Delays in diagnosis prevent patients from receiving the correct treatment in the timeframe that would result in the best health outcomes. Diagnostic errors can be fatal, and often involve common medical conditions. Incorrect or delayed diagnoses affect 1 in 20 adults in outpatient settings in the U.S., around 12 million people per year (Singh et al., BMJ Quality & Safety 2014).
A number of contributing factors lead to diagnostic errors at both the individual and system level, including: high volume of patients and time constraints that keep physicians from collecting comprehensive patient information; overconfidence in diagnostic accuracy, which can limit clinicians’ likelihood to reexamine difficult cases; and unreliable or un-integrated electronic health record (EHR) systems, especially in complex outpatient settings involving multiple locations, visits and providers, which can prevent necessary coordination between those providers. Correct diagnoses also rely on the effectiveness and efficiency of communication processes. While these errors are difficult to address partly because of their complex origins, recent research has informed their understanding and possible prevention.
From January 26th-30th, panelists will share their research about diagnostic errors in a range of settings. We are pleased to welcome our panelists for this discussion:
• Gurpreet Dhaliwal, MD - Clinician-educator and Professor of Clinical Medicine at the University of California, San Francisco and site director of the internal medicine clerkships at the San Francisco VA Medical Center
• Mark L. Graber, MD, FACP, - Senior Fellow at RTI International; Professor Emeritus of Medicine at the State University of New York at Stony Brook; Founder and President, Society to Improve Diagnosis in Medicine (www.improvediagnosis.org)
• Urmimala Sarkar, MD MPH - Associate Professor of Medicine at UCSF in the Division of General Internal Medicine and a primary care physician at UCSF's General Medicine Clinic
• Hardeep Singh, MD, MPH - General internist and patient safety researcher at the Center for Innovations in Quality, Effectiveness and Safety based at the Michael E. DeBakey Veterans Affairs Medical Center and an associate professor at Baylor College of Medicine
• Dean Sittig, PhD - Professor at the School of Biomedical Informatics in The University of Texas Health Science Center at Houston and a member of the UT Houston-Memorial Hermann Center for Healthcare Quality and Safety
Our panelists will offer insight into the following questions:
1. Measurement is the first step to improvement so how do you define and identify diagnostic errors in real-world practice?
2. What are the most common causes for diagnostic error that you have seen in your work?
3. What strategies could be successful in reducing diagnostic errors? How many of these have evidence for their implementation at this time?
4. What role does use of information technologies and electronic health records play in diagnostic error reduction?
5. How can doctors “think more effectively” to reduce diagnostic errors given the current work demands?
6. What role do patients play in reducing error?
This panel is part of our US Communities Initiative, which is supported by the Agency for Healthcare Research and Quality (AHRQ), and aims to foster discussions between health care professionals on evidence-based practices, and translating these practices across disparate settings, to improve healthcare delivery in underserved populations in the US.
In an effort to understand the impact of our Expert Panels, we’ve created a short (4 question) survey. Your responses are greatly appreciated—please take the survey before the discussion begins: https://www.surveymonkey.com/s/PRCW9G3
We look forward to a rich discussion next week – please join the conversation and share your questions or comments!