A missed stroke. A cancer diagnosed too late. A blood clot mistaken for something less serious. Medical experts say those failures are among the most preventable threats in American health care, and lawmakers from both parties are renewing an effort to reduce them after new research estimated that more than 900,000 Americans each year either die or suffer permanent disabilities because of diagnostic errors.
“Far too many Americans have experienced the loss, pain, and hardship that come with a misdiagnosed medical condition, and for many, these errors cause permanent disability or death,” said Maryland Democratic Sen. Chris Van Hollen. “Medical diagnostic errors not only impact patients’ lives – they also cost patients and our nation billions of dollars each year. This legislation will invest in efforts to prevent and reduce diagnostic errors, giving medical experts, patients, and their families the research and resources they need to better treat patients and save lives.”
Van Hollen joined Sen. Ben Ray Luján, (D-N.M.), and Reps. Don Beyer, (D-Va.), Kim Schrier, (D-Wash.), and Jeff Van Drew, (R-N.J.), in reintroducing the Saving Lives and Reducing Health Care Waste by Improving Diagnosis in Medicine Act, bipartisan legislation designed to improve diagnostic accuracy, expand research and create new federal systems to identify and prevent medical errors before they harm patients.
The measure follows years of research documenting the enormous human and financial costs of diagnostic failures. A landmark National Academies of Sciences, Engineering, and Medicine report concluded that most Americans will experience at least one diagnostic error during their lifetime and estimated that roughly 80% of the harm caused by those mistakes is preventable.
Researchers at Johns Hopkins University later estimated that approximately 795,000 Americans each year become permanently disabled or die because dangerous diseases are initially missed or diagnosed too late. Their analysis found that stroke, sepsis, pneumonia, venous thromboembolism and lung cancer account for nearly 40% of the most serious diagnostic harms nationwide, suggesting that concentrated efforts could substantially reduce preventable deaths and disabilities.
The legislation would establish an Interagency Council on Improving Diagnosis in Health Care to coordinate federal efforts, identify barriers to research and recommend policies to improve diagnostic quality throughout the health care system. It also authorizes grants to establish Research Centers of Diagnostic Excellence, directs the Agency for Healthcare Research and Quality to create a national strategy for voluntary patient reporting of diagnostic errors and supports additional research, workforce training and quality improvement initiatives.
“Every year, millions of Americans suffer the consequences of diagnostic errors, costing lives and burdening patients and our health care system with billions of dollars in avoidable costs. Every patient deserves an accurate diagnosis delivered in time to make a difference,” Luján said. “That’s why I’m joining my colleagues in reintroducing the Improving Diagnosis in Medicine Act to advance research and improve diagnostic quality and safety. No one should lose their life to a mistake we have the power to prevent.”
Beyer added that improving diagnosis has implications that extend beyond patient safety by reducing unnecessary treatment, lowering costs and narrowing disparities in care.
“Diagnostic delays affect millions of Americans, drive up health care costs, and contribute to thousands of preventable deaths each year, but it doesn’t have to be this way. Our bill invests in better data collection, stronger research, and sharing of best practices to improve diagnostic accuracy, deliver better outcomes for patients, and reduce health disparities,” Beyer contended. “It also establishes Research Centers of Diagnostic Excellence to advance research, helps bring proven methods for preventing misdiagnosis into everyday clinical practice, and gives patients pathways to report delays and contribute to a growing body of data to inform policymaking.”
Diagnostic Errors Lead in Malpractice Payments
Supporters say diagnostic mistakes stem from multiple breakdowns, including missed warning signs, communication failures among physicians, patients and families, fragmented medical records and health systems that often discourage reporting errors that could help prevent future mistakes.
Those failures also drive a significant share of medical malpractice litigation. Nationally, diagnostic errors account for roughly one-third of paid malpractice claims, making them the leading source of malpractice payments.
In the District of Columbia, successful malpractice claims remain comparatively uncommon, with roughly 20 to 24 paid claims annually totaling about $9.2 million. Even so, diagnostic mistakes continue to represent one of the leading allegations in medical negligence lawsuits.
The legislation has drawn support from Patients for Patient Safety US, the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins and Physician-Parent Caregivers, organizations that have argued for years that patients and families should play a larger role in identifying diagnostic failures and helping improve the health care system.
“Accurate diagnosis is a prerequisite for quality health care. Put simply, it’s hard to apply the right treatment if you start out with the wrong diagnosis. Furthermore, failure to accurately diagnose is a major driver of excess healthcare costs,” said David Newman-Toker, professor of neurology and director of the Armstrong Institute Center for Diagnostic Excellence at Johns Hopkins. “But diagnosis is also one of the most complex tasks in modern medicine; until we have a larger body of research that supports data-driven, reliable improvement strategies that are ‘shovel ready,’ our clinicians and health care system will be left struggling. There is much work yet to be done by all health care stakeholders to move this life-saving research forward.”
