Koppel's bombshell—he's now an adjunct professor of sociology at the University of Pennsylvania—brought down the wrath of information technology boosters. The Healthcare Information and Management Systems Society, a health IT trade group, challenged the study's “methodology and its subsequent outcomes,” and criticized its authors for their “limited view” and not “looking at the big picture.”
Undeterred, Koppel, who holds a doctorate in sociology from Temple University and serves as Penn's principal investigator in the school of medicine on the study of hospital workplace culture and medication error, kept stirring the pot.
In 2009, he revealed in another JAMA article that health IT vendors' contracts included “hold harmless” clauses that shielded software developers from legal liability for medical errors their systems caused, even if the developers had been warned about the defects.
“That got me major upheaval,” the worst of his career, Koppel recalls. “The vendors tried to say it was untrue. And they tried to show that by saying, 'Show us examples where we settle (lawsuits) on a problem.' ”
There are no open trials, Koppel says, because when there is a settlement on suits alleging wrongful death, the surviving spouse or family member signs a release, “the hospital doesn't want to talk about it (and) the vendor doesn't want to talk about it. All of these things are settled hush-hush. There are no public settlements available.”
In 2011, Koppel testified before a federal IT policy subcommittee that “usability” of EHRs had been “largely ignored” and that a program to test them for ease of use is needed—just as the Office of the National Coordinator for Health Information Technology at HHS has EHRs tested for functionality.