A cancer biomarker testing navigator corrected pre-shipment defects in 6 percent of 233 send-out orders and enabled centralized tracking with real-time electronic health record updates, according to a recent study.
The American Society for Clinical Pathology evaluated the feasibility of a cancer biomarker testing navigator – a laboratory-based role intended to coordinate cancer biomarker testing processes – in a study published in the American Journal of Clinical Pathology. The project used three phases: a quantitative needs assessment, qualitative focus groups, and a short-term feasibility pilot at two cancer centers. The needs assessment found that 30 of 47 laboratories (65 percent) lacked dedicated staff to coordinate biomarker testing. Having dedicated personnel was associated with reporting a robust system for tracking the status of send-out tests and smoother send-out operations . Participants most often cited benefits in processing and tracking functions, including specimen routing, paperwork completeness, and status monitoring.
Focus group participants, including pathologists and laboratory professionals from varied practice settings, described recurrent operational issues such as insurance authorization delays, insufficient tissue, nonstandardized pathways, and fragmented information systems. They outlined knowledge and skills relevant to a navigator role, including familiarity with cancer biomarker testing, administrative and logistical abilities, and communication across clinical and laboratory teams. Participants also discussed potential metrics for role evaluation, such as changes in ordering defects and turnaround time, and noted that feasibility could vary by institutional volume and resources.
In the pilot phase, Spartanburg Regional Healthcare System assigned a navigator to centralize send-out testing for next-generation sequencing. Across 233 send-out orders tracked from June through September 2023, the navigator identified defects in 6 percent and corrected these prior to shipment. Common delays included inpatient holds, retrieval of archived tissue, insurance prior authorization, diagnosis coding, and reference laboratory receiving constraints. The site reported workflow refinements that included real-time status updates and electronic notifications when results finalized.
University of California Davis Health piloted a navigator in hematopathology to support bone marrow testing workflows. Of 218 scheduled biopsies, 208 patients underwent testing with 844 biomarker tests ordered; 14 percent had defects that delayed testing, and 2 percent had multiple defects. The team created standardized order sets for several hematologic malignancies, delineating in-house versus send-out testing and using test volume data to plan expansion of in-house molecular offerings.
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