Structured Data Reporting: Implementation Of A Next Generation Tool
Honorable Mention - BioinformaticsJoy John Mammen ; Henry Ford Hospital;
Content:
Evolution from traditional textual reporting to structured pathology reports has been slow to develop but is gradually gaining momentum as next generation tools emerge. We report progress on an ongoing phased deployment of a laboratory information system (LIS) integrated solution.
Technology:
LIS: Sunquest Copath Plus (2.5) " (Sunquest Information Systems, Tucson AZ). Structured data capture design tool: mTuitive Agile Author" and enduser application: mTuitive xPert Client " (mTuitive, Centerville MA).
Design:
We have previously reported on the design of checklists using the mTuitive xPert " Pathology application and benefits of the LIS integration. Prior to the implementation, we composed our customized checklists in the mTuitive Agile Author". These were extensively tested paying attention to technical and content details. All lists were approved by the appropriate expert pathologist prior to implementation. The staff and residents were given demonstrations followed by education and training and were provided with procedures. Phase 1: The pre-existing checklist content was available to the users in the new format without any logical control or calculations. Relevant help files were included. Phase 2: Four tumor checklists were enhanced utilizing logical control and tumor grade calculations besides standardized format for the lists and data collection, data integrity verification and enhanced help files. Extension of the same features for other lists is in progress. Phase 3: This phase envisages automated calculation of stage and two such lists are undergoing testing. Different challenges have been identified and are being addressed in the test environment.
Results:
All tumor cases are now signed out using this tool. The most important benefits were related to efficiency namely: functionality and workflow. Additional key benefits relate to reduction in errors of omission and data integrity. Recently, five new checklists have been introduced and are undergoing validation by experts. Four Phase 2 lists are undergoing pre-implementation testing. 6 technical incidents were reported after going live that needed resolution by the vendor. Important disadvantages perceived by the users are the time required to open a case in the xPert Client and the inability to attach more than one checklist to a specimen.
Conclusion:
Deployment of new a LIS integrated data structuring tool requires close collaboration between experts and users, consistent effort and support from leadership and vendors.
