Practical APLIS-based Structured/Synoptic ReportingDavid L Booker, MD

Friday, August 18, 2006

Vancouver, British Columbia

Impediments and Solutions

ADVANCING PRACTICE, INSTRUCTION AND INNOVATION THROUGH INFORMATICS

“Blame Canada”

•Resistance to change

•“Narrative” reports – who’s really telling stories?

Top Four Obstacles to Structured Reporting?

•APLIS

•APLIS

•APLIS

• Physician resistance to change

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?

Reality Pathology

It has to play in Peoria General, not just Mass. General

Obstacles

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

“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

Extreme Workflow Makeover

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

Patient Safety

People make mistakes

Extreme Workflow Makeover

Pre-accessioned biopsy kit (patent pending)

•Error prevention

•Decreases processing time and labor

Extreme Workflow Makeover

2D bar-coding–Generate correct report template with defaults

–Match slides, blocks, reports – chain of custody

–No dictation

Extreme Workflow Makeover

Beyond Cancer Protocols–Automate reporting of all specimen types

–Automate reporting of special studies

Extreme Workflow Makeover

Enhanced Reporting

–Tables

–Diagrams

–Images

–Standardized report formats

Extreme Workflow Makeover

Other technologies

–Internet reports, notifications, and slide consultation

Extreme Workflow Makeover

Advantages–Diagnosis within one day of receipt

–Patient Safety

–Efficiencies

Solutions

Examples of Synoptic Reporting

using SoftPath® (SCC Soft Computer

Consultants)