Getting the diagnosis right when the lab results don't add up

I'm Mike Laposata. I spent my career building diagnostic management teams at MGH, Vanderbilt and UTMB. I'm writing because something I've wanted for a long time now exists, and I'd like you to know how it works.

The problem you already know

Some years ago I served on the National Academy of Medicine committee that studied diagnostic error. Our conclusion was hard to hear: most people will experience at least one diagnostic error in their lifetime.

You've seen it. A patient comes in short of breath and leaves with an asthma diagnosis, when asthma was never the problem. About 795,000 Americans die or are permanently disabled every year from diagnostic error.

Why it keeps getting harder

The tests keep multiplying, especially in genetics. They're expensive, and what we know about each disorder is growing faster than any one physician can follow.

No single doctor can hold all of it. A complex case needs someone whose whole job is getting the diagnosis right: pulling together the lab results, the radiology and the anatomic pathology into one integrated diagnostic report.

At my institutions, that's what our teams did. Putting an expert's interpretation directly in the hands of the ordering physician reduced errors and shortened the time to the right diagnosis. The limitation was always the walls. If your patient wasn't at one of those hospitals, you didn't get that help.

How ExpertDx works

You drag and drop the medical record into a simple, HIPAA-compliant intake. No new software, no fax.

AI reads every page and assembles a structured draft with a differential diagnosis.

Then a credentialed expert, starting with me, reviews it, corrects it and signs the final interpretation back to you with recommended next steps.

You stay the ordering physician. You receive a signed report you can act on and file in the record.

Coagulation is where we're deepest today. We're credentialing experts in more areas as we grow, so that a physician in a rural Texas county can get the same expert read as one down the hall from an academic center.

What ExpertDx is not

We're not a lab. We don't run tests. Your tests get done wherever they get done today. We add something without taking anything away, and we're glad to work through your local pathologist where that's how your hospital communicates.

We don't put non-experts in the pathway. The person giving you the answer is someone who knows the field.

This isn't a chatbot. The AI draft draws on reference material built over a career, including the laboratory medicine textbook I wrote. But the draft is only a starting point. What you act on is the interpretation a credentialed expert has read, corrected and signed. Think of it as a colleague helping you, with AI doing the legwork.

When to send a case

When the results don't fit together. When the patient isn't getting better. When you're not sure.

That's the moment to send it. The goal isn't another opinion to weigh. It's going from "I think" to "I'm sure."

Join the founding cohort

We're opening with a founding cohort limited to 50 practices. Founding members lock in $150 a case and have a direct line to me on how the service develops.

Take a look at www.expert-dx.com and reserve a spot, or reach out and I'll walk you through it myself. I'd be honored to read your hardest cases with you.

Mike

About the author

Mike Laposata is a laboratory medicine physician who built diagnostic management teams at Massachusetts General Hospital, Vanderbilt University Medical Center and the University of Texas Medical Branch. He wrote a laboratory medicine textbook, served on the National Academy of Medicine committee on diagnostic error, and is a co-founder of ExpertDx.

About ExpertDx

ExpertDx, Inc. connects ordering physicians with credentialed experts who read and sign complex lab and diagnostic cases. Coagulation is our deepest specialty today, with more areas being added.

Have a case that doesn't add up? Reserve your spot in the founding cohort at www.expert-dx.com

This article is written for physicians and is not medical advice for patients.