The PRIDx framework to engage payers in reducing diagnostic errors in healthcare

Area of Science:

• Healthcare policy
• Patient safety
• Health systems research

Background:

• Diagnostic errors are a significant patient safety concern.
• Existing frameworks for payer-provider collaboration on diagnostic safety are lacking.
• Engaging payers is crucial for implementing effective diagnostic safety initiatives.

Purpose of the Study:

• To develop a comprehensive framework, Payer Relationships for Improving Diagnoses (PRIDx), to guide payer-provider collaboration on diagnostic safety.
• To identify strategies for payers and providers to jointly create and implement incentives for improving diagnostic safety.
• To establish a structured approach for engaging payers in diagnostic safety improvement efforts.

Main Methods:

• A thorough literature review was conducted to identify existing knowledge and gaps.
• Interviews with subject matter experts were performed to gather insights and refine the framework.
• The PRIDx framework was developed based on the synthesis of literature and expert feedback.

Main Results:

• The PRIDx framework offers a multi-component approach to diagnostic safety.
• It conceptualizes the link between diagnostic safety and care provision.
• It outlines methods for payer and provider engagement in accountability mechanisms and data analytics.

Conclusions:

• The PRIDx framework provides a actionable model to encourage payers to improve diagnostic safety.
• Successful implementation necessitates novel partnerships and provider incentives that respect professional autonomy.
• PRIDx can foster collaborative strategies, research, policy development, and innovations in payer engagement for diagnostic safety.