Yesterday the Daily Mail ran an article entitled “How to avoid misdiagnosis: The online ‘doctor’ even GPs swear by”
The online ‘doctor ‘referred to was actually the Isabel system used by GPs at the Vale of York Clinical Commissioning Group (CCG) and the Isabel symptom checker.
The article pointed out that payouts for misdiagnosis by the NHS Litigation Authority rose from £56mn in 2009-10 to £98mn in 2010-11. Bear in mind that payouts will represent just the tip of the iceberg for misdiagnosis.
The article reports how the Vale of York CCG is using the Isabel diagnosis checklist system for professionals and quoted Dr David Hayward:
"Experienced GPs become used to thinking in a certain way," says Dr David Hayward, a GP and board member of the Vale of York Clinical Commissioning Group.
"This system allows you to think outside the box. We don’t use it for every patient, but it is useful for complex cases.
"One colleague saw a patient whose blood showed signs of inflammation, and the symptom checker suggested pneumonia.
"The patient had no obvious symptoms of a chest complaint, but when he was sent for an X-ray he did have pneumonia."
The article mentions that the system costs about £1,400 per GP practice and, significantly, that doctors say that the costs are recouped “because more patients are referred to the right consultant the first time”. This is very important as it shows that Isabel is a practical tool to help improve the appropriateness of referrals.
The article also quotes Sir Graeme Catto, the former president of the General Medical Council on his view of the symptom checker:
“Doctors have always used textbooks — this symptom checker brings that concept up-to-date,” he says.
The comments to the Daily Mail article indicate a good deal of frustration with the health system and the increasing trend for patients to make sure they are better informed.