Learning While We Build: Identifying the Must-Know Research Questions for Safe and Effective Telediagnosis

Although telemedicine has been available for decades, the COVID-19 pandemic has transformed its usage overnight. Telemedicine resources have become the mainstay for healthcare delivery today across the nation, a reality that may well continue long after the COVID pandemic has been controlled. The use of telemedicine for diagnosis at this scale is unprecedented and creates a pressing need to understand the implications of this transformation on the quality and safety of diagnosis. Diagnostic error is the most common, costly, and harmful of all medical errors. As healthcare delivery, and diagnosis specifically, is turned on its head through the use of telemedicine, what impact will this have on diagnostic accuracy and timeliness? To respond to this need, the Society to Improve Diagnosis in Medicine (SIDM) will serve as the neutral convener for a multi-stakeholder effort to prioritize and prepare for the research most needed by the diagnostic quality and telediagnosis communities. Through an environmental scan of available literature, and a series of virtual listening sessions, the project will identify the telediagnosis questions in most critical need of study. Additionally, listening session participants will share their insights and ideas about how all needed research stakeholders can most effectively be mobilized and prepared for this work. The primary objectives of the project are to facilitate future research by understanding the factors most relevant to the successful use of telediagnosis and the best mechanisms for preparing relevant stakeholders to prepare to participate in this research. The major deliverables will be a set of issue briefs, each synthesizing and curating the specific research themes and educational needs for a given stakeholder group, a master report of all findings for PCORI, and a webinar presenting the project findings across multiple audiences. These products will be disseminated to the members of SIDM's Coalition to Improve Diagnosis, and published on social media, on the SIDM website, and through other publication outlets available to SIDM. A prompt, focused comparative research response will be paramount, and the other learnings generated through this effort-unearthing the most urgent needs and emerging promising practices-can be harnessed for immediate consumption by the healthcare and patient community. Patients and other stakeholders will be equal partners in each stage of the project from early ideation of the environmental scan, through planning for and executing listening sessions, to final analysis and dissemination of the project findings. Even the proposal is being created jointly by a patient, clinician, and diagnostic safety advocate from SIDM.