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Related Experiment Videos

Identifying diagnostic errors in primary care using an electronic screening algorithm.

Hardeep Singh1, Eric J Thomas, Myrna M Khan

  • 1Division of Health Policy and Quality, Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, 2002 Holcombe Boulevard, Houston, TX 77030, USA. hardeeps@bcm.tmc.edu

Archives of Internal Medicine
|February 14, 2007
PubMed
Summary
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Computerized screening of electronic health records can identify potential diagnostic errors in primary care. This method shows promise for improving patient safety by flagging cases for review.

Area of Science:

  • Medical informatics
  • Patient safety
  • Primary care research

Background:

  • Diagnostic errors are a leading cause of malpractice claims in primary care.
  • These errors are currently underidentified and understudied.
  • Computerized screening methods, successful for other error types, have not been applied to diagnostic errors.

Purpose of the Study:

  • To assess the feasibility of using computerized screening to identify diagnostic errors in primary care.
  • To categorize diagnostic breakdowns using a novel taxonomy.

Main Methods:

  • An algorithm screened electronic medical records from a closed healthcare system.
  • Screening criteria included primary care visits followed by hospitalization or additional healthcare visits within 10 days.

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  • Two independent reviewers validated the presence of diagnostic errors in screened records.

    • Main Results:

    • Diagnostic errors were found in 16.1% of visits screened by criterion 1 and 9.4% by criterion 2.
    • The error rate in control cases was 4%.
    • Common errors involved information elicitation, data interpretation, and urgency assessment.

    Conclusions:

    • Electronic screening is a feasible method for identifying potential diagnostic errors in primary care.
    • Its performance is comparable to screening tools for other error types.
    • Further validation in diverse settings is recommended for developing improvement initiatives.