What is the importance of reducing diagnostic errors?

October 26, 2015

The trend toward transparency and optimization extends to every industry imaginable these days, including medicine. That means that medical diagnostic errors are increasingly coming under the microscope. The answer to “why now?” has one fairly simple answer: because we can. We now have the technology to collect and analyze big data about anything and everything. So, theoretically, we can reduce errors in any business or human activity, including the practice of medicine, using this data.

In an NEJM article published September 23, 2015, Dr. Dhruv Khullar and co-contributors ponder the question of why reducing incorrect medical diagnoses has come to the forefront recently. The article covers the major circumstances that have prompted today’s increased diagnostic scrutiny. The article provides some answers to the question “why the great focus on reducing diagnostic errors?”

Because We Can

In the past, it was considered too complex to precisely measure healthcare quality, effectiveness and efficiency. There was a lack of data (and collection capability) and simply too many variables and judgment calls involved in medical diagnoses. Even today, many feel that medicine is still too much of an art (combined with science, of course) to measure accurately and objectively. Now, record-keeping is becoming rapidly more sophisticated, thanks to technical innovation, enabling always-on observation, using tools like cop cams and perhaps surgery cams or black boxes, for example.

Collection of mass data makes its analysis fairly inevitable. With more and more refined protocols, the analysis should become more reliable and useful over time. This provides a new tool and an opportunity to prevent medical diagnosis errors.

Because of Government and Payor Scrutiny

This goes back to costs as well, of course. Medical practices, hospitals, etc. are being required to hit patient care quality benchmarks (such as avoiding hospital admittance) in order to receive quicker reimbursement from health insurance companies and Medicare, and to avoid sanctions.

Because Stakes are Higher for Patients

Misdiagnosis or delayed diagnosis is worst, of course, for the patient. As Dr. Khullar’s article points out, wrong or imprecise diagnoses can delay a person’s return to full health. In the worst case scenario, misdiagnosis can shorten lives. In the past, precise, effective treatments for conditions often did not exist, so delayed or imprecise diagnosis made much less difference back then.

Today, we have the power to cure more illnesses, more quickly, with very specific treatments—so delays or errors in diagnosis now have more impact on patient outcomes. In fact, medical diagnostic errors can have even further-reaching consequences, affecting the entire community. The article illustrates this point with the example of antibiotics. Misdiagnosis leads to misuse and over use, bringing about super bugs, which put not just the single patient being treated, but the wider population, at risk for rampant, untreatable infections.

Can medicine, specifically diagnostics, be optimized similarly to the way many other industries and life tasks have been in recent years? (Online shopping in general and online Rx price comparisons sites, like GoodRx, are examples of recently optimized businesses, processes and activities.) Dr. Khullar and his co-authors feel the upside of optimizing to avoid medical diagnosis errors is well worth the effort for the cost savings and better patient outcomes,

Read the entire article for more details at the NEJM.