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Inside the Lab Digital and computational pathology, Laboratory management, Software and hardware, Technology and innovation

Accelerating the Pathologist Workflow

sponsored by Cerebrum

“Doing more with less” is a phrase every lab knows well – and is likely experiencing right now. Studies show that pathologists’ workload has increased by 23 to 41 percentover the last decade, even before COVID-19 (1,2). Additionally, the Protect Access to Medicare Act (PAMA) has cut deep into labs’ revenue streams and is expected to continue slashing reimbursements by 35 percent over the next three years (3,4). Labs and pathologists must either drive efficiency and cost-effectiveness through digital optimization or risk losing revenue – or even the entire business.

Over 70 percent of labs use workflows without full digital integration, resulting in lost time, efficiency, and revenue. Even with a laboratory information management system (LIMS), the laboratory workflow may need optimization to bolster these areas while maintaining quality patient care and regulatory compliance.

For pathologists, a workflow-optimized LIMS solution with a user interface designed for efficiency can significantly increase diagnostic capacity. Read on for key tips on implementing such a system…

Organizing incoming work
 

Ensure that incoming requisition and patient demographics are digitally presented in the LIMS and specimens are barcoded throughout the process. The LIMS should organize assigned cases into separate pages – new cases, work in progress, and those awaiting tests – with detailed patient information such as medical ID and collection date.

The LIMS should display the specimen diagnosis workflow page when each barcode is scanned. Digital pathology imaging tools must have a seamless connection between the viewer and the LIMS diagnosis operations – eliminating time spent searching for image files.

The system should also allow pathologists to quickly find patient histories. Users must be able to view patient history within the case itself, rather than having to sort through paperwork. The LIMS should also sort new and in-process cases and prioritize time-critical “stat” cases.

Optimizing the diagnosis
 

An efficient LIMS can use macros with the diagnosis, microscopic, and comment text values that are auto-filled in the specimen diagnosis selection. Moving to the next specimen should only take one keypress or button click, which can be achieved through a default benign diagnosis macro assigned as the first selection. Ordering additional tests and recuts should take minimal effort during diagnosis.

A programmable scheduled release for diagnostic reports gives pathologists additional time to contemplate and the ability to recall cases and rework or re-diagnose. The system should also provide a full report preview before case completion, allowing pathologists to view exactly what the physician and patient will see.

Streamlining lab steps and downstream information
 

Additional LIMS-aided efficiencies can include automatic calculations of billing CPT and ICD codes prior to sign-out, giving pathologists complete control of any applied codes. Here again, automation is essential for workflow productivity. If any codes need to be removed, changed, or replaced, automation eliminates wasted time and potentially costly billing errors. When case amendments don’t affect the diagnosis, lab personnel can use the LIMS without a pathologist present.

These methods are proven to increase daily workflow efficiency for pathologists in the lab. Small, incremental optimizations add up to significantly alleviate each pathologist’s workload, time, and effort – so make sure to evaluate your workflow and LIMS to determine whether you can implement these productivity boosts. 

For a free demo of LABdivus for Anatomic Pathology labs, contact us at cerebrumcorp.com.

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  1. DM Metter et al., JAMA Netw Open, 2, e194337 (2019). PMID: 31150073.
  2. EC Garcia et al. (2021). Available at: https://bit.ly/3NbtnfF.
  3. Centers for Medicare and Medicaid Services (2022). Available at: https://go.cms.gov/3D23bPQ.
  4. JH Nichols et al., Clin Chem, 65, 727 (2019). PMID: 30988171.
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