Dangers of Delayed Diagnosis: A Patient Safety & Malpractice Issue
Medical and legal experts warned of health and malpractice issues related to delayed diagnosis arising from the COVID-19 pandemic at the recent Crittenden Medical Insurance Conference held in Miami from September 26-28, 2021. The Crittenden Medical Insurance Conference is an event for insurance professionals, which is attended by healthcare insurers, clinicians, and risk managers.
Speaking virtually to a live and virtual audience, Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety) led a panel discussion on the “Dangers of Delayed Diagnosis.” The Physician-Patient Alliance for Health & Safety (PPAHS) is a 501c3 nonprofit is a national advocacy force for addressing patient health and safety priorities shared by patients, physicians, regulators, and industry. PPAHS identifies, promotes, educates, and certifies clinicians in best practices that promote patient safety and improves the quality of patient care.
Presenting with Mr. Wong were:
- Naresh M. Punjabi, MD, PhD (Mary Jane and Lino Sertel Professor of Pulmonary Diseases, Department of Medicine, University of Miami, Miller School of Medicine)
- Jason P. Kirkness, Ph.D. (Medicine), ATSF (Drug/Device Discovery and Development Committee, American Thoracic Society; VP Medical and Clinical Affairs, 4DMedical)
Medical Distancing and Patient Distancing are Symptoms of COVID-19
Mr. Wong discussed the interrelated issues experienced during the COVID-19 pandemic of medical distancing and patient distancing – “Medical distancing occurred during the COVID-19 pandemic when patients, who were fearful of contracting COVID, didn’t go to see their doctors.”
“Patient distancing has also occurred,” said Mr. Wong, “where clinicians were concerned about contracting COVID from their patients. A survey we conducted with our clinical followers found that patient distancing has taken place with very few lung function tests being recommended during COVID-19.”
A copy of Mr. Wong’s presentation can be viewed and downloaded by clicking here.
Current Lung Function Testing Poses Risks to Healthcare Workers
Dr. Kirkness discussed the risks associated with the standard lung function test (spirometry), which involves the patient exhaling forcefully, resulting in an aerosol-generating procedure. During the COVID-19 pandemic, this understandably may have made clinicians more hesitant to prescribe and perform lung function testing as the PPAHS survey has found.
Said Dr. Kirkness:
“Spirometry is more likely to provoke cough, although transfer factor and static lung volume measurements were also associated with post -test cough. Lung function tests therefore pose a considerable risk for the spread of infection to individuals and surrounding surfaces within test areas.”
A copy of Dr. Kirkness’ presentation can be viewed and downloaded by clicking here.
Novel Pulmonary Function Testing Being Used at University of Miami, Miller School of Medicine
Dr. Punjabi discussed clinical applications of functional lung imaging, saying that current testing is limited and pose a major challenge in understanding the pathophysiology of lung disease and potential exploration of therapeutic interventions.
He then discussed a technique using novel technology he is currently using at the University of Miami, Miller School of Medicine, saying:
“This technique employs a unique cross-correlation analysis and non-linear optimization to reconstruct lung tissue motion from a small number of standard projections. By using this technique, we have been able to measure pulmonary function by quantifying tissue and airway changes from cine-fluoroscopy during spontaneous respiration.”
A copy of Dr. Punjabi’s presentation can be viewed and downloaded by clicking here.
Saving Money, Hassle, Lawsuits, and Reputation
Mr. Wong recommended that healthcare executives and risk managers take a proactive approach with patients to lessen the risk of malpractice lawsuits. He advised:
“Don’t Live In a Technological Box. Don’t let existing technology be a negative that causes a lawsuit.
“Actively Pursue Patient Safety Improvements You’re doing the right thing!
“If You Need Access to Patient Safety People/Resources – Contact PPAHS at mwong@ppahs.org.”