The increasing use and reliance on informatics and telematics technology in health care raises the inevitable issue of how questions of liability will be dealt with in this new technological environment. Up to a certain point the paper analogy can still be appropriate. However, it is inevitable that the introduction of new technology goes hand in hand with new and/or different types of responsibilities and liabilities that need to be dealt with away from the paper analogy. Liability is obviously a vast subject covering various spheres and a great number of legal principles. The legal study that was undertaken within the ISHTAR project has dealt with questions of liability in the telematics environment. The latter was defined as the use of information technology in combination with telecommunication technology for health care purposes. In view of the fact that a great many telematics applications originate in an informatics set-up, it is inevitable that the study considered to some extent liability in relation to informatics, but nevertheless placing the main emphasis on the telematics element.
This study adopted a two-fold approach. First of all, the principle players in the health care telematics environment were identified (i.e. persons, administrations, organizations, industry) and their potential liabilities ascertained. Secondly, and drawing on these results, practical advice in form of recommendations on questions of liability in health care telematics were drawn up.
Five main groups of people/organizations that may incur legal liability in a health care telematics scenario were identified:
(1) health care professionals, which includes mainly medical, but also paramedical professionals, as well as those under the health care professional's supervision and for whom he/she may be vicariously liable;
(2) health care providers, usually authorities and institutions, such as national or local health care authorities, health care centres and clinics, hospitals etc.;
(3) system/application producers, which encompasses those who
- design a system/application
- provide the necessary medical expertise/information
- provide the necessary technical expertise
- supply a system/application
- commercialise a system/application
- import a system/application;
(4) telecommunication providers, which includes all those who electronically carry data ranging from straight forward public telecommunications network providers to trusted third parties providing value-added services;
(5) patients, to the extent that they may increasingly be given an active role in their health care, in particular in a telemedicine set-up, such as tele-monitoring and teleassistance, there may be scope for contributory negligence on the part of patients.
This paper was structured as follows. The five main chapters correspond to the five groups of persons/organizations as outlined above. In each chapter the liability issues are discussed and recommendations are made on how the persons/organizations ought to act/behave to minimize the risk of incuring liability. For complete comprehension it is advisable to consider the recommendations in their textual context rather than separately. In view of the fact that readers may not find the entire document relevant to their situation, the main chapters have been structured in such a way so that they can be read individually and without reference to the rest of the text. A complete summary can be found in the annex at the end of the book.