Presentation on theme: "I NTERVENTIONS TO REDUCE INAPPROPRIATE TEST UTILIZATION Diagnostic Error in Medicine 12 November 2012 Paul L Epner."— Presentation transcript:
I NTERVENTIONS TO REDUCE INAPPROPRIATE TEST UTILIZATION Diagnostic Error in Medicine 12 November 2012 Paul L Epner
T RENDS SUGGEST INCREASED DIAGNOSTIC ERRORS Aging population means more diagnoses Increasing chronic comorbidities mean increased diagnostic complexity Decreasing number of primary care physicians combined with emphasis on cost effectiveness means less time with patients Anecdotal evidence of reduced skills in taking history and conducting physical Diagnosis is an evolving term 2
R EQUISITION DESIGN 12 Design changes focused on medical necessity, reduction in panels, test groupings linked to specialty, etc. Reduction in tests per visit occurred No assessment of impact on Dx errors was made Source: J.F. Emerson and S.S. Emerson, The impact of requisition design on laboratory utilization, American Journal of Clinical Pathology, vol. 116, Dec. 2001.