As we start the new year, we resolve to achieve improvements in all we do, including our medical practices and patient diagnosis efforts.
Diagnosis is the first and most important decision made about the patient -- it determines all subsequent treatment and determines the course of each patient encounter. How well this decision is made, therefore, is one of the most significant determinants of healthcare quality and efficiency.
The following are six areas where the speed and accuracy of diagnosis has a key impact and where the use of a medical diagnosis decision tools help achieve improvements.
- Referrals – Primary care to Specialists: Research shows that 30-50% of referrals from primary care to specialists are inappropriate leading to delays in diagnosis, patient dissatisfaction and lengthy waits at specialist clinics.
- Test ordering: Surveys and anecdotal evidence put the level of unnecessary and defensive test ordering at 40%. This is extremely costly and subjects patients to unnecessary clinical risk through invasive procedures and radiation exposure.
- Mitigating Risk – Medical Malpractice: Misdiagnosis accounts for 30-40% of all malpractice claims and about 2/3 of all claims in primary care.
- Patient Satisfaction: Since patient satisfaction will soon account for 30% of Medicare payments many hospitals are investing in typical customer service initiatives used for years in other industries. However, in many cases these are viewed as gimmicks and will not make up for poor quality of care. A survey of patients’ concerns showed that their top concern when visiting their primary care physician is diagnosis and in hospitals it’s their 2nd most important concern.
- Employee skills – Extending mid-level clinicians: Healthcare is a knowledge intensive industry and a key issue underpinning an institution’s success is the clinical skills of all its clinicians. One way of boosting skills cross the board is to provide tools that increase clinical skills.
- Improving the Thought Process: The most common causes of diagnosis error are related to how a doctor thinks. There is now a large body of work describing the many biases that we, as human beings not just clinicians, are prone to. Premature closure, where the clinician decides on a diagnosis very quickly but then fails to consider other reasonable possibilities until it’s too late is the leading cause. Clinical analytics and decision support embedded as part of the clinical workflow can assist in getting the clinician to consider other possibilities.
Diagnostic Error is the leading cause of medical error. It happens frequently, is almost always preventable and causes the most harm. There is now a large body of research demonstrating the size of the problem and why it happens.
Better Than Asking a Colleague: In most cases today, if a clinician does have diagnostic doubt and wishes to investigate further they typically will have to consult with colleagues, read textbooks or go online. With medical textbooks and online reference resources it is very difficult to search for something when you don’t know what you are looking for.
This area is where diagnosis decision support aids can help as they are designed to produce a list of likely diagnoses for a given set of signs and symptoms. Their job is to get the clinician thinking about a disease that he had not thought about. Instead of taking several hours, days or even years in some cases to suggest the right diagnosis using the traditional methods, the diagnosis decision aids work in seconds. These tools buy the time that the clinician needs to think.
To learn more about Isabel medical diagnosis tools, visit www.Isabelhealthcare.com