5 Obstacles to Creating a DMT

Overcoming challenges to prove value and achieve results

Ask any great thinker. The road to taking an innovative idea from concept to reality is often riddled with obstacles and opposition. Pushing past the resistance, generating support for your brainchild and proving its value are the keys to making progress and achieving results.

If you’re in the process of building a diagnostic management team — or DMT — in your organization, chances are you’re probably running into a few roadblocks.

A 2016 report by Johns Hopkins patient safety experts estimates that more than 250,000 annual deaths in the U.S. happen because of medical mistakes. The National Academy of Medicine has endorsed DMT consultative services as a means of reducing diagnostic errors. Healthcare organizations that have already created DMTs are quickly realizing the beneficial results that can stem from assembling a team of experts in a specific discipline to evaluate individual patient histories and lab data, and generating recommendations on diagnostic testing to improve outcomes.

“Instead of simply throwing test results over the wall to treating physicians, the DMT puts together the diagnostic puzzle and generates a diagnosis, or a short list of diagnostic options. This provides the information to the treating healthcare provider that they need because they do not know it,” explained Dr. Michael Laposata, Professor and Chairman of the Department of Pathology at the University of Texas Medical Branch in Galveston, and a leading proponent for DMT creation and use.

Here are five of the most common hurdles you’re likely to face in creating a DMT, with tips on how to overcome them.

Obstacle #5: Proving value  

Every organization struggles with the Catch-22 of finding a way to decrease episodic costs and prevent readmissions while at the same time improving the overall quality of patient care.

DMTs can save your organization money by minimizing overutilization and underutilization of diagnostic tests, and by helping reach definitive diagnoses in less time with fewer studies required. However, demonstrating value to the administrative powers that be in your organization comes down to a matter of being able to quantify results.

Health economist and Executive Director of Health Affairs at the Owen Graduate School of Business at Vanderbilt University, Dr. Larry VanHorn makes a compelling argument for the use of an Interrupted Time Series control that ties DMT intervention to specific cases and time frames, examining differences in resource use and length of stays — measurements that hospital management values and understands.

“The financial challenges faced by hospital administration are growing year over year,” Dr. VanHorn said. “A demonstrated ability to reduce costs and resource consumption will be key to success. One must recognize that management is frequently confronted with the ‘make an investment today and you’ll see a return tomorrow’ story line. Through the use of small pilot/proof-of-concept initiatives, you can produce real data that will make it easier for management to support broader initiatives.”

Selecting a specific patient group or DMT area of focus, Dr. VanHorn suggests comparing financial and operating metrics pre- and post-DMT intervention, taking into account length of stays, resource use, billing and the costs of operating the DMT.  

“The challenges facing the DMT team are to measure the effect of the intervention, tie it as directly as possible to the DMT initiative, and translate those changes into financially meaningful results for the facility,” he explained. “If successful, through the design of the DMT intervention, the team should be able to approximate a randomized control trial and quantify the incremental differences between the treatment and control population.”