History of SIDM: Milestones in Improving Diagnosis

The first focused discussions of diagnostic error, the Dalhousie Workshop on Diagnostic Error, was hosted by Pat Croskerry in 2005 associated with the Canadian Patient Safety Conference Series. The workshop was attended by 40 international experts on safety and human error.

The earliest meeting in the United States addressing the problem of diagnostic error was held in Naples, Florida to discuss and react to an article on diagnostic error and overconfidence authored by Eta Berner and Mark Graber. This paper, and commentaries from each of the participants, was published as a special edition of the American Journal of Medicine.

The inaugural international Diagnostic Error in Medicine Conference was convened by Mark Graber and Eta Berner in Phoenix, Arizona in collaboration with the American Medical Informatics Association meeting (AMIA), supported by a conference grant from the Agency for Healthcare Research and Quality (AHRQ). From this point, the DEM Conference would become an annual event.

While the Diagnostic Error in Medicine Conferences continued to provide an annual platform to discuss diagnostic quality and safety, the conference leaders know they would have to expand to discuss, explore, and work on the problem of diagnostic error on a continuous basis. In 2011, the SIDM was officially established. During the annual conference held in Chicago, Mark Graber, David Newman-Toker, Elizabeth Montgomery, Art Papier, Paul Epner, and Ruth Ryan were named to the board.

The newly-formed Society to Improve Diagnosis in Medicine (SIDM) assumed conference responsibility during the Diagnostic Error in Medicine Conference in Baltimore. The first founding members (The Cautious Patient Foundation and Best Doctors) and individual members were enlisted, and committees established during this time.

SIDM's official peer-reviewed journal, Diagnosis, was launched in 2014, with many of its research articles available open access.

In July, AHRQ awarded a grant to Syracuse University entitled, "Using Public Deliberation to Define Patient Roles in Reducing Diagnostic Error." SIDM was listed as the sponsor of the project and SIDM members were included as co-investigators.

SIDM petitioned the National Academy of Medicine (formerly the Institute of Medicine) to conduct a review of diagnostic error, which resulted in the landmark Improving Diagnosis in Health Care report. The recommendations shined a light on what is known—and unknown—about diagnostic error, and strongly underscored that it is under-recognized, under-studied, and not integrated into quality assurance measures or activities. Thanks to the report, diagnostic error started becoming an active subject of discussion in healthcare organizations around the country.

In August 2015, SIDM convened the Coalition to Improve Diagnosis to gain maximum impact from the National Academy of Medicine report and to generate real, lasting change. Comprised of leading healthcare organizations, including patient and consumer advocates and government partners, the Coalition aims to bring much-needed attention, awareness, and action to diagnostic error. Forming the Coalition and leveraging its expertise are essential steps in improving the quality of care that patients receive and reducing harm that results when diagnoses are inaccurate, missed, or inappropriately delayed.

In an effort to support education and foster the next generation on leaders, SIDM launched a new fellowship program focusing on diagnostic excellence and/or diagnostic error, announcing the inaugural class of fellows in July 2016.

With support from the Josiah Macy Jr. Foundation, the Inter-Professional Consensus Curriculum on Diagnosis and Diagnostic Error initiative is bringing together experts to refine education and training provided to clinicians, paving the way for improvements in patient safety.

Working with the Institute for Healthcare Improvement (IHI), SIDM and a number of healthcare organizations have developed a collective to test and develop tools and techniques to improve the safety of the diagnostic process.

SIDM’s Patients Improving Research in Diagnosis (PAIRED) project had its first face-to-face meeting Chicago, bringing together a cohort of Patient Partners with Research Mentors to integrating the patient and family voice into diagnostic research.

In June 2018, SIDM hosted a briefing on Capitol Hill to highlight very directly the human and financial toll of diagnostic error and opportunities to improve diagnostic safety and quality. Staffers from more than 50 congressional offices heard from SIDM experts, clinicians, and family members who have lost loved ones or experienced significant harm due to diagnostic error.

In 2018, SIDM launched ACT for Better Diagnosis, an initiative to make diagnosis more Accurate, Communicated, and Timely by engaging stakeholders through research, education, policy, and quality improvement. The effort goes to the heart of SIDM’s mission and our vision for the future: That everyone has a role to play in improving diagnosis.

In 2019, SIDM was awarded a $4.5 million grant from the Gordon and Betty Moore Foundation to launch the DxQI Seed Grant Program. The new program will engages healthcare organizations in efforts to identify, develop and test interventions aimed at improving diagnostic quality and reducing harm from diagnostic error. The program will support three annual grantee cohorts, awarding grants of up to $50,000 to test interventions to improve the quality, accuracy, and timeliness of diagnoses.

The worldwide COVID-19 pandemic marked 2020 as a year of unprecedented events. The pandemic made a substantial impact on our personal and professional lives as well as our nation and the world. 

However, the pandemic did not divert SIDM from its mission; it reaffirmed its urgency. Increased understanding of the role of diagnostic errors during the pandemic can spark needed change to systematically and effectively reduce harm. In 2020, SIDM led a research effort to learn about the successes, challenges, and unanswered questions in the use of telediagnosis. Additionally, SIDM continued its work of advocating for improved diagnosis by building new partnerships and leading changes that are critically needed—now and in the future. 

Thanks to the tireless work of the SIDM community and our partner organizations, the discussion around improving diagnosis has become more widespread in hopes that patients receive the care they need. While SIDM’s work is far from over, we are proud of what we have accomplished in our first 10 years.