Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Prior research has found that diagnostic errors comprise approximately one-fifth of preventable errors among hospitalized patients. Academic clinical care poses unique risks for diagnostic error because the frontline providers are residents and medical students. Thus, accurate diagnosis relies on robust communication between learners and their supervisors. A team of social scientists and clinicians conducted an ethnographic study of physicians on academic inpatient rounds to identify barriers to timely and correct diagnoses. They found that reliance on one-way communication methods and insufficient face-to-face interactions with patients and consultants hindered effective diagnostic decision-making. Additionally, the electronic health record led to data overload and data fragmentation. The authors offer concrete suggestions for more clinician- and patient-centered technical tools. A WebM&M commentary discussed a diagnostic error involving learners in psychiatry.