Bar Code Specified Surgical Pathology Workflow
Electronic Poster - Honorable MentionJoy J Mammen MD; Henry Ford Hospital; Richard Zarbo MD; Henry Ford Hospital; Adrian Ormsby MD; Henry Ford Hospital; Mark J Tuthill None, MD, DSc, DVM, CRNP, MA, BS, AOCN, ACSW, ART, AS, ASN, BA, JD, BDS, BVSc, CCRC, CMA, CTR, DMS, DrPH, FACP, FACS, FRCP, DDS, FRCS, LDS, LPN, LSW, MBA, AAS, AND, ATC, LDN, CS, FACC, ASCP, DABR, DMD, DO, BSN; Henry Ford Hospital;
Content:
Automation of histopathology laboratory process have been difficult due to the variability in specimen types, the expression of disease in a given patient and the laboratory procedures required to arrive at pathologic diagnosis. A key challenge has been to automate specimen labeling. Manual labeling is tedious, error prone, and inefficient. Revolutionary changes in materials available for use in the histopathology laboratory have allowed us to address this problem, automating cassette and slide label generation, decreasing intra-lab identification errors and improving efficiency by driving workflow using bar code technology.
Technology:
Misys CopathPlus" MHv 2.4 (Misys Healthcare, Raleigh, NC) LIS with custom interface to laser cassette etchers that use Labelase " software, both from General Data (General Data, Cincinnati, OH). 2 Dimensional barcodes etched on the cassettes are read at the microtomy stations using Dell Optiplex 745 PC (Dell, Roundrock, TX) and Symbol " barcode scanners (Motorola Inc., Holtsville, NY) to generate stain-resistant slide labels (Stainershield ", General Data) on Intermec C4 (Intermec Inc., Everett, WA) direct thermal printers A report was developed in CoPathPlus" that retrieves stain orders for each block.
Design:
Previously, tissue cassettes were printed with human-readable identification details using the Leica cassette etchers (Leica Microsystems, Bannockburn, IL) by re-entering demographic and case data. After processing, sections were cut and mounted onto slides manually labeled with the case accession number and part number. Stains were performed based on electronic requests that were available at the histology department through the LIS. After staining, labels were batch printed from the LIS and affixed onto the corresponding slides. To improve this process two General Data laser cassette etchers interfaced to CoPathPlus were placed at the accessioning stations. During accession, cassettes are etched with the case number, patient name, part type abbreviation, and a 2D barcode. Once the block arrives at the microtomy station equipped with a PC, barcode scanner and label printer, the 2D barcode is scanned printing all slide labels for that particular blocks stain orders from the LIS. Labels are printed on Stainershield label stock, applied to the glass slide and tissue sections are cut and placed. Thus blocks are positively identified and slides definitively labeled prior to staining. Slide labels include all relevant data as well as a bar code (code 128C).
Results:
Most specimens received in the lab are currently being processed using this system with slide labels printed on demand at the microtomy station. Paper labels are still utilized for slides that requiring microwave processing since the StainerShiel labels undergo degradation. In the past, the time required for labeling prostate biopsies having 36 slides was nearly 20 minutes. This has now been reduced to 30-45 seconds. Further, as a result of the CoPath interface, time and data entry errors related to re-keying data into the cassette labeling software have been eliminated saving an additional two minutes per case. Overall, this technology has saved time and effort as well as eliminating labeling errors.
Conclusion:
Integration of the barcode technology into the histopathology labeling process has resulted in process improvement, by saving time reducing errors.
