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The Greatest Hits of 2019 The year’s news about lab and diagnostics The year 2019 has been full of lab- and diagnostics-

Diagnostic errors

related news. Some developments point to a future far away – others right at hand. In either case, they offer points of conversation to share with customers.

A study published in the journal Diagnosis in March found that diagnostic errors remain the most common, most catastrophic, and most costly of serious medical errors in closed malpractice claims. Researchers examined over 55,000 closed claims and 11,600 diagnostic error cases, and found that the Big Three diseases – vascular events, infections and cancers – accounted for 74.1 percent of high-severity cases (22.8 percent vascular events, 13.5 percent infections and 37.8 percent cancers). The most frequent disease in each category, respectively, was stroke, sepsis and lung cancer.

Artificial intelligence and the lab AI was one of the biggest stories of the year. For example, in July, Paige, a New York-based pathology company, announced that a study had found that its computational decision-support systems can help clinicians diagnose and treat cancer. That same month, Geisinger and its Steele Institute for Health Innovation announced it would collaborate with Medial EarlySign (Tel Aviv, Israel) to implement machine learning technology to identify individuals at risk for a range of chronic and high-burden diseases, such as significant lower gastrointestinal disorders. Meanwhile, researchers in a study funded by the National Institutes of Health said they demonstrated the effectiveness of using algorithms that analyze electronic health records to help physicians identify patients at risk for HIV who may benefit from preexposure prophylaxis. But will AI ever make it to the physician’s office? “My impression is that it COULD help in identifying ‘best practice’ treatment for complicated diseases, such as most cancers and also the expanding array of lipid markers,” says lab expert and Repertoire contributor Jim Poggi. “I imagine a day where, as a first step, the physician enters a presumptive diagnosis or set of symptoms and the expert AI system suggests a more refined diagnosis and offers a suite of tests to confirm it. Then, either the outside lab or the POL performs these tests and inputs the results, and the output confirms the diagnosis and suggests best practice course of treatment, assuming one exists.”

“Providers have begun relying on the electronic health record to help with clinical decision support, to track test results, and to flag issues. However, the EHR is only part of the solution.” Meanwhile, ECRI Institute identified “diagnostic stewardship and test result management using EHRs” as one of its Top Ten Patient Safety Concerns of 2019. “When diagnoses and test results are not properly communicated or followed up, the potential exists to cause serious patient harm or death,” writes ECRI in its annual report. “Providers have begun relying on the electronic health record to help with clinical decision support, to track test results, and to flag issues. However, the EHR is only part of the solution. “To help ‘close the loop,’ providers must not only fully utilize an EHR designed to meet their practices’ unique needs, but also recognize the importance of clear communication, both among caregivers and between caregivers and patients.”

October 2019


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