mTuitive xPert for Pathology": The Next Generation of Structured Pathology Reports
Best Scientific Session - Pathology Imaging Informatics ApplicationsMark J Tuthill MD; Henry Ford Hospital; Joy John Mammen MD; Henry Ford Hospital;
Content:
Variation and error in pathology reports affects clinical care and workflow. Structured pathology reports contribute significantly towards standardization and error reduction. Such functionality is available in earlier versions of Misys CoPath Plus" (Misys Healthcare, Raleigh, NC). While this tool has positive impact, there were drawbacks that including a cumbersome user interface, the inability to partially populate checklists, limited/truncated display of pick-list elements, lack of forward chaining logic and lack of calculations. We worked with Misys Healthcare and mTutive (mTuitive, Centerville, MA) to re-engineer this functionality.
Technology:
mTuitive's Agile Author" is used to design checklists used by xPert Client". mTuitive's xPert Client" is used for structured data capture and is integrated into CoPath Plus" (MHv2.5).
Design:
Structured data checklists were constructed using the mTuitive Agile Author". Checklists are composed of categories and elements that display as "pick-lists" or free text/number entry fields, some of which can be made mandatory for completion. A single list can be used to collect data spanning multiple processes at different points in the diagnostic workflow. Forward chaining logic limits list options based on the data entered in earlier fields preventing duplication. Error checking and data verification logic are built into the list for quality control. Logic is incorporated for the calculation of stage or grade of disease based on the data collected. Reference information including web search is provided contextually. We have tested and begun to use xPert Client " for structuring reports based on existing CAP and AJCC checklists.
Results:
Integration of xPert Client" into CoPathPlus" has the following advantages: 1. An improved user interface with full text display. 2. Ability to save a partially populated checklist. 3. Different parts of a checklist can be populated asynchronously by the most appropriate users. 4. Forward chaining logic enables the tool to populate multiple data fields simultaneously eliminating duplicate entry. 5. Logic can be used to automate calculation of disease stage and or grade 6. Report output generates a uniform and standardized report.
Conclusion:
The integration of mTuitive's xPert Client " and Agile Author" into CoPathPlus v2.5 represents a paradigm shift in data acquisition and reporting in anatomic pathology. Further work is required in the area of mathematical formulae and use of Boolean logic.
