DX measures

Rodney Omron romron1 at JHMI.EDU
Sun Dec 9 04:01:46 UTC 2018


My admission diagnosis are usually symptoms specific and not disease specific.


S,

R
Rodney Omron, MD MPH
Department of Emergency Medicine
Johns Hopkins University School of Medicine

________________________________
From: Sanders, Lisa <lisa.sanders at YALE.EDU>
Sent: Saturday, December 8, 2018 1:33:29 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] DX measures

Emergency physicians make the admitting diagnosis. That's how they are admitted but not necessarily what the doctors caring for them think. Perhaps the admission H and P should be the start point. I'm not sure that ER physicians or medicine should be graded on the admitting dx.

From: Jason Maude <jason.maude at ISABELHEALTHCARE.COM>
Sent: Thursday, December 06, 2018 6:07 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] DX measures

This is a very interesting study (freely available) looking at the degree of match between the admission diagnosis and what the authors call the exit diagnosis.

"Our results show that only the 21.67% of cases are identified correctly on admission...."

Could this be used as a measure for diagnosis quality in hospitals? I am sure there will be concerns about the admitting diagnosis and clinicians being rushed to put something down without enough time but the ratio between the 2 diagnoses for an institution as a whole should be a useful indicator as would the trend over time. If the measure drove institutions to focus of getting the admitting diagnosis more accurate then that would be good.

This should also be practical to produce as would not involve the clinicians in any additional work.

In an earlier discussion, I asked if there were any measures that were practical, where there were no concerns and that we could all support but got replies. I really feel that if we are to get diagnosis the respect it deserves from hospitals and health systems then we need a measure. We have all been talking about this for a long time, but I do not sense we are any further forward!

Regards

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886
Tel: +1 703 879 1890
www.isabelhealthcare.com<https://na01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.isabelhealthcare.com%2F&data=02%7C01%7Clisa.sanders%40yale.edu%7Cfe876ee781744f85d84b08d65b88f4cd%7Cdd8cbebb21394df8b4114e3e87abeb5c%7C0%7C0%7C636797042785465062&sdata=3gJPfS8jaQ6gcksJ6aiQFQ5i1hEa5QuWv0Q%2FnSoMC8c%3D&reserved=0>


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


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