NQF uncovers diagnostic errors, says EHRs not equipped to help

The committee also recognized the need for interoperability among EHR systems throughout to assist providers in arriving at an accurate and timely diagnosis.
By Bernie Monegain
11:57 AM
Share
EHRs not equipped to handle diagnostic errors

A new report from the National Quality Forum reveals that 5 percent or more patients in the U.S are being incorrectly diagnosed.

Those diagnoses contribute to nearly 10 percent of deaths annually, and up to 17 percent of adverse hospital events, according to NQF, whose mission is to improve health and healthcare quality with defined measures.

National Academies of Sciences, Engineering, and Medicine (formerly called the Institute of Medicine), supports that approach for improving diagnoses, noting that the lack of effective measurement related to the diagnostic process and diagnostic outcomes is a major contributing factor.

The NQF’s deep dive into the topic found that most electronic health record systems lack the capacity to capture the evolving nature of the diagnostic process. The committee also recognized the need for interoperability among EHR systems throughout the diagnostic process to assist providers in arriving at an accurate and timely diagnosis.

[Also: Medical mistakes still kill 1,000 patients a day, Leapfrog says]

NQF convened a multi-stakeholder expert panel to develop a conceptual framework for measuring diagnostic quality and safety and to identify priorities for developing future measures. The review resulted in insights for seven areas of inquiry and improvement”

Patient Engagement: Engaging patients and using their knowledge of their own medical histories are critical aspects of the diagnostic process.

Impact of Electronic Health Records: Diagnostic quality and safety can be advanced significantly if electronic health records have the capacity to collect key information related to diagnosis and are interoperable within and across organizations.

Transitions of Care: Transitions of care and errors during care transitions (e.g., loss of information critical to patient care) can have a significant impact on diagnostic quality and safety.

Communication: Communication between the provider and the patient, and between providers – is a key issue in diagnostic quality and safety. When communicating with patients about their diagnoses, healthcare professionals should be sensitive to the patients’ health literacy and cultural needs or preferences.

Engagement with Medical Specialty Societies: Improving diagnostic quality and safety will require medical specialty societies to engage and provide guidance as diagnostic measures are developed, in particular for conditions that are frequently misdiagnosed or can lead to serious harm in the event of a diagnostic error.

Inter-professional Education and Credentialing: Diagnostic quality and safety should become an important component of professional education, and credentialing organizations should ensure that their reviews emphasize diagnostic quality and safety.

External Environment: Issues related to the external environment, such as the alignment of payment incentives to promote timely and correct diagnosis, are less amenable to quality measurement but will have a significant impact on diagnostic quality and safety.