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Responding to the troubling statistic that diagnostic errors lead to a death in U.S. hospitals every 9 minutes, AACC has joined a coalition of 40 healthcare and patient advocacy organizations led by the Society to Improve Diagnosis in Medicine (SIDM) to improve accuracy and timeliness of diagnosis through testing and other measures.
By taking part in the ACT for Better Diagnosis initiative, the groups have made a pledge to inform patients, clinicians, health systems and other stakeholders about the steps they can take to ensure accurate, communicated, and timely (ACT) diagnoses. In light of the tests clinical lab professionals conduct that provide crucial information for detecting, diagnosing, treating, and monitoring disease, laboratory medicine plays an important role in this initiative.
“Medicine—and diagnostic testing in particular—is a field that is growing at an incredible rate,” said AACC CEO Janet B. Kreizman. “Doctors and nurses with information overload need the expertise of laboratory medicine experts to ensure the latest advances in diagnostics are reaching patients at the right time. The ACT for Better Diagnosis initiative is a practical collaboration designed to help meet this need, and AACC is pleased to be a partner.”
The coalition cited a number of factors responsible for impeding diagnostic accuracy. These include: lack of measures and feedback on health system performance; lack of funding for research; limited support to help with clinical reasoning, and limited time of patients and providers to properly formulate a working diagnosis and set appropriate expectations. The complicated process of diagnosis itself is an obstacle that specifically resonates with labs.
“There is limited information available to patients about the questions to ask, or whom to notify when changes in their condition occur, or what constitutes serious symptoms. It’s also unclear who is responsible for closing the loop on test results and referrals, and how to communicate follow-up,” the coalition said in a statement. The new alliance is calling for a three-pronged approach, leveraging the use of federal funds to improve diagnostic accuracy:
- Create diagnostic excellence centers that use transdisciplinary team science to conduct diagnostic safety and quality research.
- Expand the pool of diagnostic researchers by investing in diagnostic fellowship training programs that train and foster early career scientists.
- Develop and validate measures of diagnostic processes and patient-centered diagnostic outcomes that could be used in quality improvement or research efforts.
AACC’s Lab Tests Online is an award-winning web resource that patients and caregivers could reference to help avoid diagnostic errors and gain a better understanding of the diagnostic process. Lab Tests Online publishes peer-reviewed education articles, including comprehensive lab test and related condition descriptions, news items, and feature articles to help patients better understand their lab tests, navigate the testing process, and discuss their results more clearly with their healthcare providers.
The launch of ACT for Better Diagnosis is timely in that the fiscal 2018 omnibus spending bill included language emphasizing the importance of improving medical diagnoses from a public health, professional, and moral perspective. The report accompanying the bill requested that “the Agency for Healthcare Research and Quality (AHRQ) convene a cross-agency working group to propose a strategy to enhance scientific research to improve diagnosis in healthcare.” It also recommended establishing public-private partnerships and centers to encourage research on diagnostic safety and quality.
Other participating organizations vowed to support accurate and timely diagnosis. “Providing an accurate medical diagnosis is complex and involves uncertainty, but it’s obviously essential to effective and timely treatment,” said Paul L. Epner, chief executive officer and co-founder of SIDM. “Nearly everyone will receive an inaccurate diagnosis at some point in their life and for some, the consequences will be grave,” Epner said. “Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients.”
“Quality patient care is at the core of family medicine,” said Michael Munger, MD, president of the American Academy of Family Physicians. “Continuity of care, practicing evidence-based medicine and accurate diagnosis are tenets that family physicians are committed to and always improving upon.”