The Gordon and Betty Moore Foundation will direct $85 million over the next six years to help doctors and hospitals minimize diagnostic errors.
Inaccurate explanations for patients’ health problems cause at least 40,000 deaths a year and are the most common cause of medical errors identified by patients, according to a 2015 report by the National Academy of Medicine. Moore’s Diagnostic Excellence Initiative will focus on heart problems and cancers, maladies that are responsible for a disproportionate number of preventable deaths because of misdiagnoses, the foundation said.
Many doctors have stories about making the wrong call.
For Daniel Yang, a Moore program fellow, it came one night a few years ago when he was working in the San Francisco VA hospital emergency room. A patient came in with a sore shoulder that had gotten progressively more painful. Yang’s diagnosis seemed to confirm a report from another doctor: that the patient, a carpenter, had a job-related injury. Yang told him to follow up with an orthopedist and get an MRI and sent him home.
About a month later, a colleague at the hospital called with bad news. The carpenter was undergoing palliative chemotherapy for late-stage lung cancer that had metastasized to his shoulder.
“I felt terrible,” he says.
Invisible Errors
Making the wrong call in the examination room is just part of the problem, Yang says.
If his colleague hadn’t followed up to ask about the patient, Yang wouldn’t have given it a second thought. As far as he knew, the hospital hadn’t investigated, and there was no registry to note that a potentially improper diagnosis had been made.
“To this day, I’d have no idea that the shoulder pain was not a rotator-cuff injury,” Yang says. “These errors are mostly invisible to health-care systems.
Data Collection
The initial grants in the program will go to health-care systems to improve their data collection to identify where they need to improve patient diagnoses. The foundation will assist hospitals as they come up with ways to quantify their performance and work to compare results among different health-care systems.
Last year it made a $3.5 million grant to Baylor College of Medicine to see how hospitals could do better. Working with the Geisinger Health System, Baylor aims to create a “Safer Dx Learning Lab” by 2020. The lab will collect data from electronic health records, patient surveys, and confidential reports from clinicians to try to better understand where patient evaluations have fallen short.
Yang says it can be uncomfortable for a health system to investigate its weaknesses, but the intent isn’t to shame.
“By bringing greater awareness and giving hospitals a sense of how they’re doing, we hope we’ll motivate them and direct them to how to improve their processes,” he says.
The new funding area is the second part of a broader patient-care effort at Moore. The first was a $167 million, 12-year Betty Irene Moore Nursing Initiative to support patient safety in Northern California.
