Pretty interesting to see a Developer and PM have to pay out as well. I wonder how the judge reached that conclusion.
Having worked at an EHR, PMs routinely instructed us to build things specifically. I could suggest cosmetic stuff, but couldn't really suggest changes to the underlying business logic of the requirements because it had usually been hammered out by PMs/Nurses/Doctors/Maybe-legal. These requirements formed the basis of test cases for QA to run though.
ECW was not the vendor I worked for, so it's possible the developer had more influence over business logic or its implementation.
These things sound like time or cost-cutting measures:
>opted to added the 16 drug codes necessary for certification into its software rather than enable the product to access those from a complete database
Sounds like they didn't buy the database.
>eClinicalWorks did not satisfy data portability requirements designed to enable doctors to transfer patient data to over vendor’s EHRs
This sounds like they didn't want to build something to export to CCDA?
These sound like negligence / not enough testing:
>failed to accurately record user actions with audit log functionality
>did not always accurately record diagnostic imaging orders or conduct drug-drug interaction checks
For drug-drug interaction, that is probably another drug database to purchase, so it's possible they simply hadn't bought it. Building your own is obviously out of the question.
RxNorm (the codes discussed) is wholly open source. You can download weekly and monthly updates for free. Just pure laziness/avarice. https://www.nlm.nih.gov/research/umls/rxnorm/docs/rxnormfile...
As for the CCDA piece, that's interesting. It should be pretty easy to build that, it's a pretty simple standard and I think there are C# and Java libs that basically just do it.
It's hard to say without understanding the basis for the claims against the developers, which are separate from the case against the company and its officers. I can find both the complaints and settlement agreement for the action against the company [0], but not those against the developers.
[0] both the whistleblower and government complaints, and the final settlement I agreement, are linked from this article: https://www.emrandhipaa.com/emr-and-hipaa/2017/05/31/ecw-ecl...
The end result was CMS paying out large bonuses to health systems using the eCW software when they really shouldn't have.
There's a lot more than the drug code hardcoding in this case.