Medico-legal Issues

In summary, the absence of functionality does not normally introduce clinical risk where the restrictions are a simple failure to meet one s expectations or realise benefits. On the other hand where the constraints are not fully understood, or the situation result in missing controls or key dependencies, absent functionality can contribute clinical risk. 

Occasionally HIT systems snpport a healthcare organisation s medico-legal activities. SMS developers shonld consider whether failure of these systems constitutes harm. For example, most HIT systems contain audit trail functionality to maintain a record of which nsers nndertook which actions and when. This information can be retrieved from the andit log shonld it be needed to support the investigation of complaints or legal action. If the system fails to maintain this information this may constitute a breach of data protection law but not necessarily harm in the context of CRM. 

Similarly, HIT systems may support specific legal frameworks. For example a system may be used to maintain a record of which patients are currently detained against their will for psychiatric treatment. If the system were to indicate that a patient was subject to detention when in fact this was not the case they would be detained illegally, would this fall within scope of CRM  

Avizienis A, Laprie C, Randell B. Fundamental concepts of dependability. Research Report No 1145. LAAS-CNRS. 2001 April. 

International Electrotechnical Commission. International standard lEC 61508 functional safety of electrical/electronic/programmable electronic safety related systems. Geneva 2000. Health and Safety Executive. Controlling the risks in the workplace. [Online]. 2015 [cited 2015 July. Available from http //www.hse.gov.uk/risk/controlling-risks.htm. 

---

The importance of preventing occupational contact psoriasis in the work environment goes beyond the morbidity and cost in managing these patients. As trauma may incite or trigger new lesions of psoriasis, it is potentially a medico-legal issue, especially in countries where workman s compensation is a major concern (Rietschel and Fowler 1995). 

No study has investigated the diagnostic performance of CT in detecting pleural plaques by comparison with autopsy as the method of reference, but more plaques are detected using CT than radiography and, except for obviously calcified plaques, CT eliminates false-positive diagnoses of asbestos-related pleural disease caused by extrapleural fat (Friedman et al. 1988). CT is, thus, now widely recommended to detect pleural plaques in asbestos-exposed workers and plays an important role in medico-legal and compensation issues. 

---