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. 2022 Jun 24:13:100109.
doi: 10.1016/j.jpi.2022.100109. eCollection 2022.

Anatomic pathology quality assurance: Developing an LIS based tracking and documentation module for intradepartmental consultations

Bilge Dundar  1 , Stephanie J Chen  1 , John L Blau  1 , K D Anand Rajan  1 , Megan I Samuelson  1 , Michelle L Greek-Lippe  2 , Kim S Lake  2 , Robert A Robinson  1
Affiliations

Anatomic pathology quality assurance: Developing an LIS based tracking and documentation module for intradepartmental consultations

Bilge Dundar et al. J Pathol Inform. .

Abstract

Background: An electronic intradepartmental consultation system for anatomic pathology (AP) was conceived and developed in the laboratory information system (LIS) in 2019. Previously, all surgical pathology intradepartmental consultative activities were initiated and documented with paper forms which circulated with the pertinent microscopic slides and were eventually filed. In this study, we discuss the implementation and utilization of an electronic intradepartmental AP consultation system.

Methods: Workflows and procedures were developed to organize intradepartmental surgical pathology consultations from the beginning to the end point of the consultative activities entirely using a paperless system that resided in the LIS.

Results: The electronic consult system allowed electronic documentation of all steps of intradepartmental consultative activities. The system provided tracking ability for consulted cases and improved access to consult discussion for all departmental personnel, staff, and trainees. Consultation work queue was created for each pathologist and a summary of individual consultative workload was possible. Documentation of anatomic pathology quality assurance for intradepartmental consultative activity was easily assessed.

Conclusions: The electronic intradepartmental consult system has allowed our department to electronically track intradepartmental consult cases, store the consultative opinion text with the case, record the pathologists involved, and document the consultation for internal quality assurance review as well as for accrediting organizations. Summarization of pathologist workload related to consultative activity was quantifiable and optimization of the consultative process was maximized for education in an academic setting.

Keywords: Anatomic pathology; Electronic intradepartmental consultation; Laboratory information system; Surgical pathology.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
An example of the previous, paper-based intradepartmental consultation form used in our institution. Names of the pathologists are blurred under the “TO:” section.
Fig. 2
Fig. 2
Workflow of the previous, paper-based intradepartmental consultation process. No tracking or notification system occurs on these steps.
Fig. 3
Fig. 3
Workflow of the current electronic intradepartmental consultation process at our institution. LIS: Laboratory information system.
Fig. 4
Fig. 4
An example of a consultation discussion. The names of the pathologists and the dates are concealed. This field does not appear in the final report in the electronic medical record but is visible in AP Beaker after the report is finalized.
Fig. 5
Fig. 5
An example of a consultant’s work queue showing in process and completed (“done”) consult cases.
Fig. 6
Fig. 6
“Consultants” field is the field to record the name of the consultant pathologist(s). After finalization of the case, this field appears in the report.
Fig. 7
Fig. 7
Sankey diagram showing the direction of consulted cases from primary to consultant pathologists. Primary pathologists initiating consultation are depicted by nodes encoded by alphabet letters (A, B, C...) shown on the left, linked to the consultant pathologists, encoded similarly, shown on the right. The size of the links is proportional to the consultation case numbers. Consultations originating from pathology fellows are highlighted in orange and those sent to dedicated subspecialist pathologists as a part of a group (e.g., neuropathology, hematopathology) are highlighted in blue. Consultations within and to the dermatopathology service are shown in green.
Fig. 8
Fig. 8
Within 1 year of transition, number of cases for each pathologist as consultant (blue) and primary pathologist (orange).
See this image and copyright information in PMC

References

    1. Gaye M., Mehrotra A., Byrnes-Enoch H., Chokshi D., Wallach A., Rodriguez L., et al. Association of eConsult implementation with access to specialist care in a large urban safety-net system. JAMA Health Forum. 2021;2(5) doi: 10.1001/jamahealthforum.2021.0456. e210456-e56. [published Online First: Epub Date] - DOI - PMC - PubMed
    1. Vimalananda V.G., Gupte G., Seraj S.M., Orlander J., Berlowitz D., Fincke B.G., et al. Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis. J Telemed Telecare. 2015;21(6):323–330. doi: 10.1177/1357633X15582108. [published Online First: Epub Date] - DOI - PMC - PubMed
    1. Ulloa J.G., Russell M.D., Chen A.H., Tuot D.S. A cohort study of a general surgery electronic consultation system: safety implications and impact on surgical yield. BMC Health Serv Res. 2017;17(1):433. doi: 10.1186/s12913-017-2375-0. [published Online First: Epub Date] - DOI - PMC - PubMed
    1. Kuijpers C.C., Burger G., Al-Janabi S., Willems S.M., van Diest P.J., Jiwa M. Improved quality of patient care through routine second review of histopathology specimens prior to multidisciplinary meetings. J Clin Pathol. 2016;69(10):866–871. doi: 10.1136/jclinpath-2015-203488. [published Online First: Epub Date] - DOI - PubMed
    1. Chen B., Talwar R., Schwartz L.E., Terlecki R.P., Guzzo T.J., Kovell R.C. Second opinion pathologic review in the management of prostate cancer. Can J Urol. 2021;28(1):10530–10535. - PubMed

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