Ranji Sumant R, Rosner Benjamin I
Division of Hospital Medicine, Department of Medicine, San Francisco General Hospital, San Francisco, CA, USA.
Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Int J Health Policy Manag. 2025;14:8973. doi: 10.34172/ijhpm.8973. Epub 2025 Jun 17.
Patients often experience long journeys within the healthcare system before obtaining a diagnosis. Though progress has been made in measuring the quality of diagnosis, existing measures largely fail to capture the diagnostic process from the patient's perspective. McDonald and colleagues' paper presents 7 overarching goals for the use of patient-reported measures (PRMs) in diagnostic excellence and presents visual roadmaps to guide the development, implementation, and evaluation of these measures. To accelerate the real-world use of PRMs, organizations should initially prioritize the use of patient-reported metrics that are already in development, such as patient-reported experience measures. Pairing PRMs with artificial intelligence (AI) techniques, such as "diagnostic wayfinding" (a dynamic diagnostic refinement process that also includes analysis of electronic health record data and metadata to characterize the diagnostic journey), should also improve diagnostic performance. Ultimately, combining PRMs with technological advancements holds the potential to achieve true co-production of diagnostic excellence.
患者在获得诊断之前,通常要在医疗系统中经历漫长的过程。尽管在衡量诊断质量方面已取得进展,但现有措施在很大程度上未能从患者角度捕捉诊断过程。麦克唐纳及其同事的论文提出了在卓越诊断中使用患者报告指标(PRMs)的7个总体目标,并给出了可视化路线图,以指导这些指标的开发、实施和评估。为加速PRMs在现实世界中的应用,各组织最初应优先使用已在开发中的患者报告指标,如患者报告体验指标。将PRMs与人工智能(AI)技术相结合,如“诊断导航”(一种动态诊断优化过程,还包括分析电子健康记录数据和元数据以描述诊断过程),也应能提高诊断性能。最终,将PRMs与技术进步相结合,有可能实现卓越诊断的真正共同生产。