Diagnostic errors affect more than 12 million Americans each year and likely cause more harm to patients than all other medical errors combined. The best available research indicates that one in 10 diagnoses are missed, delayed, or miscommunicated, and that all of us will suffer at least one diagnostic error in our lifetime, with up to a third of those resulting in serious harm. Best estimates also suggest that diagnostic error wastes as much as $50-100 billion per year on inappropriate testing, wrong treatments, and malpractice lawsuits. Yet diagnosis has been largely overlooked in national efforts to improve healthcare quality and safety. Federal investment in research to understand the multifactorial causes of diagnostic error and solutions to improve diagnostic safety has totaled only a few million dollars per year; as a result, the science of diagnostic safety and quality is underdeveloped and many known potential solutions have not yet been tested or confirmed in actual clinical practice.
Federal investment in research to understand the multifactorial causes of diagnostic error and solutions to improve diagnostic safety has totaled only a few million dollars per year; as a result, the science of diagnostic safety and quality is underdeveloped and many known potential solutions have not yet been tested or confirmed in actual clinical practice. The current COVID-19 pandemic has put a spotlight on the stakes of timely and accurate diagnosis, and how complex that process often can be. It also has exposed gaps in systems needed to ensure diagnostic quality and safety and underscored the need for research and action to close those gaps.
In its 2015 report, Improving Diagnosis in Health Care, the National Academy of Medicine (NAM) noted diagnostic error has been a massive "blind spot" in the national effort to improve healthcare quality and safety. It issued an urgent call for dedicated research funding and a coordinated, multi-agency federal research agenda to immediately address diagnostic errors and harms.
The Coalition to Improve Diagnosis, convened by the Society to Improve Diagnosis in Medicine, is a confederation of more than 60 key national healthcare stakeholder organizations representing hundreds of thousands of patients, physicians, nurses, and clinical educators, as well as leading health systems, risk insurers, and others who share a vision to eliminate patient harms from medical diagnostic errors. We believe it is critical that Congress act on the NAM recommendations and move quickly to eliminate key barriers to diagnostic research.
The Coalition supports a three-pronged approach to facilitate and catalyze research toward solutions that can be implemented in clinical practice and disseminated broadly:
- Establish and fund Research Centers of Diagnostic Excellence to serve as central hubs for conducting critical diagnostic safety and quality research using transdisciplinary team science.
- Support and fund diagnostic fellowship training programs that cultivate, train, and develop early career scientists to expand the currently limited pool of diagnostic researchers.
- Develop and validate operationally viable measures of diagnostic processes and patient-centered diagnostic outcomes for use in research and quality improvement efforts.
The return on new investment in research to eliminate harms from diagnostic error will be substantial. There are already promising new solutions in the research pipeline for specific, commonly misdiagnosed conditions (including stroke, sepsis, and cancer) that could eliminate tens of thousands of patient harms and billions of dollars in wasted testing and avoidable hospitalizations each year in the U.S.
The undersigned members of the Coalition respectfully asks that Congress give this non-partisan issue its full support, because it affects all of us. Research to improve diagnostic safety and accuracy will put life-saving tools, methods, and processes into the hands of clinicians, practices, and systems to help themact to improve diagnosis.
Prepared by the Joint Policy Committee of the Society to Improve Diagnosis in Medicine & Coalition to Improve Diagnosis
As of September 21, 2020
- ABIM Foundation
- Advocate Aurora Health
- Alliance for Academic Internal Medicine
- American Academy of Pediatrics
- American Association of Nurse Practitioners
- American Board of Internal Medicine
- American Board of Medical Specialties
- American College of Physicians
- American College of Emergency Physicians
- American Society for Clinical Laboratory Science
- Association of American Medical Colleges
- Association of Clinical Scientists
- Ballad Health
- Consumers Advancing Patient Safety
- Council of Medical Specialty Societies
- Institute for Healthcare Improvement
- Intermountain Healthcare
- Johns Hopkins Medicine
- The Leapfrog Group
- Maryland Patient Safety Center
- Massachusetts Coalition for the Prevention of Medical Errors
- MedStar Health
- Midwest Alliance for Patient Safety
- National Association of Pediatric Nurse Practitioners
- Northwell Health
- Penn State Health, Milton S. Hershey Medical Center
- Pennsylvania Patient Safety Authority
- The Permanente Federation, Kaiser Permanente
- Sepsis Alliance
- Society of Bedside Medicine
- Society of Hospital Medicine
- Society to Improve Diagnosis in Medicine
Policy Roadmap for Research to Improve Diagnosis
Read the Society to Improve Diagnosis in Medicine (SIDM)'s 2018 white paper, Policy Roadmap for Research to Improve Diagnosis, which showcases the vital need for increased research funding devoted to improving diagnosis.
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