clinicians
Ross Koppel and David Kreda
JAMA. 2009;301(12):1276-1278.
EXTRACT | FULL TEXT  

RELATED LETTER

Health Care Information Technology, Hospital Responsibilities, and Joint Commission Standards—Reply
Ross Koppel and David A. Kreda
JAMA. 2009;302(4):382-383.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neonatal Informatics--Dream of a Paperless NICU: Part One: The Emergence of Neonatal Informatics
Drummond
NeoReviews 2009;10:e480-e487.
ABSTRACT | FULL TEXT