The health information technology safety framework: building great structures on vast voids

With their health information technology (HIT) safety framework, Drs Hardeep Singh and Dean Sittig offer many admirable suggestions to improve the safety of computerised provider order entry and electronic health records (EHRs).1 As I shall try to explain, however, I find their proposed framework less than the sum of its parts because: (1) some of its parts, in my opinion, are misdirected; (2) they make errors in their assumptions about what we can know about errors and HIT and (3) their key recommendations lack regulatory or legal teeth. Despite the authors’ fine intentions and several excellent insights and recommendations, I fear their proposal will function more as a distraction than as a useful plan for improving HIT safety—something to make us feel useful while we do not address the underlying problems.