Reducing medical errors with data insights
Data interpretation and analytics are keys to mitigating malpractice risks.
Dana Siegal | Vice President, Risk Management and Analytics, Coverys Diagnostic errors are a significant problem in the U.S. healthcare system and are a key source of medical malpractice claims. A study published in July 2023 by a research team led by the Johns Hopkins University School of Medicine and supported by CRICO Candello (including myself, Dana Siegal, as one of the research team members) estimated that 795,000 Americans die or are permanently disabled each year due to misdiagnosis, across care settings. According to the study, the “Big Three” – vascular events, infections, and cancers – constitute 75% of the harms caused by diagnostic errors. Across these three major categories, the top five misdiagnosed conditions accounted for 38.7% of the cases of serious harm: stroke, sepsis, pneumonia, blood clots, and lung cancer. Diseases that account for the largest number of misdiagnosed harms and those with high rates of diagnostic error should therefore become top targets for developing systematic solutions, our research suggested. David E. Newman-Toker, MD, PhD, who led the study, added: “Reducing diagnostic errors by 50% for stroke, sepsis, pneumonia, pulmonary embolism, and lung cancer could cut permanent disabilities and deaths by 150,000 per year.” The need for improvement to reduce diagnostic errors is urgent for multiple reasons. First is the human cost of misdiagnosis. Second is the medical malpractice liability exposures that accompany misdiagnoses and are among the costliest malpractice claims. Adding to the financial burden of all malpractice claims is the growing concern around extreme verdicts, also known as “nuclear” verdicts, which exceed $10 million in damages and are becoming more frequent, notes the U.S. Chamber of Commerce’s Institute for Legal Reform (ILR). According to the ILR, more than 20 percent of nuclear verdicts involve medical malpractice liability allegations. Risk professionals, agents, brokers, and insurers recognize that reducing the risk of diagnostic errors and other malpractice allegations is critical to mitigating losses and will require collaboration and partnership to drive meaningful change and ensure appropriate risk management solutions are in place. If a healthcare provider understands where their risks are, they are better able to invest in targeted solutions. Agents and brokers who work with healthcare organizations can play a vital role in improving healthcare risk management practices. With data insights and the support of medical professional liability insurance partners such as Coverys, agents and brokers can have deeper conversations with their clients about the real drivers of risk and exposures and discuss targeted solutions. Risk advisors can be more consultative with greater knowledge of healthcare providers’ risks and how existing practice patterns and trends are influencing outcomes. When the loss history suggests a specific issue or area of concern, Coverys’ data and expertise can help risk advisors and their clients to focus on the specific root causes of the concern and implement and sustain positive changes. For example, in August 2023, Coverys published a white paper, “A Dose of Insight: Patient Engagement: From Noncompliance to Activation.” This report explores the reasons patients do not comply with treatment plans and found that a lack of patient engagement is a significant but remediable risk. Evaluating more than 6,000 events of closed malpractice claims over five years, Coverys identified 436 specific events where a lack of patient engagement was a major factor in claims alleging medical errors. A better understanding of what leads patients to disengage and cease complying with their treatment recommendations can become part of the risk mitigation conversation agents and brokers have with healthcare clients. For more information on tools and strategies to assist with risk management in healthcare, please visit www.coverys.com. Dana Siegal is Vice President, Risk Management and Analytics, at Coverys, an innovative provider of medical malpractice insurance dedicated to helping policyholders anticipate, identify, and manage risks to reduce errors and improve outcomes. During her extensive career, Siegal, a registered nurse, has served as Director of Patient Safety at CRICO Candello and on the Board of Directors for the Society to Improve Diagnostic Medicine (SIDM). Coverys insurance products issued by Medical Professional Mutual Insurance Company and its insurance subsidiaries, Boston, MA.
Coverys data; N=1,521 closed claims between 2018-2022 and a Diagnosis-related allegation.
Improving healthcare risk management
A vital role for risk advisors
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