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Vital Signs Blog

Group looks to IOM to help reduce diagnosis errors

It's not easy to start a movement, but a new group of physicians and healthcare researchers are hoping to do so. They are looking to the Institute of Medicine to bolster their efforts to reduce diagnosis errors that lead to delayed or inappropriate treatments.

“It's affecting hundreds of thousands of people a year, but it gets very little attention from healthcare organizations and physicians in general,” said Dr. Mark Graber, founder and president of the Society to Improve Diagnosis in Medicine. “We haven't encountered any pushback, it's more just apathy.”


While some recent studies have garnered attention by highlighting the link between successful malpractice lawsuits and diagnosis error, Graber and his colleagues think a comprehensive report by the Institute of Medicine is what is needed to put the issue on the patient-safety radar.

“If the Institute of Medicine says this is important, the Joint Commission and other organizations will give it more consideration,” said Graber, a healthcare quality and outcomes senior fellow at RTI International, a research institute based in Research Triangle Park, N.C.

Graber said his commitment to the issues comes from his experiences during 20 years at the Department of Veterans Affairs Medical Center in Northport, N.Y.

“I saw many of these errors first hand—many were my own,” he said. “It just seemed that there were too many of them and it was a problem that was not getting attention.”

Graber said he looked around and “found a dozen people” who were also interested, and they met in 2006 in Naples, Fla. The meeting led to annual conferences including the first in Phoenix in 2008 and the most recent, held last month in Chicago.

Graber said the group hopes to raise awareness and engage stakeholders such as physicians, medical educators, payers and the “diagnostic industry.” (Graber and others have noted the lack the lack of “trigger tools” in electronic health records to identify patients at high risk for diagnostic errors.)

In an effort to move the focus of the issue beyond an annual conference, the Society to Improve Diagnosis in Medicine was formally organized in 2011.

Now the focus is on getting the IOM to produce a report on the topic as an extension of its Quality Chasm series, which started with its landmark 2001 report Crossing the Quality Chasm: A New Health System for the 21st Century.

A representative from the IOM could not be reached for comment (most federal employees remain sidelined by the budget stalemate), but according to Graber, the IOM National Research Governing Board's executive committee approved the idea last month—though securing funding will be required.

Most IOM reports are requested by Congress and accompanied by an appropriation, but the IOM also considers requests from other sources if funding is available.

In his president's report on the SIDM website, Graber wrote that the cost of the report will be more than $1.3 million. So far, $695,000 has been raised. He credited contributions from the HHS Agency for Healthcare Research and Quality and an organization called the Cautious Patient Foundation for helping the effort get that far.

Graber said that “there's been steady progress” toward reaching the target.

Follow Andis Robeznieks on Twitter: @MHARobeznieks






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