The American College of Physicians (ACP) is part of a coalition of more than 40 health care and patient advocacy organizations to launch a targeted effort to improve the quality of medical diagnosis. Researchers estimate that up to 80,000 deaths a year in US hospitals can be attributed to inaccurate or delayed diagnoses.

ACT for Better Diagnosis™, an initiative of the Society to Improve Diagnosis in Medicine (SIDM), aims to improve the diagnostic process by calling on organizations to identify and spread practical steps to better ensure diagnoses are Accurate, Communicated, and Timely.

“The diagnostic process—thinking through a patient’s clinical presentation—is a defining task for our profession, and for internal medicine specialists and subspecialists in particular,” said ACP President Dr. Ana María López. “Critically assessing diagnostic decision-making reveals knowledge gaps, communication pitfalls, and risk for errors.”

To improve diagnostic skills, ACP offers learning opportunities focused on diagnostic reasoning, tools, and techniques as well as clinical practice and public policy recommendations.

“Providing an accurate medical diagnosis is complex and involves uncertainty, but it’s obviously essential to effective and timely treatment,” said Paul L. Epner, CEO and co-founder of SIDM. “Nearly everyone will receive an inaccurate diagnosis at some point in their life and for some, the consequences will be grave. Major improvement is needed to systematically identify how to improve diagnostic quality and reduce harm to patients.”

Each year, diagnostic errors affect 12 million adults in outpatient settings and is the most common cause of medical errors reported by patients. Working in collaboration over several months, ACP worked with members of the SIDM-led Coalition to Improve Diagnosis to identify a number of obstacles believed to impede diagnostic accuracy, including:

•Incomplete communication during care transitions
•Lack of measures and feedback
•Limited support to help with clinical reasoning
•Limited time
•The diagnostic process is complicated
•Lack of funding for research

The organizations behind the effort—representing clinicians, patients, health systems, researchers, and testing professionals—acknowledge that improvement will require sustained effort from engaged stakeholders over several years.

Members of the coalition, including ACP, will act to improve the accuracy and timeliness of diagnosis by implementing specific tactics. Some will provide online tools that help physicians recognize and avoid diagnostic pitfalls, whereas others are working to improve medical education for new doctors and nurses. Others are developing tools that empower doctors, patients, and caregivers to communicate test results in plain language.

The FY 2018 Omnibus Appropriations Act included language emphasizing that improved diagnosis is a “moral, professional, and public health imperative” and requested that “the Agency for Healthcare Research and Quality (AHRQ) convene a cross-agency working group to propose a strategy to enhance scientific research to improve diagnosis in health care.” The report also recommended including consideration of opportunities for public-private partnerships and the development of centers of excellence to propel research forward to improve diagnostic quality and safety.