A learning health system approach to improve diagnosis
Diagnostic errors – missed opportunities to make timely and accurate diagnoses – are hard to tackle because they are difficult to identify and measure. The 2015 National Academy of Medicine (NAM, formerly IOM) report entitled “Improving Diagnosis in Health Care” highlights the necessity and significance to improve the diagnostic process. Different studies indicate that 10-30% of all medical errors are related to errors in diagnosis. The NAM estimates that most Americans will experience a diagnostic error at least once in their lifetime. The Agency for Health Research and Quality (AHRQ) considers improving diagnosis as the next great frontier in the patient safety improvement movement. In May 2019, the AHRQ, named diagnostic errors as one of the three “critical challenges that are front and center in today’s ever-changing digital healthcare ecosystem”.
We have a professional and moral imperative to address this formidable challenge.
At Geisinger, the Committee to Improve Clinical Diagnosis (CICD) was established as a work group in 2014 to develop innovative approaches to identifying and addressing diagnostic errors. Today, the committee has representation from all major disciplines and includes many senior clinical directors, operational leaders and key stakeholders. It is currently chaired by Yatin Mehta, MD, Associate, Pulmonary and Critical Care Medicine. Dennis Torretti, MD, chairman emeritus of the Division of Medicine at Geisinger was the founding chair from 2015 until April 2021.
As a result of the work of the committee, potential diagnostic opportunities are reviewed, shared with departments, and learning opportunities are identified. Constructive feedback is completed when appropriate and any system issues that may impact diagnostic safety are identified. Lessons learned are shared broadly in an open, transparent, and constructive fashion.
Committee to Improve Clinical Diagnosis
Committee members
Amit Bansal, MD, MBA
Director, Department of Hospital Medicine, Central Region, Geisinger
Clinical Associate Professor of Medicine, Geisinger Commonwealth School of Medicine
Keith Boell, DO
Vice Chair for Clinical Affairs, Medicine Institute
Chief Quality Officer, Population Initiatives
Jay Bringman, MD
Vice Chair and Quality Director, Women’s Health Service Line, Geisinger
Alison Brodginski, DO
Associate Chief Medical Officer, GWV
System Director Public Health Preparedness
Greg Burke, MD
Chief Patient Experience Officer, Geisinger
Navneet Dang, MD
Chief Quality Officer (System/Inpatient)
Attending, Hospital Medicine
Ross Ellison, MD
Director of Geisinger Placement Services
Emergency Medicine Physician, Geisinger
Michael Fitzpatrick, MD
Co-Chair, Department of Emergency Medicine, Geisinger
Associate Chief Medical Officer, Geisinger Medical Center
Benjamin Hohmuth, MD, MPH
Chief Medical Informatics Officer, Geisinger
Attending, Hospital Medicine
Lauren Adrienne Johnson-Robbins, MD
Associate, Neonatology
Maria Kobylinski, MD
Chair, Community Medicine, Geisinger
Saritha Korukonda, MD, MS
Project Manager, Safer DX Learning Lab, Geisinger
Patricia Lamphear, RN, JD, CPHRM
Director, Risk Management & Patient Safety
Lauren Love, CRNP
Chief Advanced Practitioner, Hospital Medicine, Western Region
Gerald Maloney, MD
Chief Medical Officer, Geisinger System Hospitals
Kyle Marshall, MD
Emergency Medicine Physician and Informatician, Geisinger
Associate Program Director, Clinical Informatics Fellowship
Yatin Mehta, MD (Chair)
Associate, Pulmonary and Critical Care Medicine
Prince Mohan, MD
Medical Director, Kidney Transplant Program
Eric Newman, MD
Director of Quality and Innovation, Geisinger Medicine Institute
Associate, Department of Rheumatology, Geisinger
Anthony Noto, MD
Director, Acute Neurology, Geisinger
Rajiv Panikkar, MD
Chair, Geisinger Cancer Institute
Aalpen Patel, MD
Chair, Geisinger Radiology
Anthony Petrick, MD
Director, Division of Bariatric and Foregut Surgery, Geisinger
Chief Quality Officer (Surgery/ Inpatient)
David Rolston, MD
Chair, Department of Medicine Specialties
Director, Division of General Internal Medicine, Geisinger Medical Center
Scott Sauerwine, MD
Quality Director, Geisinger Radiology
Conrad Schuerch, MD
Chairman Emeritus, Geisinger Laboratory Medicine
Residency Program Director
Jonathan Swinden, MD
Attending Hospitalist, Geisinger
Core Faculty - Internal Medicine Residency
David Talabiska, MD
Associate, Gastroenterology, Geisinger
Dennis Torretti, MD
Chairman Emeritus, Department of Medicine, Geisinger
Divvy Upadhyay, MD, MPH
Researcher-In-Residence, Safer Dx Learning Lab, Geisinger
Scientist, Division of Quality, Safety and Patient Experience, Geisinger
Jennifer Vodzak, MD
Quality Director, Pediatrics
Pediatric Infectious Diseases Specialist, Geisinger
“We have developed a Committee to Improve Clinical Diagnosis to target vulnerabilities in the diagnostic process and sustain a culture of diagnostic excellence.”