Medical errors are the third leading cause of death in the U.S. However, due to some other headline-grabbing transformations within the healthcare industry – MACRA, insurance megamergers and digital health coming to the fore, for example – how to address medical errors can sometimes be a discussion that receives less attention than it deserves.
At the U.S. News and World Report's 2016 Healthcare of Tomorrow conference last week, Johns Hopkins Hospital President Dr. Redonda Miller sat down with Healthcare Dive to discuss how to reduce medical errors, which she tied to quality measures and physician burnout.
Tackling the issues of too many metrics and reported employee burnout could in turn help reduce medical errors, Miller says. Johns Hopkins recently launched a center – the Armstrong Institute Center for Diagnostic Excellence – targeted at reducing diagnostic errors as it should be considered a top priority for the entire industry, Miller says.
What's at stake
A recent ECRI Institute analysis shows patients are frequently misidentified for procedures or other actions that result in deadly consequences. A larger patient volume as well as interoperability and data sharing issues are perpetuating preventable medical errors. No care provider is immune of committing them, the nonprofit organization reports.
Why the launch?
Miller argued the amount of patient documentation physicians endure is an issue that's cause for concern. If more physicians engaged in regulatory processes and more of them provided feedback on proposed regulations, that could lead to regulatory wins for operations and result in reduced burnout, she added.
“I have a small practice and I spent an hour on the phone the other day trying to make sure a medication had been approved for my patient that he had been taking for 10 years,” she said. “Same dose, same medication, same amount, but his insurer changed and I had to justify it. The payer shifted the work to the provider.”
Burnout could potentially lead to misdiagnosis
“Misdiagnosis is incredibly frequent because medicine is incredibly hard. There’s uncertainty, complexity and incomplete information all the time,” Dr. David Newman-Toker, Johns Hopkins associate professor of neurology and otolaryngology who will be leading the new center, said in a prepared statement. “But we can do better than we’re doing right now, and our new center will lead change to make that a reality.”
The Armstrong Institute Center for Diagnostic Excellence, which materialized with the help of a $5 million grant, will “enhance diagnostic accuracy, cut waste on unnecessary diagnostic testing and move the needle on eliminating preventable harms from diagnostic errors worldwide,” according to the announcement. It will include a multidisciplinary team of physicians, nurses, allied health professionals and scientists from Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center campuses.
What the plans are
To reduce diagnostic errors, Miller says they are hoping to harness data and predictive modeling. The goal is to analyze patient data and accurately predict health complications. These errors are important quality metrics, according to Miller, as missing something can be devastating to a patient.
The focus will be at first on preventing stroke misdiagnosis in five emergency departments across the Johns Hopkins Health System. Ultimately, Johns Hopkins hopes to reduce episodes of stroke by 50% within the next five years.