By Kelly A. Briganti, Editorial Director, G2 Intelligence
What the Institute of Medicine (IOM) did for the discussion of medical errors in its To Err is Human report, it now seeks to do for diagnostic errors with the latest installment of its Quality Chasm Series titled Improving Diagnosis in Health Care. Released September 22, the report asserts that “[i]mproving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative.” “Diagnostic errors are a significant contributor to patient harm that has received far too little attention until now. I am confident that Improving Diagnosis in Health Care, like the earlier reports in the IOM series, will have a profound effect not only on the way our health care system operates but also on the lives of patients,” said Victor J. Dzau, president of the National Academy of Medicine, in a statement announcing the release of the report. The Institute of Medicine is a unit of the newly formed National Academies of Sciences, Engineering, and Medicine.
Predicting that diagnostic errors “will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity,” the expert committee convened for the report concluded the following causes contribute to diagnostic errors:
- insufficient communication between providers, patients and families
- lack of support for the diagnostic process within the health care system
“a culture that discourages transparency and disclosure of diagnostic errors.”
“Diagnosis is a collective effort that often involves a team of health care professionals—from primary care physicians, to nurses, to pathologists and radiologists,” said the committee’s chair, John R. Ball, executive vice president emeritus of the American College of Physicians. Explaining that diagnostic decisions can’t always be made by one lone provider and human error isn’t always the source of diagnostic errors, Ball asserted “[t]o make the changes necessary to reduce diagnostic errors in our health care system, we have to look more broadly at improving the entire process of how a diagnosis [is] made.”
Among the report’s recommendations, the committee calls for payment models to move away from fee-for-service to support collaboration in the diagnostic process and provide payment to pathologists for consultation with treating physicians about diagnostic testing for patients.
The report was sponsored by the Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, College of American Pathologists, American Society for Clinical Pathology and several other organizations and foundations.