End Diagnostic Overshadowing:Addressing Ableism in Diagnoses

"1). A baseline audit of diagnostic processes (including data from the Safer DX Checklist and CPT E/M code usage) for patients aged ≥ 3 to 89 years with one or more of 26 diagnoses prone to error to compare cases of PWD with specific disabilities (major mobility impairments,1 mental health concerns,2,3 severe visual impairments/ blindness,4 severe hearing loss/deafness,5 and IDD6,7) versus without the disabilities.~Using analyses of data, chart reviews, staff interviews and mock tracers, a frame of themes underlying increased risk of DE will be co-produced to develop algorithms to identify patients with the specified disabilities at risk. Case studies for education on DE, and EHR prompts, alerts, and decision supports related to the algorithms will be co-produced along with education on the EHR materials. Evaluate for change in use of diagnostic processes among PWD post implementation of algorithms and EHR prompts, alerts and decision supports will be conducted post-intervention."

Patients without disabilities will receive standard care related to electronic health record prompts, alerts, and decision supports.