Accuracy Issues

Errors in computer-based patient records can result from faulty software or equipment or from human error. A patient record system should be free from significant errors in computer hardware and software. Laboratory equipment and other machines providing input to a computer-based patient record system should also be free from such errors.

Mechanisms for minimizing human error, such as reviews of input for accuracy, are also advisable. When corrections are made, they should be logged on the system as suggested in the previous section concerning evidentiary issues. If clinical observations are recorded using bar coding or other programmed codes, there should be a mechanism in place for visual confirmation or other verification of the codes entered into the computer.

Selected Legal Issues in Computer Contracting

Leases and acquisitions of computers may involve some or all of the following: hardware, operating, and application software licenses; installation, testing, and implementation services; and postinstallation maintenance and support services for both operating and application software and equipment. Use of multiple agreements to address these interrelated components of computer system acquisitions creates the risk of conflict among the agreements and may confuse even more the issues of what law applies to these agreements. Unless multiple agreements cannot be avoided (e.g., different vendors for the hardware/operating software and application software), a single agreement is preferable.

Because of the hybrid nature of contracts for computer systems, it is not always clear what law governs issues of contract interpretation, the rights of the parties, procedures for resolving disputes, and so forth. If a court characterizes a transaction as a sale of goods, the Uniform Commercial Code will apply. However, computer system acquisitions involve both goods and services and often involve licenses rather than sales of software (to which the Uniform Commercial Code may or may not apply).

An inaccurate product definition in a contract for a computer-based patient record system or a product definition that is not sufficiently detailed can result in delivery of a system that does not function properly as a patient record system or in a contract that does not require the vendor to deliver a system that has certain important features or the capability to perform crucial patient record functions.

It is common for system vendors to "puff" the capabilities of their products in their marketing materials and in their proposals to health care providers or to promise software or features that are still on the vendor's drawing board. Although some contracting strategies help to minimize



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement