You've purchased the software, installed the hardware, and booked the staff training. But before you cut the ribbon on that new EHR, you might want to ensure it's legal. One of the highly-touted benefits of EHRs is the potential to help reduce an estimated $5.8 billion in annual spending on malpractice claims. But if data-entry increases exponentially without the proper audits and reviews, interoperability could lead to inter-liability, and providers may find themselves victims of HIT negligence.

Hospitals have long thought, or at least hoped, that EHRs would result in fewer medical errors and malpractice lawsuits. But some hidden downsides might threaten the positive effects.

Most EHR systems rely on the use of template-assisted patient charting. It is not uncommon to find thousands of templates bundled with EHR software. While vendors flaunt the ease of customization, the truth is busy end users are resistant to having to create and edit their own templates. Using an incorrect or poorly designed template can put a practice at increased risk of medical lawsuits.

Just because the software creates something that looks like a medical record, doesn't mean it will hold up in court.

"It's basically about recognizing that the EMR industry is still fairly new," says Dr. Reed Gelzer, co-founder of the Advocates for Documentation Integrity and Compliance, a consultancy.

"If you went to a car dealer in 1955 and demanded seat belts and air bags, they would look at you like you were nuts. But knowing what you know now, you wouldn't buy a car without seat belts or airbags. People are being asked to buy EMRs without seat belts or air bags."

In addition to error-prone data entry, templates also encourage the sketchy practices of "chart fudging" and "template cloning". Lazy, dishonest, or uninformed users taking advantage of one-size-fits-all template design "can cross the line rapidly into fraudulent charting."

Unlike installing a printer, or loading new software on your personal computer, if something goes wrong with an EHR you could be found liable. Hospitals and providers are not only being asked to implement an EHR, but to shoulder the legal risks if something goes awry.

One strategy for providers is to look for an EHR with robust self-auditing capabilities. Data should be consistently reviewed for errors. More documentation does not necessarily imply better patient care, and so far the Obama administration has not laid out specific plans to better protect doctors from needless lawsuits and uncapped damage awards.

Sometimes just saying you're sorry can go a long way, but legal concerns should remain a high priority before and after the ribbon is cut.