Digital Health Safety Surveillance: Improving Patient Support Throughout the Diagnostic Trajectory

Area of Science:

• Patient Safety
• Health Equity
• Diagnostic Error Reduction

Background:

• Missed and delayed diagnoses pose critical patient safety risks, disproportionately impacting minority populations.
• There is a significant need for improved diagnostic safety strategies.
• Addressing diagnostic errors is crucial for equitable healthcare outcomes.

Purpose of the Study:

• To evaluate the impact of Parkland Health's Safety Net Surveillance (SNS) program on diagnostic follow-up.
• To assess the program's effectiveness in managing high-risk diagnostic scenarios and reducing care disparities.
• To determine the program's role in improving patient outcomes and addressing diagnostic errors.

Main Methods:

• Established a centralized digital Safety Net Surveillance (SNS) program in response to a sentinel event.
• Expanded the program to track six high-risk diagnostic scenarios, including delayed radiology follow-up.
• Integrated bilingual staff, motivational interviewing, social worker support, and EHR workflows for comprehensive patient guidance.

Main Results:

• Follow-up scan completion improved from 41.3% to 96.6% for radiology findings.
• The program successfully managed high-risk cases, with 3.1% requiring surgery and 4.3% diagnosed with cancer.
• Addressed diagnostic inequities, serving a high proportion of Spanish-speaking patients, women, and those from disadvantaged communities.

Conclusions:

• Parkland Health's SNS program significantly enhanced the identification and management of missed/delayed diagnostic follow-up.
• The program's comprehensive patient support model offers a replicable strategy for healthcare organizations to address diagnostic errors and care disparities.
• The SNS program demonstrates a successful approach to improving diagnostic safety and health equity.