death certificates

Hueth, Kyle D. kyle.hueth at ARUPLAB.COM
Thu May 5 20:48:26 UTC 2016


Here is an additional resource from the National Center for Health Statistics at the CDC.  Nothing ground breaking, but valuable.  http://www.cdc.gov/nchs/nvss/death_certification_problems.htm

This discussion makes me think about the potential opportunity to apply EMR health information and machine learning to generate a cause of death-or suggestions to the physician signing out the record-in a uniform and consistent manner.  Accurately monitoring deaths (and all outcomes) is crucial to propel the quality movement continuously forward.  Not being able to accurately monitor quality and improvement will be very disappointing from a care and reimbursement perspective.

From: Leonard Berlin [mailto:lberlin at LIVE.COM]
Sent: Thursday, May 05, 2016 2:19 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] death certificates

This makes one wonder whether medical errors really are the third most common cause of deaths!

With all the studies out there claiming frequent fatal medical  errors, one has to wonder whether in each case the medical chart was carefully evaluated in detail to determine beyond reasonable doubt that the death was due to a medical error.......

Lenny

> Date: Thu, 5 May 2016 11:39:04 -0600
> From: lizregan53 at GMAIL.COM<mailto:lizregan53 at GMAIL.COM>
> Subject: [IMPROVEDX] death certificates
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
> I would not favor adding medical error to death certificates for a variety of reasons but the chief one being that it is so hard to define and while is obvious to those who want to see improvement, it is less obvious to those who want to avoid the concept. At the point where there is broader consensus on how to identify and reduce medical error (especially diagnostic error) I think it will be easier to record and track the event.
>
> I believe strongly that it is critical to do that, but we are not there yet.
>
> I have just completed a project to adjudicate cause of death in nearly a 1000 deaths for a large cohort study. The project involves reviewing both death certificates and medical records. At that level of review I did not see evidence of diagnostic error or other errors. Now that I consider the project in light of this discussion - I guess that is interesting.
>
> I don't interpret this to mean that none of those subjects experienced error, but rather to reflect on the invisibility of error in our record keeping.
>
> I wonder about the feasibility of re-reviewing the data with a more critical eye and finding more. However, I don't really think I would find much.
>
> Liz Regan
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