[Marketing] Re: [IMPROVEDX] Fwd: Coverys report on diagnostic errors

Jackson, Brian brian.jackson at ARUPLAB.COM
Wed Mar 21 19:02:05 UTC 2018


That request comes up all the time, but I personally don’t think it can work.  It’s just really hard to figure out what sorts of cases could be safely labelled as “no followup needed”.  A risk management mindset would likely lead to almost every case being labelled as “followup needed”, including ones with really minor findings.

I agree that communication of diagnostic findings is a huge problem and opportunity.  I just don’t think that you can solve it by asking pathology and radiology (who notably don’t have all the info on the patients) to identify reports that can be safely be left unread.  It’s sort of the same problem as when clinicians only look at chemistry and hematology results that have high/low/critical flags.  This binary approach causes you to occasionally miss important findings, and it will never work reliably.

Better, in my opinion, would be to work on the efficiency of the result review process.  It needs to be much faster and easier for a clinician to review ALL diagnostic results and decide which ones need to be read in greater detail.  The role of radiology and pathology is then to structure their results for maximum readability, with clear conclusions at the top, etc.  The role of IT/software is to make it much faster to scan results in bulk without lots of clicks, seeing what’s important, and then be able to easily zoom in on areas of interest.

--Brian Jackson

From: Tom Benzoni [mailto:benzonit at GMAIL.COM]
Sent: Wednesday, March 21, 2018 8:55 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [Marketing] Re: [IMPROVEDX] Fwd: Coverys report on diagnostic errors

As technology has occasioned these errors (There was a time when Mark would pick up the phone and tell me my patient had an abnormality on CT.) so can it be programmed to help.
*On any study mandating interpretation (Radiology and pathology come to mind, although there are many others) there is to be a mandatory field: "this study requires/does not require followup". This will activate a tickler cascade that is not stopped until action is taken.
Coding this would be a minor undertaking.
So why does it not exist?
tom

On Wed, Mar 21, 2018 at 9:29 AM, Mark Graber <Mark.Graber at improvediagnosis.org<mailto:Mark.Graber at improvediagnosis.org>> wrote:
And its not just America.  Here is a report on claims data (2000 incidents) in Australia collected by Avant.  Diagnostic errors were the second leading cause for a claim in this compilation.  Cancer and cardiovascular conditions were the #1 and #2 problem areas, as in reports from the US.

https://www.avant.org.au/diagnostic-error-claims/<https://clicktime.symantec.com/a/1/A5eH3PfTLnK2PKF1gyRwVPqtQToq_Cp99veTfjImm3Q=?d=bbEnrWSRZceP1deDrf6vYEoVEIa5mp1gro9RlgmkIvHgpCtnrpMmoqQnqLxGs6pBjCbxbXjSMCB25CUADY5UvvHsBlSwxuJ1B-qmOA_YnsYhLhl_WEkEhbkgwmyQMnrK5WJVf_2p8JTmA7f2DvtTQ33THcSFfdY8WM0a4Jjdma3lLSzTmtmwmQkct3RY4Cs8BFhyBjoMq98IbtZWIKwqlXpJBd7AMCv0qAxPlxQTMyaEoTbiJ7TaJ_EuJaZRkBsCu7h73VIAVaKdF-bB6hcHupnDdmJELr3KDlHPsO6_H7Jcy0mA6ccOc-doFfthgMifz2AMKnpYWRzqHyrZjfwATmxQ1aKOvQT6LiS0_d2WXdMxVbYHGa0y_UmnZIYHo2YWwvOocTN9tVs7QQf6HQz1QHS1uZXpDjK-U6EuVyNp76ONuRxx4ve3Df9Hg20tgzFOG38JL4h9RVdnBQ%3D%3D&u=https%3A%2F%2Fwww.avant.org.au%2Fdiagnostic-error-claims%2F>


Mark L Graber MD FACP
President, SIDM
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University
[cid:image002.jpg at 01D3C114.CE722490]




From: David L Meyers <dm0015 at COMCAST.NET<mailto:dm0015 at COMCAST.NET>>
Reply-To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, David Meyers <dm0015 at comcast.net<mailto:dm0015 at comcast.net>>
Date: Tuesday, March 20, 2018 at 12:37 PM
To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Fwd: Coverys report on diagnostic errors

To the List, Coverys, the medical liability insurer has issued a report on diagnostic errors.  You can download the PDF here.
https://coverys.com/PDFs/Coverys_Diagnostic_Accuracy_Report.aspx<https://clicktime.symantec.com/a/1/rRonm13cCh4U1ceRO5c6sa-7oSKsK9apz_lnaIx-Y6E=?d=bbEnrWSRZceP1deDrf6vYEoVEIa5mp1gro9RlgmkIvHgpCtnrpMmoqQnqLxGs6pBjCbxbXjSMCB25CUADY5UvvHsBlSwxuJ1B-qmOA_YnsYhLhl_WEkEhbkgwmyQMnrK5WJVf_2p8JTmA7f2DvtTQ33THcSFfdY8WM0a4Jjdma3lLSzTmtmwmQkct3RY4Cs8BFhyBjoMq98IbtZWIKwqlXpJBd7AMCv0qAxPlxQTMyaEoTbiJ7TaJ_EuJaZRkBsCu7h73VIAVaKdF-bB6hcHupnDdmJELr3KDlHPsO6_H7Jcy0mA6ccOc-doFfthgMifz2AMKnpYWRzqHyrZjfwATmxQ1aKOvQT6LiS0_d2WXdMxVbYHGa0y_UmnZIYHo2YWwvOocTN9tVs7QQf6HQz1QHS1uZXpDjK-U6EuVyNp76ONuRxx4ve3Df9Hg20tgzFOG38JL4h9RVdnBQ%3D%3D&u=https%3A%2F%2Fcoverys.com%2FPDFs%2FCoverys_Diagnostic_Accuracy_Report.aspx>

Art Papier MD
CEO VisualDx
Associate Professor of Dermatology and Medical Informatics
University of Rochester College of Medicine

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