The role of philanthropy in advancing diagnostic excellence and the legacy of the Gordon and Betty Moore Foundation.

In America, medical research is largely driven by large investments of federal funding administered by government agencies. However, the problem of diagnostic error falls outside the usual funding categories for government-sponsored biomedical research. While federal resources are vital to support academic institutions and research teams, private funders and philanthropic organizations often contribute a significant source of support for medical research, particularly for critical gaps in funding and for high risk or innovative ideas. In 2017, the Gordon and Betty Moore Foundation launched an initial exploration into work that addressed diagnostic error and subsequently committed $85 million to their Diagnostic Excellence Initiative. Their model of strategic philanthropy proposed a pathway to improved diagnostic outcomes. Their three-pronged strategy and a summary of their portfolio of work for Diagnostic Excellence is described in this article. Lessons from their experience are worth reflection: real-world problems with diagnosis and reliable delivery of diagnostic care are complex and solutions require coordinated efforts across many disciplines; and efforts are more effective when done in partnership with like-minded organizations. We celebrate the contributions of the Moore Foundation and acknowledge their contribution to helping build a community committed to diagnostic excellence, develop infrastructure for quality improvement, and advance ideas for the use of technology to improve care.