Evolving a Healthcare System With a Coordinated Approach for Patient-Reported Measurement of Diagnostic Quality Comment on “Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens”

Document Type : Commentary

Author

Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, MD, USA

Abstract

Quality metrics for improving care are deeply embedded in healthcare systems. Patient-reported measures (PRMs) have now been implemented for many conditions and are a high priority for the Centers for Medicare and Medicaid Services (CMS).1 However, the development of PRMs specific to diagnostic quality remains largely exploratory. Early progress in acquiring and analyzing diagnostic PRMs reveals that patients offer a novel and valuable source of information about their diagnostic journeys. To fully understand and learn from patient experiences, work needs to include varied clinical settings, sites, and conditions. This work requires and deserves focused commitment and coordinated effort with a unifying strategic vision optimally facilitated by a national, or international, coordinating center. 

Keywords

References

  1. Bernheim SM, Rudolph N, Quinton JK, Driessen J, Rawal P, Fowler E. Elevating Quality, Outcomes, and Patient Experience Through Value-Based Care: CMS Innovation Center’s Quality Pathway. NEJM Catal Innov Care Deliv. 2024;5(5). doi:1056/CAT.24.0132
  2. Chung AE, Basch EM. Incorporating the patient's voice into electronic health records through patient-reported outcomes as the "review of systems.” J Am Med Inform Assoc. 2015;22(4):914-916. doi:1093/jamia/ocu007
  3. Stiglic G, Kocbek P, Fijacko N, Sheikh A, Pajnkihar M. Challenges associated with missing data in electronic health records: a case study of a risk prediction model for diabetes using data from Slovenian primary care. Health Informatics J. 2019;25(3):951-959. doi:1177/1460458217733288
  4. Bell SK, Delbanco T, Elmore JG, et al. Frequency and types of patient-reported errors in electronic health record ambulatory care notes. JAMA Netw Open. 2020;3(6):e205867. doi:1001/jamanetworkopen.2020.5867
  5. Bell SK, Bourgeois F, DesRoches CM, et al. Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care. BMJ Qual Saf. 2022;31(7):526-540. doi:1136/bmjqs-2021-013672
  6. Epstein HM, Haskell H, Hemmelgarn C, et al. The Patient's Role in Diagnostic Safety and Excellence: From Passive Reception towards Co-Design. Rockville, MD: Agency for Healthcare Research and Quality; 2024. AHRQ Publication No. 24-0010-8-EF.
  7. Data Analysis Reveals Common Errors That Prevent Patients from Getting Timely, Accurate Diagnosis. ECRI; 2024. https://home.ecri.org/blogs/ecri-news/data-analysis-reveals-common-errors-that-prevent-patients-from-getting-timely-accurate-diagnoses. Accessed November 12, 2024.
  8. Burke A, Hanscom R, Lambrecht A, Patel A, Small M. A Call for Action: Insights from a Decade of Malpractice Claims. Coverys; 2020. https://www.coverys.com/expert-insights/a-call-for-action-insights-from-a-decade-of-malpractice-claims. Accessed November 12, 2024.
  9. Johansen MB, Bendstrup E, Davidsen JR, Shaker SB, Martin HM. The diagnostic trajectories of Danish patients with autoimmune rheumatologic disease associated interstitial lung disease: an interview-based study. Eur Clin Respir J. 2023;10(1):2178601. doi:1080/20018525.2023.2178601
  10. van Nimwegen KJ, Schieving JH, Willemsen MA, et al. The diagnostic pathway in complex paediatric neurology: a cost analysis. Eur J Paediatr Neurol. 2015;19(2):233-239. doi:1016/j.ejpn.2014.12.014
  11. Castelo M, Sue-Chue-Lam C, Paszat L, et al. Time to diagnosis and treatment in younger adults with colorectal cancer: a systematic review. PLoS One. 2022;17(9):e0273396. doi:1371/journal.pone.0273396
  12. Dukhanin V, McDonald KM, Gonzalez N, Gleason KT. Patient reasoning: patients' and care partners' perceptions of diagnostic accuracy in emergency care. Med Decis Making. 2024;44(1):102-111. doi:1177/0272989x231207829
  13. Giardina TD, Choi DT, Upadhyay DK, et al. Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes. J Am Med Inform Assoc. 2022;29(6):1091-1100. doi:1093/jamia/ocac036
  14. Schlesinger M, Grob R, Gleason K, et al. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors. Volume 1: Why Patient Narratives Matter. Rockville, MD: Agency for Healthcare Research and Quality; 2023. AHRQ Publication No. 23-0040-2-EF.
  15. Schlesinger M, Grob R, Gleason K, et al. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors. Volume 2: Eliciting Patient Narratives. Rockville, MD: Agency for Healthcare Research and Quality; 2023. AHRQ Publication No. 23-0040-3-EF.
  16. McDonald KM, Gleason KT, Jajodia A, Haskell H, Dukhanin V. Achieving diagnostic excellence: roadmaps to develop and use patient-reported measures with an equity lens. Int J Health Policy Manag. 2024;13:8048. doi:34172/ijhpm.8048

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History

  • Receive Date: 15 November 2024
  • Revise Date: 17 April 2025
  • Accept Date: 20 April 2025
  • First Publish Date: 22 April 2025

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