Twenty years ago last month the National Academy of Sciences published the landmark report, “To Err Is Human, Building a Safer Health System.” The report found upwards of 98,000 people die each year in hospitals alone as a result of medical errors. One specific medical error, diagnostic error, was, and remains today, a substantial contributor. Defined as a wrong, delayed or missed diagnosis, misdiagnoses continue to constitute a major public health problem, adversely affecting more than 12 million annually. Approximately one-third of whom are seriously harmed and an estimated 40,000 to 80,000 die each year from diagnostic failures in hospitals alone. Resulting costs are estimated over $100 billion annually. Despite the problem's pervasiveness and dire effects, the federal government spends less than $10 million annually researching the problem. (For perspective, the 2019 NIH budget was $39 billion.)
During this 30 minute conversation, Mr. Epner briefly describes the Society to Improve Diagnosis in Medicine's activities, discusses the use/non-use of autopsies in reducing diagnostic errors, the extent to which improved imaging technology is reducing errors and the extent to which this issue is a disparities problem. He, moreover, discusses efforts to increase funding to address the problem, needed payment reforms, efforts to identify related quality performance measures and recently introduced legislation to improve funding and research.
Mr. Paul L. Epner, MBA, is the Chief Executive Officer and Co-founder of the Society to Improve Diagnosis in Medicine (SIDM). He is also Chair of the Coalition to Improve Diagnosis, a collaborative with more than fifty of the country’s leading healthcare societies, health systems, patient organizations, and organizations focused on improving quality. He recently was named to the National Steering Committee for Patient Safety. Mr. Epner is a Past President of the Clinical Laboratory Management Association (CLMA) where he also created the Increasing Clinical Effectiveness (ICE) initiative. He was recently a member of the CDC’s “Clinical Laboratory Integration into Healthcare Collaborative” and a consultant to their Laboratory Medicine Best Practices program (an evidence-based practice initiative). Mr. Epner is an Associate Editor for the peer-reviewed journal, Diagnosis.
Information on SIDM is at: https://www.improvediagnosis.org/.
The 2015 National Academy of Sciences expert committee report noted during this interview, "Improving Diagnosis in Health Care," is at: http://www.nationalacademies.org/hmd/Reports/2015/Improving-Diagnosis-in-Healthcare.
Recently introduced legislation to address misdiagnoses, i.e., the "Improving Diagnosis in Medicine Act of 2019" (HR 5014), is at: https://www.congress.gov/search?q=%7B%22congress%22%3A%22116%22%2C%22source%22%3A%22legislation%22%2C%22search%22%3A%22HR%205014%20%22%7D&searchResultViewType=expanded.
SIDM's Paul Epner Discusses the Pervasive Problem of Medical Misdiagnoses (December 3rd)