Abstract
Diagnostic investigations (pathology laboratory and medical imaging) aim to: increase certainty of the presence or absence of disease by supporting the process of differential diagnosis; support clinical management; and monitor a patient's trajectory (e. g., disease progression or response to treatment). Digital health can be defined as the collection, storage, retrieval, transmission, and utilization of data, information, and knowledge to support healthcare. Digital health has become an essential component of the diagnostic process, helping to facilitate the accuracy and timeliness of information transfer and enhance the effectiveness of decision-making processes. Digital health is also important to diagnostic stewardship, which involves coordinated guidance and interventions to ensure the appropriate utilization of diagnostic tests for therapeutic decision-making. Diagnostic stewardship and informatics are thus important in efforts to establish shared decision-making. This is because they contribute to the establishment of shared information platforms (enabling patients to read, comment on, and share in decisions about their care) based on timely and meaningful communication. This paper will outline key diagnostic informatics and stewardship initiatives across three interrelated fields: (1) diagnostic error and the establishment of outcomes-based diagnostic research; (2) the safety and effectiveness of test result management and follow-up; and (3) digitally enhanced decision support systems.
Highlights
Diagnostic investigations and tests involve the observation of personal characteristics, symptoms, signs, and history
Digital health contributes to effective decision-making by improving the ability to gather, organize, and display information or by enhancing timely access to diagnostic reference information, facilitating followup, and providing feedback to clinicians and patients [3]
Diagnostic informatics is a key component of successful diagnostic stewardship, which encompasses the coordinated guidance and interventions to ensure the appropriate utilization of diagnostic tests for therapeutic decision-making [5]
Summary
Diagnostic investigations and tests (pathology and medical imaging) involve the observation of personal characteristics, symptoms, signs, and history. Linked and integrated digital health data sources and repositories across hospital, pathology, and primary care provide a means to identify, measure, and monitor the quality of care They can deliver key outcome-based measures of diagnostic utilization such as patient outcome or hospital admissions, which can be used to evaluate the impact of key interventions (e.g., electronic decision support). This is the premise underlying key initiatives like the New South Wales (NSW) Health Pathology Atlas of Variation (in collaboration with the NSW Emergency Care Institute and NSW eHealth Integrated Care), designed to create a statewide quality improvement project [10]. A significant source of diagnostic error can be attributed to shortcomings in the follow-up of test results, identified as a priority area by the World Health Organization’s World Alliance
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