5. Powerful interested parties. The United Kingdom has launched a special initiative focused on improving timeliness of cancer diagnoses, inspired partially by anecdotal reports from a decade or so ago of lethal delays in certain diagnostic procedures. And the Institute of Medicine may soon assign a task force to write a special report on the extent and cause, as well as the ramifications, of diagnostic error.
6. Gap alerts. The growth of electronic medical records and health information technology may give vendors opportunities to embed gap alerts or alarms indicating when certain follow-up tests or notifications have not taken place as they write software updates. An unintended 20-pound weight loss in one month, for example, would prompt an alarm.
7. Team decision-making. Since diagnostic errors might be attributed to private practice clinicians making decisions by themselves, perhaps in a partial vacuum, which Singh says may be influenced by "heuristics, biases, overconfidence," team decision-making or consults may become more routine, especially when rarer and more serious illness are under discussion.
Singh acknowledges that the misdiagnosis area of quality measurement "still has a very long way to go." And it must compete for attention with much more obvious, acute healthcare-acquired conditions such as infections, medication errors, and surgical mishaps, especially those with obvious links to poor outcomes such as mortality.
The extent of the problem, which nearly everyone in healthcare quietly acknowledges is serious and widespread, must be quantified and systematically parsed to find the biggest weak gaps so they can be closed.
Doctors get it wrong 10% of the time. If that truly is the case, it's healthcare's dirty little secret.