Presented at the 2000 APIII Conference Return to 2000 Abstract Index
INTEGRITY: A "HOME-BUILT" ANATOMIC PATHOLOGY DATABASE MAKES A GOOD COMPANION TO COMMERCIALLY AVAILABLE CONTINUOUS VOICE TRANSCRIPTION PROGRAM
A. O. Fox Hospital
Oneonta, New York
William Shang, MD
The confluence of increased surgical pathology workload,
an administration's uncertain purchasing timetable, and
availability of a relatively easy-to-program Access 97 resulted
in the author's creation of a full-featured anatomic pathology
database system beginning in 1998.
This system receives demographic input from a flat-form text file transferred from the hospital’s LIS. Computerized generated free-form grossing and microscopic text is pasted from a commercial continuous speech recognition program, (Dragon Naturally Speaking®). In addition to password-protected sign-out privileges, customizable diagnosis/microscopic templates are available from a drop down menu. Cytologists create reports from drill-down menus. The principal advantages of an open architectural system are the abilities to create customized queries and reports without the hinderance, added expense, or delay of a third-party vendor. The system operates on a LAN of seven simultaneous users. Nearly 100,000 reports have been archived in a stable environment. All created reports may be retrieved in full formated text, viewable in a separate window linked by medical record number at the time of signout or a separate multivariable query.
Integrity’s wide variety of reports meet the needs of quality assurance, tumor, and cumulative reporting. One form, run quarterly correlates all subsequent anatomic studies after an index abnormal pap smear allowing rapid determination of adequacy of follow-up. A report generates provider-specific letters listing patients without indication of follow-up. Returned letters update patient status. Periodic distribution of diskettes to off-site copies of the database facilitate retrieval and reporting for users not on the immediate LAN.
The system has all of the features listed in Ackerman's "Surgical Pathology", Appendix I, "Basic Design Criteria for an Automated System in Surgical Pathology". Since implementation, clerical staffing has been reduced by 1 FTE (>30%) due to automation. Surgical reports release coincides with each report being signed out. Transcription skills are no longer requisite nor possessed by office clerical staff. This "home-built" computer married to Dragon Naturally Speaking® V3.0 system has increased the efficiency of this small pathology practice and offers practical automation suitable for routine reporting, evolving administrative tasks, including mandatory regulatory agency reporting and compliance.
