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How could the Federal Government best spend $10,000,000 to improve diagnostic accuracy?

  • 1.  How could the Federal Government best spend $10,000,000 to improve diagnostic accuracy?

    Posted 04-02-2022 14:10
    The President's Budget proposal would provide $10 million to the Agency for Healthcare Research and Quality (AHRQ) to establish Diagnostic Safety Centers of Excellence.  Is this the best way to achieve the goal of reducing harm to patients as quickly as possible?

    Let's seed the discussion.  We know that AHRQ has not proven itself highly effective over the last two decades in reducing patient harm.  Why not ask Congress to allocate that $10 million to the FDA?  Congress could ask the FDA to spend $2 million to promote and administer a contest for the best software created to implement automated differential diagnosis generation in an electronic medical record system. They would insist the EMR include learning-machine technology and address knowledge coupling as described in Larry Weed's 1991 book.  The FDA would then award $8 million to the winner.  As compared to the AHRQ the FDA has proven safety-based technology.  Electronic medical record systems have to date operated outside of the FDA's scrutiny by avoiding active support of clinical decision making.  Such a prize could change that avoidance behavior and lead to EMR systems that promote precise, rapid, cost-effective diagnosis with documented decision trees while creating problem-oriented records that coordinate specialized healthcare activities.  Larry Weed proposed this approach three decades ago and the medical community has failed to insist that hospitals acquire the technology required to take this step.  Does not this sort of approach better move us closer to the goal than establishing centers of excellence doing what we have always done with perhaps a little more focus?

    Richard Griffith
    Retired Physician and Electrical Engineer