Although health information technology (IT) holds great promise for improving patient safety, many of the purported benefits have not yet been realized, and an ever-lengthening list of implementation problems and unintended consequences have been documented. This Institute of Medicine report states that "the current state of safety and health IT is not acceptable" and discusses various safety issues associated with health IT. The report contains a series of recommendations for evaluating and monitoring the safety of health IT, ranging from greater attention to interoperability and human factors engineering in the health IT design process to revisiting the "hold harmless" clause that currently limits health IT vendor liability should systems fail. The Agency for Healthcare Research and Quality recently published an online guide to reducing safety consequences of electronic health records.