This JAMA letter covered some of the same points I addressed extensively at my Drexel HIT website essay "Hold Harmless and Keep Defects Secret Clauses", including the major point that hospital executives signing HIT "Hold Harmless" and "Defects Nondisclosure" contracts are in violation of Joint Commission standards for conduct related to safety, and in violation of their fiduciary responsibilities towards patient and employee safety and freedom from undue liability.
I've sent the following inquiry to Paul M. Schyve, M.D., Senior Vice President, The Joint Commission:
July 24, 2009I await a response.
Paul M. Schyve, M.D.
Senior Vice President
The Joint Commission
Cc: MChassin@jointcommission.org, firstname.lastname@example.org
Dear Dr. Schyve,
In testimony to the House Committee on Veterans' Affairs on July 22, 2009 at this link , you state:
... The Joint Commission has established standards that require the hospital to:
- Create a culture in which adverse events are reported and evaluated for underlying ("root") causes, and preventative actions are taken.
- Identify high-risk processes and prospectively determine their possible modes of failure, the effects of those failures, and the actions that will prevent the failures or mitigate their effects.
- Establish a culture of safety throughout the hospital. This accreditation standard became effective January 1, 2009, although its purpose and expectations were publicized for over a year in advance.
In my JAMA letter to the editor of July 22, 2009 entitled " Health Care Information Technology, Hospital Responsibilities, and Joint Commission Standards" ( link ), I point out that the Hold Harmless and Defects Nondisclosure clauses signed by hospital executives in contracting for healthcare information technology (such as CPOE and EHR systems) are in violation of Joint Commission safety standards, as well as hospital executive fiduciary responsibilities to patients and clinicians. These clinical IT systems can and do cause medical errors and patient harm.
My letter was in response to Koppel and Kreda's March 25, 2009 article " Health Care Information Technology Vendors' "Hold Harmless" Clause: Implications for Patients and Clinicians ", JAMA. 2009;301(12):1276-1278.
I am interested in the Joint Commission's response to the issues I raise.