https://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&feed=atom&action=historyJournal:Anatomic pathology quality assurance: Developing an LIS-based tracking and documentation module for intradepartmental consultations - Revision history2024-03-28T13:53:28ZRevision history for this page on the wikiMediaWiki 1.36.1https://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48630&oldid=prevShawndouglas: /* Abstract */ Fix2022-08-01T20:08:11Z<p><span dir="auto"><span class="autocomment">Abstract: </span> Fix</span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 20:08, 1 August 2022</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''Background''': An electronic intradepartmental consultation system for [[Anatomical pathology|anatomic pathology]] (AP) was conceived and developed in the [[laboratory information system]] (LIS) of University of Iowa Hospitals and Clinics in 2019. Previously, all surgical pathology intradepartmental consultative activities were initiated and documented with paper forms, which were 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.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''Background''': An electronic intradepartmental consultation system for [[Anatomical pathology|anatomic pathology]] (AP) was conceived and developed in the [[laboratory information system]] (LIS) of University of Iowa Hospitals and Clinics in 2019. Previously, all surgical pathology intradepartmental consultative activities were initiated and documented with paper forms, which were 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.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''Methods''': [[<del style="font-weight: bold; text-decoration: none;">Workflows</del>]] 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.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''Methods''': [[<ins style="font-weight: bold; text-decoration: none;">Workflow</ins>]]<ins style="font-weight: bold; text-decoration: none;">s </ins>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.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''Results''': The electronic consult system allowed electronic documentation of all steps of intradepartmental consultative activities. The system provided a tracking ability for consulted cases and improved access to consult discussion for all departmental personnel, staff, and trainees. A consultation work queue was created for each pathologist, and a summary of individual consultative workload was made possible. Documentation of anatomic pathology quality assurance for intradepartmental consultative activity was easily assessed.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>'''Results''': The electronic consult system allowed electronic documentation of all steps of intradepartmental consultative activities. The system provided a tracking ability for consulted cases and improved access to consult discussion for all departmental personnel, staff, and trainees. A consultation work queue was created for each pathologist, and a summary of individual consultative workload was made possible. Documentation of anatomic pathology quality assurance for intradepartmental consultative activity was easily assessed.</div></td></tr>
</table>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48604&oldid=prevShawndouglas: Finished adding rest of content.2022-07-18T21:40:40Z<p>Finished adding rest of content.</p>
<a href="https://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48604&oldid=48603">Show changes</a>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48603&oldid=prevShawndouglas: Saving and adding more.2022-07-18T21:28:34Z<p>Saving and adding more.</p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 21:28, 18 July 2022</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Discussion==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Discussion==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>In a pathology department, the consultation process involves a multi-step circulation of consultation materials within the department, as well as the effective management and documentation of the process. Documenting the details of each consultation is an important task for patient care, for pathologist continuing education through workplace activities, and as a requirement for laboratory accreditation. The College of American Pathologists Master Anatomic Pathology Checklist from 2020 requires that SP laboratories <del style="font-weight: bold; text-decoration: none;">must </del>have a "procedure for handling intra- and extra-departmental consultations in the patient’s final report." [7] The ability to track slides and case paperwork traveling between primary pathologist and consultant pathologist is particularly valuable, ideally to provide work queues for consultants and account for pathologists’ time spent on consults.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>In a pathology department, the consultation process involves a multi-step circulation of consultation materials within the department, as well as the effective management and documentation of the process. Documenting the details of each consultation is an important task for patient care, for pathologist continuing education through workplace activities, and as a requirement for laboratory accreditation. The College of American Pathologists Master Anatomic Pathology Checklist from 2020 requires that SP laboratories have a "procedure for handling intra- and extra-departmental consultations in the patient’s final report." [7] The ability to track slides and case paperwork traveling between primary pathologist and consultant pathologist is particularly valuable, ideally to provide work queues for consultants and account for pathologists’ time spent on consults.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Consultation in medical practice is important and has been documented to improve overall patient care. Electronic consultation has become more widespread in recent years, extending the benefits of the consultation process. [1, 2, 3] Consultation in anatomic pathology is an important component of the quality assurance functions in a laboratory and can prevent misdiagnosis. Prior studies in our department, as well as in many others, have shown significant numbers of major diagnostic discrepancies on re-review of pathology reports from other institutions’ pathology departments. [8,9] Given this data, one can readily see the potential benefits of such re-reviews taking place as intradepartmental consultations prior to sign out.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Intradepartmental pathology consultations are conducted in various forms, but little information is available in the published literature regarding these practices. A common method across academic and private practice settings involves face-to-face discussions between the primary pathologist and the consultant across the microscope. [10] Another common practice, owing to demands of time placed on the consultant and a desire to obtain an unbiased and unhurried opinion, involves routing of cases via a trainee or pathologists’ mailbox. In some instances, consultation opinions are verbally rendered and paraphrased into reports from jotted-down notes or memory, possibly an error prone step. A formalized recording of the content of consultation exchanges, however, is not always a part of SP case handling. [10] Intradepartmental consensus case conferences utilizing a multi-headed microscope or a projector is a method of reaching consensus diagnosis by multiple pathologists. [11] Typically, a log record of agreement with diagnoses and those present at the conference is maintained. However, it is uncommon for there to be verbatim capture of the opinions rendered and a granular record of differences in opinion and approaches from the pathologists offering expert opinions in these conferences.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The e-consultation system which we now utilize reduces further the chances of misdiagnosis as the opinions expressed by the consultant are gathered by direct input, rather than by oral "curbside" opinions, handwritten notes, or information transmitted through an intermediary, such as a pathology trainee, all of which are common means for some departments.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In our institution, Epic Systems Corporation's AP Beaker was implemented in 2015; however, it did not have a module to perform intradepartmental consultations electronically. For this reason, a long-standing paper system was in place and utilized, but with many of the problems of a system that is not tied into the LIS and not attached directly to the working draft components of the report.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Consultants did not know what was in their consultant work queue without walking to their mailbox to see the slides, whereas the electronic system allows pathologists to check their queue for consults from any location with a network connection. Previously, no LIS-wide mechanism allowed for determination of where the slide assets resided, either with the primary pathologist or the consultant. The primary pathologist did not know if a consult was finished until the slides and paperwork were back in their mailbox. Deciphering handwriting was also sometimes a time-consuming and error-prone step.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The e-consult system greatly increased the effectiveness of our SP consult system by making all aspects of the process easier. It has become widely accepted amongst faculty with essentially 100% usage for all consultations. Making the process easier makes it more likely that a pathologist will initiate a consult. It is not only easier to initiate a consult but also easier to respond with all the clinical, laboratory, and radiology data from the chart in one place.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The electronic, LIS-based intradepartmental consultation system improves management and documentation of the consultation process. For the primary pathologists, initiating consultations does not require handwriting the tissue site, history, or other information to be passed to the consultant pathologist, as these can easily be gathered electronically. The system allows for tracking of consulted cases. Rather than physically checking a mailbox to see if a consult is finished, this task is facilitated by the pathologist’s individual work queue. For more complex cases which have multiple parts, it is more practical to edit the electronic consultation report, rather than handwriting an extensive reply on a paper form. In some situations, the electronic system provides a simple way to incorporate the consultant pathologist’s reply into the diagnosis line by using the copy and paste function. Although somewhat unexpected, this system prevents time lost attempting to decipher and re-transcribe handwritten text.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">For the consultant pathologist, a pending outstanding list for new consults is generated with implementation of the electronic consultation process. This provides immediate awareness of new pending consults and allows an opportunity for consultant pathologists to improve time management. The consultant pathologist is also able to easily see comments from other consultants on the case.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In our department, where we have a hybrid of generalist and specialist practices, we have found the system useful for both types. Diagnoses are increasingly nuanced by more complex data that is continually being added by the literature, and it is becoming more difficult for generalists to be aware of all developments. For pathologists that are on a generalist service, opinions come from subject matter experts, such as those with gynecologic, breast, or gastrointestinal interests or special training. These opinions greatly reduce the chance for misdiagnosis, as they reflect the latest in diagnostic criteria and standards of diagnosis.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">For pathologists who are subject matter experts, consultation to another pathologist with expertise in the same area greatly increases the consistency of diagnosis and increases the chance of collaboration on studies that are instigated by an interesting finding in what would be an index case.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">We have found the electronic consultations helpful for the management and function of our department in regard to tumor boards. When the physical consultation materials for the cases are requested for conferences or tumor boards, tracking ability provides quick localization of the cases for everybody. This decreases time spent on finding the case materials, which is usually critical before the conferences. Further, an unexpected benefit of having a consultative opinion connected to the report and available to the pathologists involved has been useful when cases are discussed at tumor boards, sometimes long after the report has been issued.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The system has educational benefit for trainees. It is easier for them to track all the steps of the consultation process electronically, as the physical paper forms were not always easily available for them to review. Further benefit was noted for SP fellows in our preliminary diagnosis rotation when providing preliminary diagnoses to clinicians by easily locating the case and accessing the consultation discussion. In addition, ready access to the recorded thoughts of consultants in prior cases can aid in the resolution of diagnostic dilemmas in current cases.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Internal consultation in AP constitutes a significant amount of workload for pathologists. [10] The system provides electronic documentation for all AP consultations and removes the difficulty of performing retrospective reviews of paper-based forms, the need for a physical paper storage area, and clerical time spent on archiving paper consult forms. It also prevents cases from being finalized without formal documentation of consultations. Estimation of workload is performed easily by tallying the number of times an individual pathologist was named in the "Consultants" field. This feature is especially helpful to detect underreported workload for many pathologists. We had no mechanisms to detect undocumented consultations in the paper-based system.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">One of the downsides of this system includes the potential for a portion of a consultation discussion to be inadvertently edited or deleted, although we are not aware that this has happened thus far. In addition, it is necessary for the consultant to open the LIS to see the consult question and type his/her reply. Although typing is more efficient than handwriting for most pathologists, some experienced less efficiency with typing.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==Conclusion==</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In summary, our experience of managing intradepartmental consultative activities electronically improved our documentation and operation of the consultation process. It provided tracking ability and facilitated the consultation process for both active and finalized cases by removing paper forms used for consultation. This is a useful tool to improve intradepartmental consultation activities, which have a vital role in preventing misdiagnosis and improving pathology reporting and trainee education.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==Acknowledgements==</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">There are no conflicts of interest or financial disclosures.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">===Authors' contributions===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Bilge Dundar contributed to manuscript preparation, data collection, and figure creation. Megan I. Samuelson conceived the project idea and contributed to manuscript editing. Stephanie J. Chen contributed to manuscript editing and figure editing. Anand Rajan KD contributed to manuscript editing, data analysis, and figure creation. John L. Blau, Robert A. Robinson, Michelle L. Greek-Lippe, and Kim S. Lake contributed to manuscript editing.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">===Competing interests===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">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.</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td></tr>
</table>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48597&oldid=prevShawndouglas: Saving and adding more.2022-07-17T19:37:02Z<p>Saving and adding more.</p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:37, 17 July 2022</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Discussion==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Discussion==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div> </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In a pathology department, the consultation process involves a multi-step circulation of consultation materials within the department, as well as the effective management and documentation of the process. Documenting the details of each consultation is an important task for patient care, for pathologist continuing education through workplace activities, and as a requirement for laboratory accreditation. The College of American Pathologists Master Anatomic Pathology Checklist from 2020 requires that SP laboratories must have a "procedure for handling intra- and extra-departmental consultations in the patient’s final report." [7] The ability to track slides and case paperwork traveling between primary pathologist and consultant pathologist is particularly valuable, ideally to provide work queues for consultants and account for pathologists’ time spent on consults.</ins></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
</table>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48596&oldid=prevShawndouglas: Saving and adding more.2022-07-17T19:34:52Z<p>Saving and adding more.</p>
<a href="https://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48596&oldid=48583">Show changes</a>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48583&oldid=prevShawndouglas: Saving and adding more.2022-07-17T18:55:14Z<p>Saving and adding more.</p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 18:55, 17 July 2022</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Introduction==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Introduction==</div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">Although relatively recent, the benefit of electronic consultation (e-consultation) has been noted across the spectrum in medicine. In the clinical setting, the availability of such consultation has decreased patient waiting times for specialist consultation and has had a particularly positive effect in patient populations that are underserved. [1,2] Surgical specialties have also noted increased efficiency in scheduling surgical intervention in their waiting lists when utilizing e-consultation. [3]</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">In [[Anatomical pathology|anatomic pathology]] (AP), it has been shown that intra‐departmental consultations increase the value and diagnostic accuracy of reports and are vital steps to improve patient care. [4, 5, 6] However, while consultation in AP is long established, e-consultation is less well established.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The University of Iowa Hospitals and Clinics sought to improve its tracking and documentation process for AP intradepartmental consultations by using its [[laboratory information system]] (LIS), AP Beaker, in 2019. In this study, we describe the development, implementation, and utilization of an electronic intradepartmental AP consultation system and discuss its advantages and disadvantages.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==Background==</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">===Institutional details and historical context of paper-based intradepartmental consultations===</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">The Department of Pathology at our institution is a mid-sized academic [[pathology]] program (presently 36 clinical faculty, 20 residents, nine fellows) with a partially subspecialized service model in anatomic pathology, including renal pathology, hematopathology, dermatopathology, and neuropathology serving as dedicated subspecialty services. Gastrointestinal pathology and [[cytopathology]] services are essentially subspecialized. Prior to converting to an electronic form of consultation in AP, a long-standing paper system was in place and utilized despite the implementation of a now legacy electronic LIS (Cerner Corporation's PathNet) several decades ago and of the current AP LIS (Epic Systems Corporation's AP Beaker), which went live in 2015. Neither LIS had modules to implement or store intradepartmental consultation discussions and did not allow intradepartmental consultations to be performed electronically. In the paper-based workflow, an 8.5 x 11-inch form was colored yellow to stand out from other forms and reports (Fig. 1). Consultations were initiated by handwriting on the paper form. These consultation forms were placed with the slides and directed to the consultant faculty, who in turn wrote their consultative thoughts and returned the sheet with the slides to the primary pathologist (Fig. 2). The primary pathologist recorded the consulting pathologist in the final report in a dedicated data field in the LIS.</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">[[File:Fig1 Dundar JofPathInfo2022 13.jpg|610px]]</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">{{clear}}</ins></div></td></tr>
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<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">{| border="0" cellpadding="5" cellspacing="0" width="610px"</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"> |-</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"> | style="background-color:white; padding-left:10px; padding-right:10px;" |<blockquote>'''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.</blockquote></ins></div></td></tr>
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<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"> |-</ins></div></td></tr>
<tr><td colspan="2"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"> | style="background-color:white; padding-left:10px; padding-right:10px;" |<blockquote>'''Fig. 2''' Workflow of the previous, paper-based intradepartmental consultation process. No tracking or notification system occurs on these steps.</blockquote></ins></div></td></tr>
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</table>Shawndouglashttps://www.limswiki.org/index.php?title=Journal:Anatomic_pathology_quality_assurance:_Developing_an_LIS-based_tracking_and_documentation_module_for_intradepartmental_consultations&diff=48578&oldid=prevShawndouglas: Created stub. Saving and adding more.2022-07-17T18:39:01Z<p>Created stub. Saving and adding more.</p>
<p><b>New page</b></p><div>{{Infobox journal article<br />
|name = <br />
|image = <br />
|alt = <!-- Alternative text for images --><br />
|caption = <br />
|title_full = Anatomic pathology quality assurance: Developing an LIS-based tracking and documentation module for intradepartmental consultations<br />
|journal = ''Journal of Pathology Informatics''<br />
|authors = Dundar, Bilge; Chen, Stephanie J.; Blau, John L.; Anand Rajan, K.D.; Samuelson, Megan I.; Greek-Lippe, Michelle L.; Lake, Kim S.; Robinson, Robert A.<br />
|affiliations = University of Iowa Hospitals and Clinics<br />
|contact = bilge-dundar at uiowa dot edu<br />
|editors = <br />
|pub_year = 2022<br />
|vol_iss = '''13'''<br />
|at = 100109<br />
|doi = [http://doi.org/10.1016/j.jpi.2022.100109 10.1016/j.jpi.2022.100109]<br />
|issn = 2153-3539<br />
|license = [https://creativecommons.org/licenses/by-nc-nd/4.0/ Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International]<br />
|website = [https://www.sciencedirect.com/science/article/pii/S2153353922007039 https://www.sciencedirect.com/science/article/pii/S2153353922007039]<br />
|download = [https://www.sciencedirect.com/science/article/pii/S2153353922007039/pdfft?md5=fd969e0ae1e3acc7a2cef5c0ca161b03&pid=1-s2.0-S2153353922007039-main.pdf https://www.sciencedirect.com/science/article/pii/S2153353922007039/pdfft] (PDF)<br />
}}<br />
{{ombox <br />
| type = notice <br />
| image = [[Image:Emblem-important-yellow.svg|40px]] <br />
| style = width: 500px; <br />
| text = This article should be considered a work in progress and incomplete. Consider this article incomplete until this notice is removed. <br />
}}<br />
==Abstract==<br />
'''Background''': An electronic intradepartmental consultation system for [[Anatomical pathology|anatomic pathology]] (AP) was conceived and developed in the [[laboratory information system]] (LIS) of University of Iowa Hospitals and Clinics in 2019. Previously, all surgical pathology intradepartmental consultative activities were initiated and documented with paper forms, which were 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.<br />
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'''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.<br />
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'''Results''': The electronic consult system allowed electronic documentation of all steps of intradepartmental consultative activities. The system provided a tracking ability for consulted cases and improved access to consult discussion for all departmental personnel, staff, and trainees. A consultation work queue was created for each pathologist, and a summary of individual consultative workload was made possible. Documentation of anatomic pathology quality assurance for intradepartmental consultative activity was easily assessed.<br />
<br />
'''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 [[Pathology|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.<br />
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'''Keywords''': electronic intradepartmental consultation, anatomic pathology, surgical pathology, laboratory information system<br />
<br />
==Introduction==<br />
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==References==<br />
{{Reflist|colwidth=30em}}<br />
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==Notes==<br />
This presentation is faithful to the original, with only a few minor changes to presentation, grammar, and spelling. In some cases important information was missing from the references, and that information was added. No other modifications were made in accordance with the "no derivatives" portion of the distribution license.<br />
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<!--Place all category tags here--><br />
[[Category:LIMSwiki journal articles (added in 2022)]]<br />
[[Category:LIMSwiki journal articles (all)]]<br />
[[Category:LIMSwiki journal articles on clinical informatics]]<br />
[[Category:LIMSwiki journal articles on pathology informatics]]</div>Shawndouglas