The right dx

Jason Maude Jason.Maude at ISABELHEALTHCARE.COM
Wed Jan 22 08:12:14 UTC 2014

There have been a few mentions about the value of decision support in helping physicians and also their potential affect on NPs and PAs.

James Carlson at Rosalind Franklin University, who presented at DEM last year, has some done great work with his his students actually quantifying the impact. One study<> showed that the use of a diagnostic reminder tool increased their diagnostic accuracy significantly in 3 out of the 4 cases.

Another study<> by Rita Marie John at the Columbia School of Nursing also showed a significant effect on the diagnostic accuracy of APN nurses.

These studies show that probably all clinicians would be more accurate and timely with their diagnoses if they routinely used diagnostic decision support tools. Some might improve by only 5% while others might improve by 30% or more.

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890

On 21/01/2014 17:36, "Graber, Mark" <Mark.Graber at VA.GOV<mailto:Mark.Graber at VA.GOV>> wrote:

This is an important comment, and thanks Victoria for both sending the note to your physician and mentioning it on this forum.  In an ideal world, care would be both patient centered AND knowledge-based.  These goals come into conflict a lot these days - many physicians don't take the time to take advantage of decision support resources, and some believe that their patients will perceive them negatively for doing so.

Hopefully someday we will get to the point that physicians use decision support routinely, and patients see the value in this, as you did.  The trick is to somehow maintain the patient-centered focus, and not spend so much time at the keyboard that the patient feels neglected.

From: Vic Nicholls <nichollsvi2 at GMAIL.COM<mailto:nichollsvi2 at GMAIL.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Vic Nicholls <nichollsvi2 at GMAIL.COM<mailto:nichollsvi2 at GMAIL.COM>>
Date: Mon, 20 Jan 2014 20:13:58 -0500
Subject: [EXTERNAL] [IMPROVEDX] The right dx

Question for the medical professionals on this list.

I have a doctor who looked up something in UpToDate at my last
appointment months ago. She gave me another test which showed a problem.
I remembered that.

I put a note to her, coming up at my next appointment, saying that I
hadn't said so but that I appreciated her doing that. I said there are
those who wouldn't do that in front of a patient, but the fact that she
went searching for an answer on my account really made me feel like she
put my welfare and patient care first.

Do doctors really appreciate that? She hasn't said anything but I know
she got it. I have asked for the bosses of doctors before and given them
things that I said I appreciated about them and how much it meant to me.



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