Reducing Dx Errors in the Patient-centered Medical Home

August 19, 2010
Jeffrey Kaplan, MD

The use of EMRs in the patient-centered medical home can reduce diagnostic error and improve coordination, communication, and continuity of care.

According to the JAMA article "Reducing Diagnostic Error Through Medical Home—Based Primary Care Reform,” the patient-centered medical home (PCMH) is one important conceptualization that potentially can address safety concerns in primary care, especially diagnostic error (ie, missed, delayed, or incorrect diagnoses).

This issue is “possibly the leading type of error in primary care. Diagnostic errors are the single largest contributor to ambulatory malpractice claims (40% in some studies) and cost approximately $300,000 per claim on average.”

The underpinning of this concept of practice improvement and safety is that it makes changes that: “improve coordination, communication, and continuity of care” and that it employs “electronic health records (EHRs), which, despite their current limitations, can enhance access to data and advanced decision support to reduce diagnostic error.”

The above commentary, uses Vincent et al's framework of five “rights” for reducing diagnostic errors:

  • Right Teamwork
  • Right Information Management
  • Right Measurement and Monitoring
  • Right Patient Empowerment
  • Right Safety Culture