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Frost & Sullivan report on Increasd IT adoption of healthcare enterprises and their Medico- Legal aspects

In the recent years, healthcare organizations are showing an increased rate of acquisition of computer technologies and their spending rates shows an upward tendency placing the industry as one to the major consumers of ICT products and services. Frost & Sullivan estimates the Health Information Technology market (by revenue) in 2008, in APAC (Southeast Asia, China, Japan and Australia) was close to USD5.04 billion with an annual growth rate (CAGR) of 11.8 percent from 2005-2008. Although the APAC HIT market represents currently only 2.1 percent of the total healthcare market, it is very likely that the figure could double if not triple that in the next 10 years.

Dr Pawel Suwinsk, senior consultant at Frost & Sullivan says, 'The HIT is here to stay with even more ubiquitous presence in all aspects of healthcare delivery systems. Moreover, it will be the main factor and driver in the transformation of healthcare industry towards translation care by providing common collaboration platform for information processing and exchange between related sciences and industries.'

He further elaborates, " 50 percent of the medical practice activities can be controlled. The remaining 50 percent depends solely on human judgment and cognitive functions that when unfavourable conditions are present could lead to substandard care. The implementation of HIT can improve the quality of care by providing better control (up to 80 percent). However, while decreasing the legal exposure of traditional medical practice it introduces legal implications related to the usage of HIT." The following are some of the medico-legal aspects of the usage of healthcare IT solutions including electronic medical records.

Medical liability which is also entitled as medical negligence or medical malpractice is a special component of tort law which governs the professional relationship between physicians and their patients. It is concerned about the duties of care expected between physicians and their patients in delivering health care. It is said that the duty of a physician to his or her patients is to practice medicine which meets or exceeds the standard of care.

If the hospital or healthcare delivery organizations violate standard of care (through inadequate oversight of its staff physicians) by allowing EHR or other technology of its choice to be used in such a way to harm patients, it might become the subject of corporate negligence action.  The case of Vicarious liability occurs when there is a design or other type of flaw in any of the  technologies including electronic health record or computerized physician order entry that causes harm to patients even though the physicians or other caregivers who uses that committed no negligence.

The unauthorized access to patient's private information results in the privacy violation.  User negligence, misdirected information flow or intentional security breach by a third party etc..could be some of the reasons for this information leakage. Security breached is recognized as unauthorized sharing of patient's private information. Inappropriate disclosure can happen in clinical setting when multiple copies of Electronic Health Record (EHR) persist even after destruction of original file is being accessed by unauthorized personnel.

Medical liability actions may also arise from acts of commission which breach the standard of care and result in injury and damages to patients. Physicians could also find themselves in trouble by failing to use diagnostic and treatment modalities suggested by the embedded best practice guidelines in certain types of electronic health records. Here there could be an act of omission contributing to patient injury.

Some of the  preventative measures suggested in the course of medical liability are the selection of appropriate healthcare information system,  proper training of staff to ensure efficient use of system, documenting all information with justification (whether or not care provided), and preventing any further alteration to this records without proper documentation etc..

Source: Frost & Sullivan