Diagnostic Errors in Primary Care  (DxPSLL)


Diagnostic errors in primary care are costly and can be attributable to failures or delays in follow up on diagnostic testing, referrals, and patient symptoms. The proposed research seeks to “close the loop” on this public health problem by employing system engineering methods in three diverse healthcare practices to create a system that provides highly reliable follow-up of diagnostic tests, referrals, and symptom evolution.
Results will be disseminated broadly so as to improve diagnostic safety nationally.

Specific Aims :

Aim 1:​Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for diagnostic tests and referrals that ensures diagnostic orders and follow-up occur reliably within clinically- and patient-important time-frames.

Aim 2: Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for symptoms that ensures clinicians receive and act on feedback about evolving symptoms and physical findings of concern to patients or clinicians. 

Aim 3: Design for generalizability across health systems more broadly so that the processes created in Aims 1 and 2 are effective in (1) a practice in an underserved community, (2) a large tele-medicine system, and (3) a representative range of simulated other health system settings and populations.

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Affiliated Health Centers

Beth Israel Deaconess Medical Center (BIDMC) is part of Beth Israel Lahey Health, a new health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,000 physicians and 35,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.


Founded in Boston's Dorchester neighborhood in 1972 by community residents, Bowdoin Street Health Center remains focused on providing outstanding medical care while maintaining a tradition of working with residents to identify and meet their unique health needs. The mission of the health center is to provide excellent, compassionate care to our patients and support the health of the entire community.