Digital and face-to-face advances and detractions to cure the personal and financial cost of misdiagnosis
Authors: Towery Heather , Hough Michael 
Published: December 2017

Purpose

Digital transformation holds promise for addressing one of the biggest challenges in health care – misdiagnosis. About 30 per cent of health spending in 2009, i.e. roughly $750bn, was wasted on unnecessary services, excessive administrative costs, fraud and other problems. Moreover, inefficiencies cause needless suffering, states the Institute of Medicine. Leveraging emerging digital technologies in this sector stands to save thousands of lives and billions of dollars. Digital technology is being applied to this field owing to the great demand for a solution. Misdiagnosis is causing a major hemorrhaging hundreds of billions of dollars in the health industry – an estimated 10-20 per cent of cases are misdiagnosed, sometimes resulting in death or permanent disability, according to studies cited by the National Center for Policy Analysis. Additionally, experts believe as many as 31 per cent of all breast cancer cases are misdiagnosed, according to the New England Journal of Medicine, and 90,000 women are misdiagnosed with invasive breast cancer, according to Susan G. Komen.

Design/methodology/approach

Digital technology is being applied to this field owing to the great demand for a solution. Misdiagnosis is causing a major hemorrhaging hundreds of billions of dollars in the health industry – an estimated 10-20 percent of cases are misdiagnosed, sometimes resulting in death or permanent disability, according to studies cited by the National Center for Policy Analysis. Additionally, experts believe as many as 31 percent of all breast cancer cases are misdiagnosed, according to the New England Journal of Medicine, and 90,000 women are misdiagnosed with invasive breast cancer, according to Susan G. Komen.

Findings

Advance Medical’s experience is that 39 per cent of a self-selecting group of medical advocacy seekers are misdiagnosed. Directly related to this challenge, a major battleground where the war on escalating healthcare costs is being fought is in the space of utilization management tools, which help ensure insurers are paying for the right care. These tools depend on the doctor making the right diagnosis and that the treatment matches the diagnosis. But these tools are broken. Instead of checking accuracy of diagnosis (e.g. the right test was done and interpreted accurately), they are at best checking to see if the “box was checked” for any testing being done. The solution is to not only to ensure that the diagnosis is correct by having it reviewed independently but also to use technology to aid diagnosis and the physician’s overall job. Using tools such as patient portals and data management technology can aid doctors to not burn out from sorting through data but rather using healthcare technology to reduce physician exhaustion and thus misdiagnosis.

Originality/value

New and old tools hold promise for addressing one of the costliest and most able-to-be-impacted challenges in health care – misdiagnosis. Because of misdiagnosis, the health industry is hemorrhaging hundreds of billions of dollars and causing patients undue stress and negative medical impact. Not only does misdiagnosis have a strong effect on the economy and the solvency of the US health care system, it also has a profound effect on the people who are being misdiagnosed, as well as their families and loved ones.