Beyond diagnosis: Are there blind spots in our approach to ensuring patient safety?
In my 20+ years in healthcare, I’ve seen tremendous progress in how we diagnose and treat illnesses. If my grandparents had lived a century ago, their life expectancy would have been much shorter due to undiagnosed or misdiagnosed conditions. Today, thanks to advancements in medical technology, we live longer, healthier lives.
Indeed, we are getting it right for the most part, and the healthcare ecosystem is dedicated and committed to “getting it safe.” But how do we ensure that we are also addressing the challenges that threaten the accuracy of diagnoses and the safety of patients?
Accurate diagnosis is the cornerstone of effective treatment. [i] It directly impacts patient safety and the trust people place in our healthcare systems. I recall a close friend who visited several doctors for recurring symptoms, only to be misdiagnosed multiple times. By the time a correct diagnosis was made, precious time had been lost, and the delayed treatment led to a far worse prognosis than if it had been identified earlier. It was a sobering reminder of how critical timely and accurate diagnosis is to improving health outcomes.
Inaccurate diagnosis results in exposure to inappropriate prescription medicines, that can pose unnecessary but significant health risks to patients. The World Health Organisation (WHO) has developed guidelines to improve diagnostic accuracy, like the Global Patient Safety Action Plan, which advocates for systematic practices to reduce errors and improve patient outcomes.
Ensuring accurate diagnosis remains challenging, especially in under-resourced areas. Many healthcare facilities lack the equipment needed for timely and accurate diagnoses. Continuous education and training for healthcare professionals are also crucial to reducing errors. Additionally, financial and infrastructural barriers often prevent patients from accessing necessary diagnostic services.
One significant, yet often overlooked threat to accurate diagnosis is the issue of diverted pharmaceutical products. These products, which enter the market through unauthorised channels, can lead to the distribution of falsified or substandard medicines. Such medicines might not contain the necessary active ingredients, could be harmful, or may be improperly stored, all of which can result in misdiagnoses and ineffective treatments.
According to a World Bank report, for many people in low-income countries with weak regulatory systems, the likelihood that their hard earned money is spent on fake or ineffective drugs can be as high as 50 per cent. The consequences of using these substandard drugs can be severe, leading to treatment failures and even death. It estimated that the use of fake drugs causes thousands of deaths and even larger numbers of severe cases of illness every year due to the use of illicit medicines.
To improve diagnostic accuracy, we must prioritise access to advanced diagnostic tools, especially in underserved regions. This requires investment in healthcare infrastructure and ensuring that healthcare professionals have the training they need. Financial and infrastructural barriers must also be addressed to make diagnostic services accessible to all.
Recognizing the need for trained professionals, Ghana has the Value Chain Academy in Ghana which strengthens local healthcare systems by equipping students and professionals with knowledge of best practices in medicine distribution, quality control, and patient safety. By harmonising the understanding of standard value chain policies, we help reduce diagnostic errors and improve the overall healthcare experience.
A perfect healthcare infrastructure is the aim for all stakeholders in the industry, but we need to acknowledge that misdiagnoses can happen, and develop feedback mechanisms for patients and healthcare professionals to share such reports to the manufacturers or regulatory bodies. As medicines follow diagnosis, it is important the pharmaceutical companies invest in a Patient Safety department whose role is to monitor, assess, and prevent adverse drug reactions, ensuring that every patient receives safe and effective treatment.
Human medicine manufacturers must exude their commitment to strengthening healthcare systems by continuing to work with like-minded partners and institutions to improve patient outcomes. Recently, as part of the Avoidable Blindness initiative, in partnership with the Fred Hollows Foundation (FHF), a Fundus Camera was presented to JOOTRH Hospital in Kenya. This advanced tool will enable ophthalmologists to detect conditions like diabetic retinopathy, glaucoma, and macular degeneration at an early stage, which is crucial for accurate diagnosis and effective treatment.
Addressing the issue of diverted pharmaceutical products is equally critical. Strengthening regulations and raising public awareness about the risks of falsified medicines can protect the integrity of our healthcare systems. The Pharmacy and Poisons Board’s Operation African Star Initiative, which combats counterfeit medicines are commendable. However, more needs to be done to tackle the exploitation of parallel imports and diverted products.
As we commemorate World Patient Safety Day, let us reaffirm our collective responsibility to safeguard patient health. Public awareness is key. Patients, healthcare professionals, and policymakers must collaborate to ensure that diagnostic practices are both safe and reliable. Patients and families should also be empowered to actively engage with health workers and health care leaders to improve diagnostic processes. Through education and advocacy, we can create a healthcare system that truly prioritises patient safety.
Improving diagnostics and ensuring patient safety is a challenging journey, but it’s one worth taking. By addressing these issues with determination and collaboration, we can ensure that every patient receives safe, effective, and timely care.
The writer is the Cluster Head for Novartis East & Southern Africa
BY DR ANTHONY MWANGI
