In Search of a Common Definition of Dx Error

robert bell rmsbell200 at YAHOO.COM
Sun May 8 04:55:28 UTC 2016


Just watched Noam Chomsky - ‘Requiem For The American Dream' <https://www.youtube.com/watch?v=zI_Ik7OppEI>

And I might change my mind about litigation reform being a solution - with Citizens United, companies considered to be people, all the lobbyists, and the concentration of power in the US to the top 1%, it seems very unlikely that any significant legislation will be passed in the coming years to help. With companies running the healthcare show significant legislation does not seem likely. I hope that I am wrong. Did we miss our single payer opportunity where changes presumably could have occurred more easily? 

RB

> On May 7, 2016, at 11:00 AM, Cameron Powell <cameron at PHYSICIANCOGNITION.COM> wrote:
> 
>> Could changing litigation laws for the Medical Industry help us collect good error data? (Rob Bell)
> 
> 
> 
> The solution would be something like what has already been done in negligence cases. 
> 
> If you come into my hotel lobby through the revolving door and it’s going too fast behind you, so that it breaks your ankle, you can sue me for negligence. You can enter many types of evidence to show that I was negligent in installing and maintaining a dangerously fast revolving door.
> 
> But there’s one type of evidence you cannot enter, and that a jury may not consider: evidence that I tried to fix or improve the door’s performance. As a public policy matter, we don’t want to discourage repairs and fixes, so we’ve decided to say it’s no evidence of negligence.
> 
> In the case of medical errors, you’d need a repository where errors are reported, and that repository is accessible only by researchers, and not discoverable by parties to litigation.
> 
> That would probably require a state-by-state change in state tort laws. Such modifications are usually not considered appropriate at the federal level.
> 
> Cameron
> 
> 
> 
> Appfully Yours (Android <https://play.google.com/store/apps/details?id=com.physiciancognition.xebrapro> | IOS <https://itunes.apple.com/us/app/xebra-pro/id1051676634>),
> 
> 
> Cameron Powell, J.D.  |  CEO, Physician Cognition, Inc.
>   ———————————————————————
>   (:  503 502 5030 
>   -:  Cameron at PhysicianCognition.com <mailto:Cameron at physiciancognition.com>
>   ::   PhysicianCognition.com <http://physiciancognition.com/>
> 	 Watch Xebra Pro in action! <https://youtu.be/D_ZZPYbA6Q8> 
> 	  Follow On: 
> 	  	Twitter - Company <https://twitter.com/PhysicianCog> 
> 	  	Twitter - Personal <http://www.twitter.com/cameroncpowell> 
> 		Facebook <https://www.facebook.com/Physician-Cognition-1542884199311822/>
> 
> “Wow. This Thing Is Better Than I Am!” — CMO, Major Urban Hospital, And Many Others
> 
> <PhysicianCognitionLogo_email.png>
> 
>> On May 6, 2016, at 6:12 PM, robert bell <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG <mailto:0000000296e45ec4-dmarc-request at list.improvediagnosis.org>> wrote:
>> 
>> Lenny, 
>> 
>> Could changing litigation laws for the Medical Industry help us collect good error data?
>> 
>> If yes, should we do something now?
>> 
>> My gut feeling tells me with all the constant small errors that HCPs make, that deaths are probably more than 100,000 a year - but please prove me wrong!  Is that about 17 per hospital per year?
>> 
>> Rob Bell
>> 
>> 
>> 
>> 
>> 
>> 
>>> On May 6, 2016, at 8:24 AM, Mittal, Manoj K <MITTAL at EMAIL.CHOP.EDU <mailto:MITTAL at EMAIL.CHOP.EDU>> wrote:
>>> 
>>> Here! Here!
>>> Well said, Lenny!
>>> 
>>> Manoj
>>> 
>>> 
>>> 
>>> Manoj K. Mittal, MD, MRCP (UK), FAAP, FACEP
>>> Medical Director, 
>>> Pediatric ED, St Mary Medical Center, Langhorne, PA
>>> Attending Physician
>>> Co-Chair, QI and Patient Safety Committee
>>> Division of Emergency Medicine
>>> The Children's Hospital of Philadelphia
>>> Associate Professor of Clinical Pediatrics
>>> Perelman School of Medicine, University of Pennsylvania
>>> Philadelphia, PA
>>> Tel: (215) 590 1944
>>> Fax: (215) 590 4454
>>> 
>>> From: Leonard Berlin <lberlin at LIVE.COM <mailto:lberlin at LIVE.COM>>
>>> Sent: Friday, May 6, 2016 10:55 AM
>>> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>>> Subject: Re: [IMPROVEDX] In Search of a Common Definition of Dx Error
>>>  
>>> Over the past several days I have enjoyed reading the long list of commentaries submitted by very bright and caring physicians.  medical-associated people,  and researchers,  on the subject of the frequency of medical errors and their  role in causing death of patients. This has led me to conclude the following undeniable fact: 
>>>  
>>>  NOBODY KNOWS HOW MANY MEDICAL ERRORS ARE COMMITTED, AND NOBODY KNOWS HOW MANY PEOPLE ARE KILLED BY MEDICAL ERRORS!
>>>  
>>> The articles by Makary and others that calculate numbers related to medical errors and patient injury are nothing more than statistical projections,  extrapolations, estimates, and conjectures.  
>>>  
>>> Makary, Johns Hopkins, and the BMJ got great international headlines by "estimating" that 251,454 patients die of medical mistakes annually. Needless to say, the word "estimating" doesn't appear very much,  if at all, in the headlines and limited text proclaimed  in newspaper and TV news reports.  
>>>  
>>> Today, physicians  in all specialties are presumably  practicing   "evidence-based-medicine."  
>>>  
>>> When it comes to medical errors, there is no "evidence!"
>>>  
>>> Yes, focusing attention on medical errors is certainly productive, and indeed encourages all of us to improve medical care safety and reduce errors.  And clearly, supporting organizations such as  SIDM is a step in the right direction.
>>>  
>>> We should be transparent to the public, but frightening everyone and causing them to lose confidence in their physicians is counterproductive. Our message to the public should be an honest one:  MEDICAL ERRORS DO OCCUR, BUT WE DO NOT KNOW, AND WILL NEVER KNOW, HOW MANY PATIENTS DIE DUE TO A MEDICAL ERROR; HOWEVER, WE ARE WORKING ON WAYS TO REDUCE THEM.
>>>  
>>> Lenny
>>> Date: Thu, 5 May 2016 14:23:22 -0500
>>> From: ruthryan at COX.NET <mailto:ruthryan at COX.NET>
>>> Subject: [IMPROVEDX] In Search of a Common Definition of Dx Error
>>> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> To all,  
>>>  
>>> Allow me to pick the finest brains on this topic.  Should SIDM adopt one of these definitions below, or craft a combination of these elements?  How would you define it?
>>>  
>>> DEFINITIONS OF DIAGNOSTIC ERROR
>>>  
>>> Author
>>> Source or Citation
>>> Definition
>>> Mark Graber
>>> Diagnostic errors in medicine: a case of neglect. Jt Comm J Qual Patient Saf. 2005.
>>>  
>>> Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med. 2005
>>> Medical diagnoses that are wrong, missed, or delayed.
>>>  
>>> A diagnosis that was unintentionally delayed (sufficient information was available earlier), wrong (another diagnosis was made before the correct one), or missed (no diagnosis was ever made), as judged from the eventual appreciation of more definitive information.
>>>  
>>> Hardeep Singh
>>>  
>>> Helping healthcare organizations to define diagnostic errors as opportunities in diagnosis. Jt Comm J Patient Safety, 2014.
>>>  
>>> A breakdown in the diagnostic process and a missed opportunity to have made the diagnosis more accurately or more efficiently…regardless of whether there was patient harm.
>>> Gordon Schiff et al
>>> Schiff GD, Hasan O, Kim S, Abrams R, Cosby K, Lambert BL, et al. Diagnostic Error in Medicine: Analysis of 583 Physician-Reported Errors. Arch Intern Med. 2009
>>> Any mistake or failure in the diagnostic process leading to a misdiagnosis, a missed diagnosis, or a delayed diagnosis. This could include any failure in timely access to care; elicitation or interpretation of symptoms, signs, or laboratory results; formulation and weighing of differential diagnosis; and timely follow-up and specialty referral or evaluation.
>>>  
>>> Institute of Medicine
>>> Improving Diagnosis in Health Care, 2015 report Institute of Medicine (IOM)
>>> The failure to establish an accurate and timely explanation of the patient's health problem(s) or to communicate that explanation to the patient.
>>>  
>>>  
>>> BEST DEFINITION OR COMBINED DEFINITION:
>>>  
>>> Fill in the blank
>>>  
>>>  
>>>  
>>> Ruth
>>>  
>>> Ruth Ryan RN, BSN, MSW, CPHRM
>>> Medical writer
>>> Risk management/patient safety
>>> Continuing medical education
>>> Telephone (504) 256-8797
>>> Email ruthryan at cox.net <mailto:ruthryan at cox.net>
>>> <image001.jpg>
>>>  
>>>  
>>> 
>>> 
>>> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> To unsubscribe from IMPROVEDX: click the following link:
>>> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1> 
>>> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX>
>>> 
>>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
>>> 
>>> To learn more about SIDM visit:
>>> http://www.improvediagnosis.org/ <http://www.improvediagnosis.org/>
>>> 
>>> 
>>> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> To unsubscribe from IMPROVEDX: click the following link:
>>> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX>
>>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
>>> 
>>> To learn more about SIDM visit:
>>> http://www.improvediagnosis.org/ <http://www.improvediagnosis.org/>
>>> 
>>> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> To unsubscribe from IMPROVEDX: click the following link:
>>> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>>> 
>>> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX>
>>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
>>> 
>>> To learn more about SIDM visit:
>>> http://www.improvediagnosis.org/ <http://www.improvediagnosis.org/>
>> Robert M. Bell, M.D., Ph.C.
>> P.O. Box 3668
>> West Sedona, AZ  86340-3668
>> USA
>> Tel: Fax: 928 203-4517
>> 
>> 
>> 
>> 
>> 
>> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at list.improvediagnosis.org>
>> 
>> To unsubscribe from IMPROVEDX: click the following link:
>> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>
>> 
>> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX-SIGNOFF-REQUEST at list.improvediagnosis.org>
>> 
>> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX>
>> 
>> 
>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
>> 
>> To learn more about SIDM visit:
>> http://www.improvediagnosis.org/ <http://www.improvediagnosis.org/>
>> 
> 
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>
> 
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
> 
> Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
> 
> 
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine
> 
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
> 

Robert M. Bell, M.D., Ph.C.
P.O. Box 3668
West Sedona, AZ  86340-3668
USA
Tel: Fax: 928 203-4517









Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


HTML Version:
URL: <../attachments/20160507/2afcf8ec/attachment.html>


More information about the Test mailing list