Dr. Hardeep Singh and his Houston VA Patient Safety Center team are the recipients of the 2016 VA Health Services Research and Development Health System Impact Award, which honors VA-funded research that has directly and significantly impacted clinical practice or policy within the VA health care system. Singh is chief of the Health Policy, Quality and Informatics Program at the Houston VA Center for Innovations in Quality, Effectiveness and Safety and associate professor of medicine at Baylor College of Medicine.
The team’s research, aimed at reducing missed and delayed diagnoses, has impacted patient safety in the VA outpatient setting by strengthening communication and follow-up of test results, identifying and reducing diagnostic errors and refining use of the VA Computerized Patient Record System. The team has developed “trigger tools” to identify patients with missed or delayed follow-up of test results, safety assessment guides for electronic health records and decision-support software to improve patient follow-up.
This research has gained national and international recognition and established Singh and his team as a global leader in patient safety and diagnostic error reduction. The 2015 Institute of Medicine (now the National Academies of Sciences, Engineering and Medicine) report, “Improving Diagnosis in Healthcare,” was heavily influenced by several of the team’s publications in its description of what is known about diagnostic error and recommendations to improve the diagnostic process. Additionally, the team’s work has had tremendous impact on the public and has been highlighted by the New York Times, Washington Post, U.S. News & World Report and Wall Street Journal.
“Diagnosis is one of the most important tasks performed by physicians,” said Singh. “It is gratifying to do research that aims to make a difference in patient outcomes and improves the system in which we practice. We are grateful that our work has received such an honor.”
At the VA, he recently co-developed the national policy and guidance on communication of test results to patients and providers, now in place at all 150-plus VA facilities and impacting care for millions of veterans.
Singh and his Houston VA Patient Safety Center team are part of the Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, based at the Michael E. DeBakey VA Medical Center and Baylor College of Medicine. Established in 2007, the Patient Safety Center includes experts from cognitive psychology, computer science, human factors engineering, social sciences, internal medicine and clinical informatics and has the support of the VA National Center for Patient Safety.
Through several multidisciplinary research projects, the team has examined many cognitive and systems factors related to improving diagnosis. Together, they developed computerized algorithms to allow identification of patients at risk of having delayed diagnoses for various forms of cancer and several toolkits and strategies to help clinicians safely manage diagnostic test results.
The imperative of improving the safety of the diagnostic process is now an international one. The World Health Organization recently recognized diagnostic errors as a high-priority problem in primary care and invited Singh to help develop a guidance document on the topic. Singh recently led an article in BMJ Quality & Safety, “The Global Burden of Diagnostic Errors in Primary Care,” which recommended that WHO convene relevant leaders, experts, policymakers and clinicians to address the common challenges and opportunities to reduce diagnostic error.
Singh has received considerable national recognition for his work, receiving the AcademyHealth Alice S. Hersh New Investigator Award for high-impact research in 2012 and the Presidential Early Career Award for Scientists and Engineers from President Obama in 2014.