Use of HIT to reduce diagnostic errors

Jason Maude Jason.Maude at ISABELHEALTHCARE.COM
Fri Aug 23 09:58:26 UTC 2013


Thanks for highlighting this interesting paper. It raises some keys issues, some of which are alluded to in the paper, but which need emphasising:

 1.  Any analysis of "the current state of diagnostic HIT" that relies solely on published peer reviewed articles will, by definition, be many years out of date. The relevant technology is changing almost by the day so a paper from 2000 that reflects a study carried out say 2 years earlier is now really history. In looking at technology tools that will help with diagnosis I think that this group will need to look not only at published papers but also talk with actual users and look beyond into the labs. A very interesting developing area,for example, is the role of smart phones and monitors in diagnosis and the increasing ability of patients to measure and monitor many areas of their body which can actually warn of impending illness. There are now apps that can diagnosis depressed states by the way somebody changes how they use their phone. The point is that none of this has appeared in the published literature but is what is actually happening and, I believe, would be usefully included in papers such as these.
 2.  Studies like this paper will often conclude that there is scant evidence that tools such as dx generators make any positive impact. I think that this is a disservice and actually serves to slow the adoption of these tools which are starting to be used more widely by both doctors and patients. The fact that there is not any published evidence showing this does not mean that these tools are not being used and not being found useful. As the paper mentions, part of the problem is that nobody is yet measuring how accurate the diagnostic process currently is, therefore, it is impossible for a tool to show an impact on something that is not measured in the first place. The blame should therefore be placed on healthcare institutions for not measuring such fundamental processes such diagnosis and appropriateness of test ordering, referral or admissions rather than implying that the tools fall short as they cannot show any impact.


Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<http://www.isabelhealthcare.com/>

From: Bill Thatcher <BillThatcher at MINDSPRING.COM<mailto:BillThatcher at MINDSPRING.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Bill Thatcher <BillThatcher at MINDSPRING.COM<mailto:BillThatcher at MINDSPRING.COM>>
Date: Thursday, 22 August 2013 23:45
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Use of HIT to reduce diagnostic errors


I’ve posted a link on the SIDM News web page for an article titled, “Use of Health Information Technology to Reduce Diagnostic Errors.” As all things related to diagnostic errors, the HIT research field on this topic is in its early days. However, I think some subscribers on our list might find the open source (via BMJ) article of interest.

You can find it as the second listing at this location:

http://improvediagnosis.site-ym.com/blogpost/950784/Latest-News

Bill










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