The Institute of Medicine (IoM) recently released a landmark report, “Improving Diagnosis in Health Care,” which calls diagnostic errors a major “blind spot” in U.S. healthcare. The 450-page report comes nearly 16 years after IoM’s groundbreaking study “To Err Is Human: Building a Safer Health System” that estimated 98,000 people in the United States die in hospitals from preventable medical errors.
This report changed the way healthcare professionals thought about medical errors, making them more aware of safety hazards and triggering hospitals to enhance safety practices, and education, such as those required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). However, there are still significant challenges that have been overlooked by the healthcare industry that need immediate attention.
The latest study in the IOM’s Quality Chasm series focuses on overcoming errors to deliver quality healthcare. This report sheds light on the prevalence of diagnostic errors and its resulting risks to patients. The IoM defines diagnostic errors as the failure to:
establish an accurate and timely explanation of the patient’s health problem(s), or
communicate that explanation to the patient.
What surprised most people was this report found that diagnostic errors represent 10% of patient deaths, as many as 18% of hospital adverse events, and are the leading cause of medical malpractice claims. The IoM report notes because of the prevalence, most people will experience at least one diagnostic error in their lives, “sometimes with devastating consequences.” To date, however, little has been done to address diagnostic errors in hospitals and healthcare systems.
“Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in healthcare,” the report said. “Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of healthcare and the diagnostic process continue to increase in complexity.”
Failure of people & systems to collaborate
While there are a variety of factors that cause diagnostic errors, this report points to inadequate collaboration and communication among clinicians, patients, and their families as one of the main issues. Since diagnostic images are such a critical part of the diagnosis and treatment of clinical problems, exchanging this information is essential to keeping patient’s informed and safe. At Nuance, we process 264 million exams a year through PowerScribe, which is an important tool for delivering the right information to the right people at the right time. Healthcare leaders agree that there is no easy way to reduce the number of errors, but I see real industry advancements, particularly in two areas that the IoM recommends: collaboration and an industry-wide commitment to change. For example, we’re working jointly with the American College of Radiology (ACR) to bring clinical guidelines to the fingertips of radiologists. PowerScribe 360 Reporting enables radiologists to create higher quality reports supported by real-time, evidence-based guidance using content developed by the ACR.
In addition, the IoM advocates for more efficient healthcare systems – particularly those that allow patients and physicians more timely access to medical records. However, a lot of the healthcare technology currently available actually impedes access to patient records. In fact, according to the IoM, a “barrier to good healthcare” includes poor health information technology that lacks real-time, or even appropriate, access to records and requires advanced technical knowledge to operate.
Modern healthcare technology and real-time mobile access to critical test results not only overcome the barrier of good healthcare, but can also mean the difference between life and death for a patient. For example, the PowerShare Network’s mobility feature allowed Dr. Donald Plumley, pediatric surgeon at Arnold Palmer Hospital for Children, to access a patient’s medical image in real-time and order an emergency procedure, all from his iPad – ultimately saving a baby’s life when time was of the essence.
Hospitals are turning to cloud technology that can make sharing and collaboration among physicians as easy as using DropBox or LinkedIn. A secure, cloud-based imaging network can help clinicians receive instant access to medical images and share, collaborate and communicate diagnostic images across miles, handoffs and even beyond health systems so that different physicians, and patients themselves have the information they need to make more accurate decisions for quality patient care.
The IoM recommends collaboration in diagnostic imaging and Nuance PowerShare Network provides healthcare organizations with a simple approach to connecting physicians and patients.
Karen Holzberger is the vice president and general manager of Nuance’s Healthcare’s diagnostic solutions business. Karen joined Nuance in 2014 with more than 15 years of experience in the Healthcare industry. Prior to Nuance, she was the vice president and general manager of Global Radiology Workflow at GE Healthcare where she managed service, implementation, product management and development for mission critical healthcare IT software. Karen attended Stevens Institute of Technology where she earned a B.S in Mechanical Engineering.