In a report released this week, ECRI warned that misdiagnosis due to artificial intelligence and limited access to care in rural areas should be a top priority for healthcare organizations seeking to minimize preventable harm and improve patient outcomes in 2026.
These two issues rank at the top of the Medical Safety Group’s annual list of patient safety concerns, which span a wide range of focus areas, including technology, public health, staffing, organizational culture, and structural barriers to care.
Regarding the front-line issue of “addressing the AI diagnostic dilemma,” ECRI pointed to a 2025 American Medical Association survey of approximately 1,200 physicians that showed the use of AI rose from 38% in 2023 to 66% in 2024. It also highlighted peer-reviewed research from the past few years in which tested machine learning models consistently failed to detect serious health conditions and struggled to maintain accuracy when prompted. These are based on persistent biases introduced by simulated patient conversations, training datasets, and have weakened the vigilance of clinicians who rely on such tools for diagnosis (referred to as ‘automation bias’).
“For AI to be used effectively in diagnosis, clinicians need to view AI as a tool designed to complement and support clinical expertise, rather than replace it,” ECRI said in the report. “This requires a balanced implementation approach that carefully considers both the benefits and risks of AI to the diagnostic process.Clinicians who want to make the most of AI systems for diagnosis need to be trained on how to properly use the systems and understand their capabilities and limitations.”
Landing on the back of AI diagnostics were concerns that medical deserts in rural areas were poised to worsen amid hospital closures, negative operating margins in general, and impending federal health funding cuts (which also warranted its own entry at number four on ECRI’s list). The safety group highlighted that more than 60% of primary care, dental and mental health professional shortage areas are in rural areas.
These barriers can lead to delays in care, increased mortality and chronic disease, poor health habits, and lower life expectancy. To avoid these, ECRI recommended that organizations pursue innovative care models such as telemedicine and partnerships with community-based organizations.
Here is a complete list of the report’s top patient safety concerns in 2026:
- Overcoming the AI diagnostic dilemma
- Reduced access to health care in rural areas increases health risks and disparities
- Increased incidence of preventable acute diseases in communities and healthcare settings
- Impact of federal funding cuts on healthcare operations and patient safety
- Lack of recognition and reporting of hazardous events
- Structural and systemic barriers impede equitable pain management for women
- Persistent workforce shortages continue to strain staff and limit access to care
- Implications for system improvement when a culture of blame impedes learning
- Emergency department boarding worsens patient outcomes
- Persistent gaps in manufacturers’ packaging and label design continue to undermine drug safety efforts
ECRI and its affiliate, the Institute for Safe Medical Practice (ISMP), created its annual list and report by asking staff, the public, and members to nominate potential safety topics for evaluation. A multidisciplinary team of experts from each group reviewed the available evidence on these topics and rated each for its severity, frequency, scope, insidiousness (difficulty to recognize or remediate), and whether it would put pressure on the organization.
Each item on the list is accompanied by recommendations from a panel of experts on how organizations can address the issue to avoid preventable harm to patients.
The group noted that in addition to the inherent benefits of improved patient outcomes, “there are equally compelling financial arguments” for organizations to pursue these issues. Preventable adverse events cost U.S. hospitals $17.1 billion annually, and clinician burnout costs an additional $4.6 billion.
Last year’s list was headlined “Medical Gaslighting,” which refers to instances in which clinicians minimize the severity of a patient’s symptoms, ignore or interrupt patients, blame patients, or generally behave in a condescending manner. In 2024, the group highlighted the difficulty of transitioning newly trained clinicians into the broader workforce, which has been attrited due to pandemic-induced attrition and burnout.
ECRI has just recently released another report that specifically identifies the most significant medical technology risks to patients and organizations. Topping the list was the rise and abuse of large-scale language model-based chatbots (such as ChatGPT, Claude, Copilot, Gemini, and Grok) that were not designed or regulated for medical purposes.
