Presented at the 2000 APIII Conference                        Return to 2000 Abstract Index

ERROR REDUCTION IN SURGICAL PATHOLOGY THROUGH SIMPLIFIED COMMUNICATION OF THE PATHOLOGIST WITH THE CLINICIAN

Montefiore Medical Center
Division of Dermatopathology
Bronx, New York

Brigitte Bauch, MD
Steve McClain, MD

We developed semi-automated imaging of patient slides with bar coded labels creating a parallel path for images to appear directly in reports. Synoptic diagnostic codes based on reproducible histopathologic criteria were used for text reporting. Proofreading of reports with images reduced the corrected report rate by making diagnostic and typographic errors more apparent. The primary outcome measured was the corrected report rate (% of reports corrected for any reason). We observed a corrected report rate of 0.2 % pre-image reports versus 0.04 % with images.

Errors in Pathology reports result from a variety of other causes beyond pathologist error, including basic errors in demographic patient data on request forms. Patient data (Age, sex, site, history and image or clinical description) are especially significant for clinical-pathologic correlation and accurate diagnosis. Efforts to obtain missing data are time consuming. Ready access to this data could improve process and feedback.

The database was designed to coordinate report image acquisition, enhancement and labeling in 20-40 seconds. Images in proofreading lead to detection and correction of potential report errors. Simplified data entry and synoptic coding also lead to more rapid entry and proofreading and a reduction in staff man-hours needed for reporting.

The inclusions of color image illustrations, permitting dialog and improved clinical-pathologic correlation, results in a five-fold reduction in the corrected report rate.

The same images were also used for physician conferences and teaching.