Ethical and legal issues in the use of health information technology to improve patient safety

The Institute of Medicine reports, To Err is Human and the subsequent Crossing the Quality Chasm spurred an increased attention nationally to problems in patient safety, in particular medication errors. Health information technology (HIT) was seen as a key mechanism to improve patient safety and health care quality, by reducing handwriting errors through electronic health records (EHRs) and providing clinical decision support (CDS). While the adoption rate of HIT has been increasing, the related legal and ethical issues have not received as much attention as other issues. In addition to concerns about privacy and security, the key ethical issues in the use of HIT revolve around the principles of providing safe and effective care and avoiding harm. Like other interventions, the legal issues revolve around regulating the use of these systems and monitoring their impact to assure that they are used properly and safely.