Impediments and Solutions

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Impediments and Solutions

• ADVANCING PRACTICE, INSTRUCTION AND INNOVATION
  THROUGH INFORMATICS

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Blame Canada

• Resistance to change
• Narrative reports whos really telling
  stories?

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Top Four Obstacles to Structured Reporting?

• APLIS
• APLIS
• APLIS
• Physician resistance to change

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Top Four Obstacles to Structured Reporting

• Perception extra work
• Generally true!
• Cancer cases only two work flows!
• Inflexible tools
• Cannot customize at point of care
• To hard to set up and maintain
• Benefits to most pathologists?

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Obstacles
Reality Pathology It has to play in Peoria
General, not just Mass. General
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Solutions

• Must improve workflow
• For pathologists!
• Same workflow for every case
• Must be customizable and easy to set up and
  maintain
• At the point of care, on live patient reports!
• Helpful to show other benefits
• Automate billing and enhanced reporting

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Side Benefits of Structured Reporting

• Structured Pathologic Data
• XML and/or database(s) for query
• Much more efficient and accurate
• QC at the point of care
• Decision support
• Requires Common Data Elements
• For internal maintenance
• For data sharing across institutions/systems
• HL7 effort underway

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Extreme Workflow Makeover

• Patient Safety
• Ideally, requisition forms, blocks, slides, and
  reports should match

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Patient Safety
People make mistakes
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Extreme Workflow Makeover

• Pre-accessioned biopsy kit (patent pending)
• Error prevention
• Decreases processing time and labor

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Extreme Workflow Makeover

• 2D bar-coding
• Generate correct report template with defaults
• Match slides, blocks, reports chain of custody
• No dictation

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Extreme Workflow Makeover

• Beyond Cancer Protocols
• Automate reporting of all specimen types
• Automate reporting of special studies

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Extreme Workflow Makeover

• Enhanced Reporting
• Tables
• Diagrams
• Images
• Standardized report formats

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Extreme Workflow Makeover

• Other technologies
• Internet reports, notifications, and slide
  consultation

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Extreme Workflow Makeover

• Advantages
• Diagnosis within one day of receipt
• Patient Safety
• Efficiencies

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Solutions
Examples of Synoptic Reporting using SoftPath
(SCC Soft Computer Consultants)