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Patient misdiagnoses likely to get worse without changes

Kathleen Blanchard's picture
IOM report highlights need for improving health care diagnostic mistakes

Most consumers of health care have at least one story to tell about how they have experienced an illness and were misdiagnosed. A new report highlights the urgency of finding ways to curb the incidence of diagnostic mistakes that researchers say will get worse unless changes are made urgently to reduce errors.


The answer to better health care, according to the researchers, is teamwork that includes communication among nurses, doctors, families, pathologists and radiologists.

The new report from the Institute of Medicine (IOM) of the National Academies of Sciences, Engineering, and Medicine highlights the prevalence of misdiagnosis that for patients could mean the difference between life and death.

The IOM is calling for a collaborative effort among health care providers as well as more research that they say will require change from “a variety of stakeholders”, including patients who are encouraged to learn how to effectively communicate with their health care provider and become a part of the diagnostic process.

John R. Ball, chair of the committee and executive vice president emeritus, American College of Physicians says to reduce the number of diagnostic mistakes made in the health care system it will be necessary to “look more broadly at improving the entire process of how a diagnosis made."

Misdiagnosis not always human error

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Ball says it isn’t always human error that leads to a patient getting a wrong diagnosis, nor is it accurate to expect a single physician to make a diagnosis.

The report is part of an IOM impetus to help improve health care outcomes for patients and is a part of the Institute of Medicine's Quality Chasm Series.

In 1999 the IOM released a report titled “To Err Is Human: Building a Safer Health System”. The report found that tens of thousands of patients die each year from mistakes made within the health care system. The result of the report has lead more attention toward patient safety and quality of care.

To Err is Human also highlighted just how difficult it is to effect change because of lack of reporting of health care mistakes. Since 1999 the IOM has produced 9 other reports.

The newest and tenth IOM report, titled “Improving Diagnosis in Health Care”, defines diagnostic mistakes as “failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.”

The IOM is encouraging the following changes to help protect patients from harm:

  • Better education of health care providers in the diagnostic processTeamwork that should include improved collaboration between patients, families and health care professionals.
  • Supporting health care professionals involved in the diagnostic process that places value on feedback and is “non- punitive”.
  • Improved health care technology to support patients and the diagnostic process
  • Implementation of tracking systems of diagnostic errors that would in turn enhance learning from mistakes.
  • Development and implementation of policies and procedures to identify and reduce the number of “near misses” and health care misdiagnoses.

The report also provides resources to patients to help better communicate symptoms to their health care provider that includes a checklist. Patients are encouraged to “take charge” of their health by becoming informed consumers, keeping good records and involving themselves in the diagnostic process.