CAP TODAY magazine features advances in tests and laboratory equipment, trends in management and clinical operation, regulatory changes and finance, plus news about the laboratory improvement programs of the College of American Pathologists.
Issue link: https://captoday.epubxp.com/i/362213
stepping up its automation: "Going automated is going to require attain- ing both hardware and software solu- tions. If you're going to have multiple vendors or one vendor, think about the end product and have a serious planning session. Will there be an overarching solution? Or will you have to develop homegrown inter- faces to tie everything together?" U SC Keck Medical Center, in Los Angeles, uses the Leica Cerebro tracking system for its outreach ser- vices. Cerebro tracks and verifes the identity of every specimen at each point of tissue transfer within the lab. "It works fantastically," says John Val- lone, MD, director of informatics and digital pathology. "We use the tracking functionality of Cerebro in conjunction with a cloud-based AP LIS called Path- Central." The medical center chose Leica because the company agreed to develop a bidirectional interface with the outreach LIS, he says. At every point from accessioning to archiving, the patient specimen is validated. The system allows for print- on-demand services, so cassettes and slides are specifc to the bar-coded parent container and are generated only as needed—that is, when tissue is transferred from container to cas- sette or at the microtome when tissue is transferred from block to slide. Dr. Vallone's laboratory is now planning to track specimens from their points of origin—in endoscopy suites, surgical rooms, and clinics, for exam- ple. "We've relooked at how pathol- ogy functions within the hospital and we're incorporating processes that used to occur when specimens hit our gross room into the general hospital workfow," he says. "We don't want to know the specimen exists when it hits our desk. We want to know it ex- ists when it is removed from the pa- tient." By replacing paper requisitions with electronic requisitions, nurses will be able to generate a tissue request like they would any other order, link- ing the tissue to the patient's EHR in real time. Written errors will be pre- vented and specimen standardization supported, Dr. Vallone says, by allow- ing nurses to choose from predefned back-end dictionaries to populate specimen name, specimen location, and other felds. "The new process will improve ef- fciency by alleviating the need for nursing to notate dates, procedure type, clamp times for breast cases, and formalin times for immunohistochem- ical processing because that informa- tion is populated as the specimen is acquired," Dr. Vallone says. Account- ability for patient information will reside with the person responsible for generating the information. "And its fdelity is enhanced via programming services that can be automated in the EHR and AP LIS," he adds. Once the electronic requisition is complete, a bar-coded label that in- cludes patient demographics and specimen information is generated and placed on the container. "Before the specimen reaches pathology, we will know the specimen exists, when it was generated, where it resides, how many specimens are present, and 95 percent of the accessioning process has already been complet- ed," Dr. Vallone says. When the spec- imen arrives in the gross room, its bar code will be scanned, which auto- mates the time received and pulls the information from the electronic req- uisition within the EHR into the AP LIS. A lab technician will verify the information in the AP LIS, and "the accessioning process is reduced from two to three minutes per case to fve to 10 seconds." The Department of Pathology will know in real time the number of speci- mens coming from each location. "This makes it possible for us to plan our personnel for increased specimen loads and makes us immediately aware of specimens that haven't ar- rived in pathology," Dr. Vallone says. The process will continue beyond ac- cessioning, "to track all specimen con- tainers to gross benches where cas- settes are printed on demand, into and through histology processing, and ultimately to the pathologist to whom cases are assigned." Once complete, they will be scanned into archives. D enise Bland-Piontek, CTBS (AATB)HTL(ASCP)QIHC, senior technical director for histopathology in the pathology service at Massachu- setts General Hospital, is a believer in health information technology driving automation. Her pathology service has experi- enced signifcant budget savings by insisting on an open Automation continued from 46 48 CAP TODAY | AUGUST 2014 OPPE/FPPE? No problem. © 2014 College of American Pathologists. All rights reserved. 23080 0714.1807 cap.org ™ Simplify compliance and demonstrate excellence with Evalumetrics. With Evalumetrics, it's easy to comply with Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE). • Streamline the OPPE/FPPE process with customized performance metrics for each pathology provider within a pathology department or group. • Support all practice competency and provider privileging with detailed reports. • Demonstrate—through objective evidence- based reports—the level of excellence you bring to your institution and patients. To learn more, visit cap.org/evalumetrics. —continued on 50