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The Diagnostic Dilemma: Addressing Errors in Modern Healthcare

Contributed Commentary by Jolly Nanda, Altheia Inc 

May 23, 2025 | Diagnostic errors remain a persistent and costly challenge in healthcare worldwide, leading to significant patient harm and financial burden. Despite advances in medical technology and research, these errors—missed, delayed, or incorrect diagnoses—cause thousands of preventable deaths and billions in healthcare costs each year. This article explores the current landscape of diagnostic errors, the underlying causes, the importance of patient-provided context, and promising solutions. 

The Scope of Diagnostic Errors: A Persistent Challenge 

Diagnostic errors are alarmingly common. Studies estimate that one in 20 adults in outpatient care in the United States experiences one annually—about 12 million cases—with nearly 50,000 deaths resulting from these failures. These errors account for 15% of preventable adverse events in hospitals

Sepsis, a life-threatening response to infection, is particularly affected by diagnostic errors. Research in Critical Care Medicine showed that about 30% of sepsis cases are initially misdiagnosed in emergency departments, delaying critical treatment. Every hour of delay increases mortality risk by 7-9%, highlighting how errors can be especially dangerous for time-sensitive conditions.  

Financially, diagnostic errors are estimated to cost the U.S. healthcare system $100 billion annually, including unnecessary tests, prolonged hospital stays, and malpractice claims. 

Why Do Diagnostic Errors Occur? 

Despite technological advances, several factors contribute to persistent diagnostic errors: 

  1. Ambiguous Symptoms and Disease Complexity 
     
    Many diseases present vague symptoms that overlap with other conditions, complicating diagnosis. Sepsis, for example, often mimics flu or dehydration early on and is misdiagnosed in up to 40% of cases, delaying critical interventions
     
    Similarly, rare diseases also pose a challenge, with patients often waiting 6-7 years for an accurate diagnosis

  2. Fragmented and Incomplete Medical Records 
    Electronic medical records (EMRs) have improved data access but often lack the full context of a patient’s health, such as lifestyle changes or subtle symptom progression. These details, best provided by patients, are crucial for diagnosing chronic or intermittent conditions. For example, a single normal lab result may overlook a pattern of fatigue that, over time, could indicate hypothyroidism or sleep apnea. 
  3. Cognitive Biases and Burnout 
    Clinicians are susceptible to cognitive biases like anchoring (fixating on initial impressions) and availability bias (favoring recent diagnoses). Time pressures and fatigue exacerbate these issues. A study revealed that over 60% of clinicians reported diagnostic decision fatigue during the COVID-19 pandemic, leading to increased errors in emergency and critical care settings. 
  4. Disconnection Between Clinicians and Patients 
    Brief consultations often miss valuable patient insights about symptom patterns and context: Nearly 30% of diagnostic errors could be attributed to incomplete patient histories or miscommunication between patients and providers

Why Patient Context Matters: Beyond the EMR 

EMRs, while useful, are limited in scope. Accurate diagnosis often requires supplementing clinical data with patient-provided context over time. 

  1. Detecting Subtle Symptom Progression 
     
    Patients are often the best source for tracking gradual changes. Chronic conditions, such as autoimmune diseases or migraines, may only become evident when symptoms are viewed as a pattern rather than isolated incidents. An example would be identifying lupus earlier than assessing symptoms individually during sporadic visits. 
  2. Capturing Environmental and Lifestyle Factors 
    EMRs do not typically account for external factors like stress levels, diet, exercise habits, or living conditions—all of which influence health. For instance, a patient who experiences frequent respiratory infections might reveal, through their own records, that symptoms worsen during allergy seasons or after mold exposure, which is valuable information for diagnosing and managing chronic conditions like asthma
  3. Engaging Patients in Shared Decision-Making 
    When patients actively track and share symptoms, medication adherence, and lifestyle changes, clinicians gain actionable insights. Diagnostic accuracy increases by 20% when clinicians incorporate patient-provided data from symptom-tracking apps into their assessments

Solutions to Reduce Diagnostic Errors 

Improving diagnostic accuracy requires integrating patient context with systemic reforms and emerging technologies. 

  1. AI-Powered Tools for Pattern Recognition 
     
    Artificial intelligence can analyze patient-provided data alongside EMRs to detect patterns that might be missed. For example, AI systems evaluating wearable device data have improved early detection of conditions like Parkinson’s disease and heart failure. A 2022 study in Nature Medicine demonstrated that such tools improved diagnostic timelines by 25% for chronic conditions. 

  2. Interoperable Platforms for Comprehensive Health Records 
    Healthcare systems need interoperable platforms that unify EMRs, direct-to-consumer testing, wearable data, and patient-reported outcomes. This integration allows both patients and providers to access a complete health record, bridging the gap between episodic clinical data and longitudinal patient context. 

  3. Encouraging Longitudinal Symptom Tracking 
    Providers should encourage patients to track symptoms and contextual factors over time using apps or digital diaries. It was found that patients who used symptom trackers were diagnosed with chronic diseases 18% faster than those who relied solely on periodic clinic visits

  4. Training Providers to Utilize Context 
    Medical education should emphasize the value of patient-reported data. Training clinicians to ask open-ended questions and incorporate longitudinal context can reduce diagnostic errors. Workshops on shared decision-making have been shown to decrease errors by 15% in primary care

The Future of Diagnostics: Combining Technology and Human Insight 

Integrating patient-provided context with clinical data is vital for improving diagnostic accuracy. By leveraging AI, interoperable systems, and patient engagement tools, healthcare can become more proactive and personalized. The future lies in a collaborative approach, where clinicians and patients work together to identify patterns, close information gaps, and prevent errors before they occur.  

 

Jolly Nanda, Co-Founder and CEO of Altheia Inc, is passionate about data-driven innovation to address the gaps in advancing health literacy and improving care.  She can be reached at jollynanda@altheia.com

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