Care Triad

More on technology (and communication)

There is no question that technology can improve the quality of healthcare but it can’t replace the need for good communication.

Dr. Peter Pronovost, a leader in patient safety at Johns Hopkins, wrote a blog post today about how technology can help doctors make the right diagnosis. He cites alarming statistics about how the wrong diagnosis may cause as many as 80,000 deaths each year in the US. He discusses the exciting news that a portable bedside device that is able to measure eye movements, may prove to be useful in emergency rooms to figure out which patients who complain of dizziness are likely to be having a stroke. This development could save lives and also save time and money.

However, in many of the cases of misdiagnosis, the problem is that doctors don’t listen carefully to what patients and their families are saying. They forget that patients are the experts about their own symptoms. Doctors have a tendency to get locked into thinking about a particular diagnosis and may not listen to what patients (and their families) are telling them.

In a tragic case last year, Rory Staunton a 12 year old boy, died of sepsis – bacteria in his blood stream. He was examined on several occasions in the doctor’s office and in the emergency room and was repeatedly sent home with what was thought to be a minor stomach ache. His death has prompted hospitals to improve their ability to diagnose sepsis which is very important. The medical team in this case appears to have ignored lab tests, physical signs and symptoms all of which pointed to sepsis. If checklists had been in place to detect all of these things (much the way airline pilots have checklists to make sure they think of everything that is important) perhaps his life could have been saved.

So, technology and checklists (and other processes to make healthcare more organized) are great. And if there were a rapid test to detect sepsis in the emergency room, that would be even better.

But, in the Rory Staunton case, it seems like the doctors failed to take a careful history and the parents were ignored when they questioned the diagnosis of a stomach ache. The doctors also failed to check the lab tests they had sent and failed to communicate with each other (and with the parents).

So, it is great to develop technology tools and better processes to improve the way doctors make diagnoses.

But let’s not forget that the most important diagnostic tool is to listen to the patient.