2006 Scientific Session Abstracts
Scientific Session Presentations & Schedule
E-Poster Presentations
Submission Compliance and Guidelines
Copyright Transfer Form (PDF)
Abstract Archive
PathStation – A Pathology Workflow Integration Engine using an Enterprise Application Mash-up Design Pattern
Mark J. Routbort, MD, PhD (mark.routbort@mdanderson.org) , Sajjad Mussani, MS, and Michael Riben, MD , Division of Pathology and Laboratory Medicine, Section of Laboratory Informatics, University of Texas MD Anderson Cancer Center, Houston, TX
Context: A patient safety driven workflow analysis in the Pathology laboratory highlighted processes hindered by numerous “hold-over” manual paper-driven tasks and multiple dissynchronous sources of relevant clinical information. This complicated and delayed the pathology clinical workflow process. We developed a new paradigm derived from a pathologist’s care perspective and authored PathStation, a workflow integration engine which uses bar coding and behind-the-scenes automation to seamlessly integrate several disparate and previously unconnected applications. We call this design pattern an “enterprise application mash-up”, derived from the term used for web sites which focus on combining content from more than one source into an integrated browsing experience.
Technology: PathStation, an application written in VB.NET, brings together key applications using common context setting for case and patient. The techniques used to accomplish this vary depending on the external application, but range from direct embedding of compatible controls to Win32 API based external automation. PathStation integrates with our AP-LIS (PowerPath, Impac), the MD Anderson EMR application (ClinicStation), our CERNER PathNet LIS, and the WinScribe dictation application.
Design: The PathStation engine embeds a streamlined and automated case workflow to eliminate error prone hand-entry practices, and coordinates clinical context in multiple information systems. Our strategy involved molding both custom-developed software and functionality with key commercial software systems. Core design concepts included 1) use of bar-codes to eliminate error prone data entry, 2) integration of a digital dictation system, 3) application access via single sign-on, 4) synchronizing case and patient context across independent applications, 5) development of an enterprise software deployment infrastructure to support expanded future functionality, and 6) introduction of custom application “carrots’ to drive adoption.
Results: The implementation process highlighted a number of challenges, including 1) identifying foundation applications required to meet the workflow needs, 2) overcoming barriers to change with change management strategies, 3) identifying commercial partners to facilitate the vision 4) driving end-user buy-in to the system for successful deployment, and 5) avoiding scope creep. The design of the PathStation project, with full local control over the implementation and application source code, proved instrumental in meeting these challenges.
Conclusion: An enterprise mash-up design pattern can be used to engineer solutions capable of more sophisticated integration and automation then is possible with off-the-shelf vendor solutions. We posit that this technique can be used at relatively low cost to combine some of the advantages of “best-of-breed” versus “single-source” enterprise software acquisition as regards the clinical laboratory.