Medical | Donald H. Bauman, Jr. | May 30, 2018
Don Bauman, CEO of Isabel Healthcare, explores the benefits of reducing medical errors in patient care, and the critical area that still needs to be addressed — diagnosis error.
Reducing medical errors is good for patient care, improving outcomes and reducing costs. There have been tremendous advances in reducing medication errors, wrong site surgeries, hospital associated infections and other adverse events, yet one key area that has been left behind is diagnosis error.
A correct differential diagnosis is the first decision made about the patient that determines all subsequent treatment. A delayed or inappropriate diagnosis can lead to unnecessary care, costs and burden to the patient and in some cases, it can be fatal.
The road to tackling diagnosis error is rapidly changing with multiple organizations confronting the issue.
ECRI Institute’s 2018 list of patient safety concerns are listed below:
A delayed or inappropriate diagnosis can lead to unnecessary care, costs and burden to the patient and in some cases, it can be fatal.
The list identifies the top concerns that have appeared in the ECRI Institute member’s inquiries, their root cause analyses, and in the adverse events submitted to their Patient Safety Organization (PSO). ECRI Institute PSO has received two million event reports and reviewed hundreds of root-cause analyses since 2009.
Reviewing their top concern of diagnosis error, ECRI Institute declared, “Each year approximately 1 in 20 adults experience a diagnostic error, according to published studies. These errors and delays can lead to care gaps, repeat testing, unnecessary procedures and patient harm.”
Gail M. Horvath, MSN, RN, CNOR, CRCST, a patient safety analyst at the ECRI Institute, went on to say that “Diagnostic errors are not only common but can have serious consequences. A lot of hospital deaths that were attributed to the normal course of disease may have been the result of diagnostic error.”
The recommendations from the ECRI Institute includes using structured tools and algorithms to overcome cognitive biases that leads to errors. Organizations can capture data when errors or near misses occur, which they can then use to learn from the errors. Horvath also mentioned clinical decision support interventions can flag incidental findings that require follow-up and identify tests which have not been done.
While diagnosis error has received little attention in the patient safety field until recently, great strides have been made in the past four years. Solving diagnosis error is not a simple task, as there are environmental, cognitive and system errors that may play a role in leading to a diagnosis error or delayed diagnosis. One specific actionable step that can be implemented today is encouraging the use of digital tools available to help clinicians with their differential. They are increasingly accessed in the clinician’s workflow inside the EMR. Clinicians can research clinical features, find accurate evidenced based information about diagnoses and engage with each other collaboratively to reach a differential diagnosis. An accurate differential diagnosis will lead to a correct final diagnosis.
Isabel Healthcare actively participates in the movement to decrease diagnosis error by providing an enhanced deep learning differential diagnosis generator for clinicians, the Isabel DDx Generator. It is great to see diagnosis error receiving the attention it deserves within the patient safety and healthcare organizations. You can learn more in our white paper about improving the quality of diagnostic decision making and by accessing our information on diagnosis error.
Mr. Bauman joined Isabel in April 2010 and brought with him more than 30 years of experience in healthcare software sales and marketing activities. In his recent tenure in healthcare safety solutions, Mr. Bauman has served as vice president of sales and marketing for InformMed, a provider of innovative medication safety solutions, LMS Medical, a leading provider of obstetrical decision support solutions, and Cereplex Inc., an early stage market innovator in automated infection prevention solutions. He currently serves on the board of Better Day Health, an innovative EMR company. His experience includes direct sales, numerous area and national sales leadership roles, product marketing and partnership development at Premier, Inc., Bridge Medical, McKesson, CliniCom and Community Health Computing. Mr. Bauman holds a Bachelor of Science degree from the University of Michigan.
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