Our New Collaborative for Diagnostic Innovation – How We Are Reducing Err and Improving Care

Among the many reasons that I love being in pathology and laboratory medicine is the fact that we are so central and foundational to the practice of medicine. After all, it's impossible to provide good health care without a timely and accurate diagnosis — our tests and services are at the heart of the diagnostic process. As we often share, 70% of all medical decisions are based on lab testing. Imaging is another important diagnostic modality, and a partner and complement to our services – like lab testing, diagnostic imaging is growing in frequency and in healthcare dollars spent.

I also love that the practice of our specialty is so collaborative – we regularly share cases and consult with colleagues to get additional opinions to confirm our working diagnoses or challenge our preliminary impressions. We also collaborate with our clinical colleagues to guide test orders, and to gain history, imaging and physical findings necessary for clinical context. This allows pathologists to provide additional interpretative information, ensuring that we are more effective consultants, and that our diagnoses are well understood for appropriate treatment and management. Teamwork is at the heart of diagnostic accuracy, minimizes errors and helps patients get the best care possible. And because the diagnostic process is still imperfect, I love that there is so much opportunity to be creative, innovative and improve on what we do – after all, improving patient care via the discovery of new knowledge and development of new tools and approaches is what the research mission of a medical school is all about.

For all these reasons, I am very excited about a new program led by our department and launching next month – our new Collaborative for Diagnostic Innovation. As the name implies, this Collaborative represents an inter-disciplinary group who will be working together to create unique new approaches to improve the diagnostic process. This Collaborative specifically responds to the 2015 National Academy of Medicine's report “Improving Diagnosis in Healthcare” which raised awareness that “most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.” (1). Diagnostic errors lead to 62,000+ deaths from each year, more than the number of deaths due to diabetes and flu/pneumonia combined (1). Even if not deadly, diagnostic errors cause many serious complications, in addition to anxiety, pain, and unnecessary expense. The National Quality Forum reported that at least 5% of U.S. adults seeking outpatient care experience a diagnostic error. Errors also contribute up to 17% of adverse hospital events (2). Clearly, this is a problem worthy of our attention.

I've been on the campaign trail for several months “pitching” our new Collaborative for Diagnostic Innovation and recruiting partners — I've been delighted with the enthusiasm from everyone I'm talked with – this has not been a hard sell! The National Academies' report emphasized the importance of a multi-disciplinary team to improve the diagnostic process, and a very diverse group of collaborative partners have joined in to help shape this new program at UC Davis Health. The group includes ten academic departments from our medical school (Biochemistry & Molecular Medicine, Emergency Medicine, Family Medicine, Internal Medicine, Otolaryngology, Pathology & Laboratory Medicine, Pediatrics, Public Health Sciences, Radiology, Surgery) along with five centers (Cancer Center, Center for Health Care Policy and Research, Center for Regenerative Cures, and the Eye Center), the UCD Office of Research, and the School of Veterinary Medicine.

The Collaborative's first activity is an inter-disciplinary seed grant program that will focus on 4 themes:

  • Creation of new or better tests and test strategies.
  • Optimization of test utilization (particularly reducing underuse, overuse, and misuse of tests and imaging procedures).
  • Reduction of diagnostic errors (particularly reducing delays in diagnosis).
  • Integration of diagnostic data with other data such as clinical information, microbiome and other phenotypes, social determinants of health, behavioral medicine, and others.

The pool for the seed awards is currently $360,000, thanks to a generous philanthropic gift from Brook and Shawn Byers which has served as the foundation for the award pool. This gift and the importance of improving diagnosis in healthcare has sparked contributions from the Practice Management Board, and drawing contributions from all the collaborative partners listed above bringing us to the grand total we have today. There is even a future possibility of additional institutional resources to aid in growing the Collaborative into a larger program which is an extra exciting new development – enthusiasm is obviously contagious!

To kick-off the seed grant program, we will sponsor a networking event on November 6, 2017 from 5-7 pm in the MIND Auditorium so that faculty and housestaff from our department and all the other collaborating units can meet, share ideas and talent, and to aid the formation of project teams. To register for the event, visit https://www.eventbrite.com/e/collaborative-for-diagnostic-innovation-networking-event-tickets-38291056581

The due date for proposals is December 1, 2017. A multi-disciplinary review team will review the submissions and will grant awards from $5000-30,000 in January 2018. Learn more about the seed grant program and the Collaborative at http://www.ucdmc.ucdavis.edu/pathology/collaborative-for-diagnostic-innovation/index.html

UC Davis has always prided itself on a culture of collaboration, so our new program fits with our identity and tradition. Collaboration has been described as the “secret sauce” necessary for strategic transformation and to ensure competitiveness in the contemporary and rapidly changing world of science, technology, and healthcare (3). As noted in a recent article in Harvard Business Review, “Yesterday's model of innovation is no longer adequate — instead, the entire ecosystem must work together.” (3) Be part of our ecosystem, join our Collaborative on November 6, find partners, and let's do great and innovative things together to support patient care, grow knowledge, and improve health!