Abstract
Diagnostic errors are poorly understood despite being a frequent cause of medical errors. Recent efforts have aimed to advance the "basic science" of diagnostic error prevention by tracing errors to their most basic origins. Although a refined theory of diagnostic error prevention will take years to formulate, we focus on communication breakdown, a major contributor to diagnostic errors and an increasingly recognized preventable factor in medical mishaps. We describe a comprehensive framework that integrates the potential sources of communication breakdowns within the diagnostic process and identifies vulnerable steps in the diagnostic process where various types of communication breakdowns can precipitate error. We then discuss potential information technology-based interventions that may have efficacy in preventing one or more forms of these breakdowns. These possible intervention strategies include using new technologies to enhance communication between health providers and health systems, improve patient involvement, and facilitate management of information in the medical record.
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Acknowledgments
We acknowledge Dr. Richard Street, PhD, Head, Department of Communication, Texas A&M University and Chief, Health Decision-Making and Communication Program at the Houston Center for Quality of Care and Utilization Studies, for his thoughtful insights about an earlier version of this manuscript, and Annie Bradford for her assistance with technical writing.
Conflict of Interest
None disclosed.
Funding
This work was supported by Grant Number K23CA125585 from the National Cancer Institute to Dr. Singh.
Dr. Naik is supported by the National Institute of Aging (NIH K23AG027144).
Dr. Petersen was a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar (grant number 045444) at the time this work was completed and is a recipient of the American Heart Association Established Investigator Award (grant number 0540043N).
This article is the result of work supported with resources and the use of facilities at the Houston Center for Quality of Care & Utilization Studies, The Center of Inquiry to Improve Outpatient Safety through Effective Electronic Communication and Michael E. DeBakey Veterans Affairs Medical Center.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institutes of Health, or the Department of Veterans Affairs.
None of the funding sources had any role in the preparation, review, or approval of the manuscript.
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Singh, H., Naik, A.D., Rao, R. et al. Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology. J GEN INTERN MED 23, 489–494 (2008). https://doi.org/10.1007/s11606-007-0393-z
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DOI: https://doi.org/10.1007/s11606-007-0393-z