Can the inefficiencies, wasted resources and costs associated with delayed or misdiagnosis be tolerated and absorbed in the new healthcare paradigm? As the health system migrates from fee-for-service to value-based purchasing arrangements such as ACOs, bundled payments and shared savings, providers are already bracing themselves to go to extraordinary lengths to coordinate and deliver care efficiently across settings to survive and stay in the black. While the national spotlight is focused on management of care for patients with known conditions, there is tremendous opportunity for quality and cost improvement associated with getting the diagnosis correct as soon as possible.
Missed or delayed diagnoses occur far too often. Approximately 15 to 30 percent of patients experience them, resulting in injuries, deaths, inappropriate treatments, malpractice lawsuits and higher costs. A recent survey of more than 6,000 physicians revealed 47 percent of clinicians encounter cases of diagnostic error at least monthly, and 96 percent of them believe those errors are preventable. Diagnostic decision support software can help hospitals and physicians at the point of need accomplish this mammoth changeover by getting to the correct diagnosis faster; moreover, these proven tools are invaluable, aiding physicians in making informed decisions, which can eliminate duplicate or unnecessary tests, wasted resources and costs expected to be absorbed under VBP.
Helping clinicians quickly determine the correct diagnosis the first time would significantly reduce those problems, right? The intent of clinicians is always to do the right thing and get the right diagnosis; however, in the world of fee for service, there is almost always a negative ROI in cases of delayed or misdiagnosis. Patients who are misdiagnosed are tolerable in this environment but unacceptable in an outcomes-based care delivery system that rewards quality and penalizes inefficient and wasteful clinical practices.
To illustrate what would happen if the right tools were used, simply picture a health system equipping physicians, who are part of its ACO, with online diagnostic decision support to facilitate efficient and timely decisions. The empowered clinician now has the capability to "think through" a differential to improve diagnosis accuracy, along with referral appropriateness. The tool is easily and quickly accessed as an integrated part of an EMR, a terminal, mobile device or physician portal — whether during rounds, at the bedside or off site — as part of the clinician's daily workflow.
Next, consider a real-life case where a patient is admitted with an unspecified diagnosis and nonspecific symptoms such as fever, fatigue and headaches. After three long days and tens of thousands of dollars in ordered tests and procedures, there is still no firm diagnosis. Using DDS, physicians run the patient's case through a diagnosis checklist tool that generates a differential list for consideration. A diagnosis that no one thought of pops up on screen. The patient is then tested and results confirm the diagnosis, cat scratch fever for instance, comes with a $60 lab test and antibiotics costing nearly the same. This case is a prime example of preventable costs and waste had the care team "thought through" all of the possibilities by way of using their expertise to apply probability for each to that patient.
This real-life example plus many others substantiates the financial value of DDS. It is unrealistic to expect providers to perform at peak levels without access to the right tools, which inevitably results in avoidable costs prone to erode already thin profit margins. Saving lives and managing costs begins with making the right diagnosis. It is imperative — and not optional — that clinicians be given affordable DDS tools as part of standard practice.
Don Bauman is CEO of Isabel Healthcare USA. He has 20-plus years of experience in healthcare software sales and marketing programs. Bauman has held rising executive positions at InformMed, LMS Medical, Cereplex Inc, Premier, Inc., Bridge Medical, McKesson, CliniCom and Community Health Computing.
Study: Clinical Decision Support Associated With Better Outcomes
Missed or delayed diagnoses occur far too often. Approximately 15 to 30 percent of patients experience them, resulting in injuries, deaths, inappropriate treatments, malpractice lawsuits and higher costs. A recent survey of more than 6,000 physicians revealed 47 percent of clinicians encounter cases of diagnostic error at least monthly, and 96 percent of them believe those errors are preventable. Diagnostic decision support software can help hospitals and physicians at the point of need accomplish this mammoth changeover by getting to the correct diagnosis faster; moreover, these proven tools are invaluable, aiding physicians in making informed decisions, which can eliminate duplicate or unnecessary tests, wasted resources and costs expected to be absorbed under VBP.
Helping clinicians quickly determine the correct diagnosis the first time would significantly reduce those problems, right? The intent of clinicians is always to do the right thing and get the right diagnosis; however, in the world of fee for service, there is almost always a negative ROI in cases of delayed or misdiagnosis. Patients who are misdiagnosed are tolerable in this environment but unacceptable in an outcomes-based care delivery system that rewards quality and penalizes inefficient and wasteful clinical practices.
To illustrate what would happen if the right tools were used, simply picture a health system equipping physicians, who are part of its ACO, with online diagnostic decision support to facilitate efficient and timely decisions. The empowered clinician now has the capability to "think through" a differential to improve diagnosis accuracy, along with referral appropriateness. The tool is easily and quickly accessed as an integrated part of an EMR, a terminal, mobile device or physician portal — whether during rounds, at the bedside or off site — as part of the clinician's daily workflow.
Next, consider a real-life case where a patient is admitted with an unspecified diagnosis and nonspecific symptoms such as fever, fatigue and headaches. After three long days and tens of thousands of dollars in ordered tests and procedures, there is still no firm diagnosis. Using DDS, physicians run the patient's case through a diagnosis checklist tool that generates a differential list for consideration. A diagnosis that no one thought of pops up on screen. The patient is then tested and results confirm the diagnosis, cat scratch fever for instance, comes with a $60 lab test and antibiotics costing nearly the same. This case is a prime example of preventable costs and waste had the care team "thought through" all of the possibilities by way of using their expertise to apply probability for each to that patient.
This real-life example plus many others substantiates the financial value of DDS. It is unrealistic to expect providers to perform at peak levels without access to the right tools, which inevitably results in avoidable costs prone to erode already thin profit margins. Saving lives and managing costs begins with making the right diagnosis. It is imperative — and not optional — that clinicians be given affordable DDS tools as part of standard practice.
Don Bauman is CEO of Isabel Healthcare USA. He has 20-plus years of experience in healthcare software sales and marketing programs. Bauman has held rising executive positions at InformMed, LMS Medical, Cereplex Inc, Premier, Inc., Bridge Medical, McKesson, CliniCom and Community Health Computing.
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