Diagnostic Accuracy Initiative Demonstrates Reduced Hospital Stays, Fewer ER Visits and Lower Overall Medical Costs

FRANKLIN, Tenn., Oct. 14 /PRNewswire/ -- MedSolutions and Corporate Research Group today announced initial results from a groundbreaking diagnostic accuracy program, which showed shortened hospital stays, reduced emergency room visits and lower overall medical costs among participants.

The program's findings demonstrate a 23 percent lower cost per episode of care among participants—the equivalent of greater than $1,000 in savings per episode. Average hospital stays among the study population were 1.5 days shorter; the group experienced nearly 50 percent lower ER utilization and required about 30 percent fewer outpatient services.  

Often unrecognized or unreported, misdiagnosis is a growing concern for America's health plans and self insured. Medical services triggered by a wrong diagnosis increase risk of harm for patients and significantly drive up cost due to unnecessary tests, surgeries and treatments. The Institute of Medicine has estimated that the cost of medical error is $29 billion annually.(1)  A study by the Mayo Clinic identified misdiagnosis rates of 26 percent.(2) More importantly, these diagnostic errors take the lives of 40,000 to 80,000 hospitalized patients annually.(3) Recent studies have shown that misdiagnosis is the leading cause of medical malpractice cases and costs insurers an average of $300,000 per case to settle.(4)

"Our already burdened healthcare system can't afford the unnecessary expense of diagnostic errors and patients shouldn't have to endure the cost, pain or uncertainty of unnecessary and invasive procedures or delays in care that result from misdiagnosis," said C. Alan Henry, M.D., noted breast surgeon and chief medical officer of MedSolutions' Premerus® Diagnostic Accuracy program. "Our research and experience show that connecting a patient with a diagnostic specialist whose background and expertise match the patient's needs not only reduces cost, but also improves quality of care."

Research affirms that a physician's degree of specialization and volume of experience reading certain types of medical scans, such as CT and MRI, dramatically increases the probability of accurate diagnosis. According to a mammography study published in Radiology, radiology specialists have a 30 percent lower recall rate than general radiologists, meaning significantly fewer additional tests are needed to confirm screening mammography findings.(5) In addition, these specialists had a 75 percent greater cancer detection rate than that of general radiologists, as well as finding 75 percent more stage 0-1 cancers. A follow-up study in the Journal of the National Cancer Institute confirmed this finding, noting that it was the degree of specialization and the volume of experience that increased diagnostic accuracy rates.(6)

In current practice, matching medical scans with the radiologists who interpret them is often left to chance. Many on-duty radiologists must review any study that comes across their desk—be it a brain MRI, a CT of the heart, or a scan of the knee. MedSolutions' Premerus Diagnostic Accuracy program seeks to dramatically reduce diagnostic error by matching medical scans with highly specialized diagnosticians based on the anatomy affected and the clinician's recognized expertise. For example, a brain scan would be matched with a certified expert neuroradiologist for interpretation and reporting of results to the patient's treating physician. This approach results in more reliable first-time diagnoses and dramatically reduced downstream costs.

"While the financial benefit of this approach should be enough to convince a responsible payor, the benefits in human terms are incalculable," said Dr. Henry. "Getting the diagnosis right the first time means the patient can more rapidly begin an appropriate course of treatment. That translates into quality of life improvements as well as financial savings."

Presented via an online webinar, the new data reflect a national health plan's experience implementing the Premerus Diagnostic Accuracy program in a large metropolitan market. For inquiries about Premerus and other programs from MedSolutions, please call 800.467.6424 or visit www.medsolutions.com.

About Premerus and MedSolutions

Premerus, from MedSolutions, offers a new diagnostic healthcare model: the coordinated focus of resources, expertise and technology to improve the accuracy of diagnosis.  Dedicated to reducing the rate of misdiagnosis in the U.S., Premerus provides the platform and routing mechanism to connect each diagnostic study with a clinician whose background and expertise match the patient's needs. This results in more predictable and accurate first-time diagnoses, higher quality patient outcomes and a reduced cost and resource burden on America's healthcare system. Premerus leverages the experience and visionary leadership of MedSolutions, a leading intelligent cost management provider serving the healthcare community for more than 15 years. www.medsolutions.com/premerus

Using independently validated savings methodologies, MedSolutions specializes in quality-driven, intelligent cost management of medical services for commercial, Medicare and Medicaid payors. The company maintains management contracts for 27 million individuals nationwide. Using robust data, predictive intelligence technology and evidence-based clinical expertise, the company's innovative solutions extend beyond Radiology Management to other areas of medical specialty, including oncology, cardiac imaging, sleep, ultrasound, and MedSolutions' groundbreaking Premerus® Diagnostic Accuracy program – the nation's first solution for reducing diagnostic error rates to improve the quality and cost of care. MedSolutions has been recognized for outstanding customer service and effective call center management by the International Customer Management Institute. MedSolutions has also been recognized for three consecutive years by the prestigious J.D. Power and Associates Award. Visit www.MedSolutions.com.

About Corporate Research Group

Corporate Research Group has been serving the managed healthcare marketplace since 1993 as the industry's leading source for news, strategic intelligence, market research and custom consulting. CRG products consist of print and electronic newsletters, e-mail updates, annual forecasts, conferences, audio conferences, and the unique Managed Care Access online information service. Disclosure: Many leading health plans, managed care services companies and other healthcare organizations have retained CRG for specialized consulting projects and targeted information services – including companies covered in our newsletters, reports and blog. www.CorporateResearchGroup.com

1) To Err Is Human: Building a Safer Health System, Institute of Medicine, 1999.

2) Roosen J, Frans E, Wilmer A, et al. Comparison of premortem clinical diagnoses in critically ill patients and subsequent autopsy findings. Mayo Clinic Proceedings 2000; 75: 562 - 567.

3) Landro, Laura. What the Doctor Missed: Using Malpractice Claims to Help Physicians Avoid Diagnostic Mistakes, Delays; Wall Street Journal, September 27, 2010. http://online.wsj.com/article_email/SB10001424052748703694204575517834198205438-lMyQjAxMTAwMDIwODEyNDgyWj.html#

4) Ibid.

5) Sickles, EA, Wolverton DE, Dee KE. Performance Parameters for Screening and Diagnostic Mammography: Specialist and General Radiologists. Radiology 2002; 224:861-869.

6) Journal of the National Cancer Institute, 2005. Physician Predictors of Mammography Accuracy.

SOURCE MedSolutions