Most people in the U.S. will experience at least one misdiagnosis or delayed diagnosis in their lifetimes, according to a new report from the Institute of Medicine (IOM). Such mistakes—called diagnostic errors by physicians—could be as simple as failing to forward the results of a medical test showing that a patient recovered from a recent illness. Other errors can have devastating consequences: Perhaps a lung scan that reveals potentially cancerous tissue never makes it to a doctor’s desk where it could receive further scrutiny. If the patient and health care provider discovered lung cancer, the patient could have received earlier treatment that might have saved his or her life.
Researchers know very little about the full extent of such errors or how to fix them. But they are pervasive—and deadly. Investigations over several decades have indicated that diagnostic errors contribute to around 10 percent of patient deaths. Recent work also concluded that some 5 percent of U.S. adults who seek outpatient care experience a diagnostic error—and that is a conservative estimate.
A health advisory committee with the private, nonprofit IOM is now calling for that to change. In a new September 22 report the group of experts recommends that federal agencies, including the Health and Human Services, Veterans Affairs and Defense departments, develop a coordinated research agenda on the diagnostic process and diagnostic errors by the end of 2016.
The committee’s work builds on a 1999 IOM report that found up to 98,000 people a year die because of mistakes in hospitals. One respected estimate projected that medical errors nowadays could contribute to as many as 210,000 to 440,000 patient deaths annually.
To help avoid diagnostic errors going forward, the new IOM recommendations call for more medical school and continuing education training in making diagnoses and communicating them to patients. Medical providers can also help avert such problems by ensuring that patients have access to their electronic medical records and know how to read them.
More broadly, employers and federal agencies should encourage the reporting of diagnostic errors or “near misses” to help everyone learn about how to avoid them, the report notes. “Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated,” wrote report Chair John Ball, executive vice president emeritus of the American College of Physicians, along with his colleagues. “Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity.”