Baylor College of Medicine

Baylor, Geisinger work to improve diagnostic performance

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Dr. Hardeep Singh
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Although recent studies show that misdiagnosis affects at least one in 20 U.S. adults each year, health systems have yet to develop a systematic approach to measure and improve diagnostic performance. Researchers from Baylor College of Medicine, in collaboration with Geisinger, have been awarded a grant to develop a novel program to systematically measure and improve safety of clinical diagnosis, which they have named “The Safer Dx Learning Lab.”

“I often get asked how health systems can reduce errors in diagnosis and use our emerging research findings to improve patient safety. Developing the Safer Dx Learning Lab offers us a perfect opportunity to work with health system leaders and clinical teams to translate research into meaningful care improvements,” said principal investigator, Dr. Hardeep Singh, 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.

To create this first of its kind learning lab, Singh and his multidisciplinary team have partnered with Geisinger, a pioneering integrated healthcare system known for its work in improving healthcare quality.

“We have developed a Committee to Improve Clinical Diagnosis to target vulnerabilities in the diagnostic process and sustain a culture of diagnostic excellence,” said Dr. Dennis Torretti, associate chief medical officer at Geisinger Medical Center in Danville, Pa. “We are enthusiastic about this new partnership with Dr. Singh’s team and believe our combined efforts will yield additional insight and approaches to the problem of diagnostic error.”

The partnership will be facilitated by a “Safer Dx Researcher-in-Residence,” who will act as a catalyst connecting the research team in Houston and the clinical operations team on the ground at Geisinger.

In 2015, the National Academies of Medicine (formerly Institute of Medicine) released a landmark report Improving Diagnosis in Health Care that concluded “most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.” It also recommended health systems to develop approaches to “identify, learn from, and reduce diagnostic errors and near misses in clinical practice.” The lab will build upon this recommendation and conduct a portfolio of activities to create a learning health system for improving diagnosis.

In addition to analyzing data on missed diagnostic opportunities by leveraging Geisinger’s robust electronic health record data warehouse, the team will evaluate how best to gather diagnostic safety concerns directly from patients and clinicians. Lessons learned will be translated to solutions that can be implemented to improve care delivery related to the diagnostic process.

Singh adds that their research also will focus on estimating the cost of these missed opportunities. Understanding the economic benefits associated with making safer, accurate and timely diagnoses could provide further stimulus for efforts to reduce diagnostic errors across many health systems, something that has been slow to get off the ground.

“Tools, strategies, innovations and lessons from this project would enable other health systems to learn from our experience and help scale up this program to other sites in the future,” said Singh, who is also a recipient of the 2012 Presidential Early Career Award for Scientists and Engineers for his work on patient safety and diagnostic errors.

The learning lab will be made possible by a three-year, $3.5 million grant from the Gordon and Betty Moore Foundation. This grant is part of the foundation’s Patient Care Program which aims to improve the experience and outcomes people have with their care. Currently, the program is exploring patient safety and serious illness care related concerns.

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