How decision support tools could address the malpractice “crisis”

How decision support tools could address the malpractice “crisis”

I’m a big advocate of decision support tools like SimulConsult and Safemed, which can help doctors make better diagnoses and treatment decisions. A new analysis of closed malpractice cases provides powerful ammunition for more widespread use of such tools.

From the Boston Globe (Basic errors hurt patients):

Basic errors made by doctors, including tests ordered too late or not at all and failure to create follow-up plans, played a role in nearly 60 percent of cases in which patients were allegedly hurt by missed or delayed diagnoses, a study [in the Annals of Internal Medicine] found.
[M]ost claims involved several factors;… major ones included mistakes by doctors: failure to order appropriate diagnostic tests (100 cases); failure to create a proper follow-up plan (81); failure to obtain an adequate history or perform an adequate physical examination (76); and incorrect interpretation of tests (67).

The study’s lead author, Dr. Tejal K. Gandhi, director of patient safety at Brigham and Women’s Hospital , said the research shows that doctors could use more help in making decisions…

“I don’t want to say that it’s not the physician’s responsibility,” Gandhi said. “We think there could be tools to help physicians make these decisions better.”

When errors in diagnosis and treatment occur, people often conclude that doctors should know more about the disease in question. That’s part of the solution, but as Dr. Gandhi points out there also needs to be more focus on tools to help the doctor, not just piling more information on the doctor and encouraging the doctor to order more tests.

October 3, 2006

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