Accurate Diagnosis: The Conduit for Value-Based Care

by Siemens Healthineers on May 26, 2016

By: David Fisher, Head of Global Policy and Government Affairs at Siemens HealthineersDavid_Fisher.jpg

Our changing healthcare system requires all of us to change along with it. Just as medical device manufacturers have to adjust to increased scrutiny of value, so do hospitals, physicians and health IT manufacturers need to modify based on the new environment. This is especially true regarding diagnostic accuracy.

In my mind, no healthcare dollar is wasted more than one spent to cure the wrong disease. Shouldn’t we focus on using every tool in our arsenal to get a diagnosis right? Frankly, there has never been a better time to focus on the science of diagnosis. Put plainly, highly accurate diagnosis is a sure path to more efficient, value-based care. And as the healthcare economy transitions from fee-for-service to value-based systems, we have an unprecedented opportunity to harness cutting-edge medical technology – from lab diagnostics, to medical imaging, to HIT – to develop new solutions for cost savings and superior patient satisfaction.

The fact is that the steady shift from volume to value will increasingly demand accountable tools and programs that reduce waste, save time and offer patients unfettered access and understanding of their health needs. This means that medical professionals need better tools to determine what is valuable and what is wasteful. Health information technology – as the binding system that connects patient status to healthcare delivery – has a crucial role to play in this new environment.

Here are two areas where I see the most potential:

Knowing when we are right
According to a recent study cited in Fierce Healthcare, doctors make 12 million outpatient diagnostic errors each year – roughly a 95% accuracy average. This is good, but it’s not great and the result causes patient suffering and a mountain of unnecessary spending. In this new era, where medical professionals are being held to a higher standard than ever, shouldn’t our system strive for more? We should shed more light on diagnosis and misdiagnosis by measuring diagnostic performance. Luckily, healthcare leaders across the country have begun to put forward plans to address and quantify misdiagnosis and waste.

One simple initiative, for instance, has been the implementation of care checklists to reduce duplication of services, eliminate errors, and also create new standards for testing procedures. Similarly, the Institute of Medicine issued the report, "Improving Diagnosis in Healthcare" that outlined eight strategies that all healthcare stakeholders can follow to prevent widespread clinical errors. These types of precautions signal how accuracy in diagnostics will soon also infiltrate the HIT sector. The more data that exists to highlight quality care and accurate diagnosis, the more doctors will rely upon the strongest tools and systems that are designed to avoid misdiagnosis.

Furthermore, there is tremendous new opportunity to improve accuracy and lower misdiagnosis under the payment bundling system introduced by the Affordable Care Act. Currently, the system is focused on bundles based on treatment; but what if we created bundles based on condition? By including the diagnostic process under the umbrella of the bundle, we create new incentives to get the diagnosis correct and a better system to track precisely how correct diagnoses are achieved.

Bigger data, better diagnosis
The other area I find really exciting is the opportunity for wider and more specialized – and therefore more accurate – consultation in the era of big data. New software that enhances navigation of patient data presents new opportunities to analyze wider data sets and seek outside counsel. Of course, patient privacy protocols here will be essential, but the opportunities this opens up to address the misdiagnosis problem are just enormous. We applaud new innovations and tools such as CDS (clinical decision support), that enable physicians to access known best practices, providing added methods for physicians to improve their decision-making.

Overall, it’s an exciting and stressful time for doctors. Moving from a system that demands more and more procedures to one based on outcomes is a real challenge. However, transitioning to the value-based care model will improve the quality and productivity of our health systems by expanding technology and clinical expertise across networks. The marriage of big data and accurate diagnosis exemplifies how diagnostic technology and sharper patient information can collectively revolutionize medical specialties and subspecialties. However, without a universal commitment throughout the HIT communities to both measure and improve accuracy in diagnostics, our healthcare system will continue to misdirect too many resources.

I am eager to hear about your experiences and recommendations for creating value through diagnostic accuracy.

As we navigate the great technological advances popping up across the healthcare industry, these disruptive developments will continue to shape everything from traditional practices and organizational structures to regulatory policies and workflow processes. To stay up to date with the latest thoughts from Siemens Healthcare, visit the company’s Healthcare Insights site.

Meet the Author

Siemens Healthineers AG (listed in Frankfurt, Germany: SHL) pioneers breakthroughs in healthcare. For everyone. Everywhere. As a leading medical technology company headquartered in Erlangen, Germany, Siemens Healthineers and its regional companies are continuously developing their product and service portfolio, with AI-supported applications and digital offerings that play an increasingly important role in the next generation of medical technology.

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