Healthcare changes shine a spotlight on how essential pathology informatics are to the healthcare professionals
Vol. 24 • Issue 9 • Page 14
The abundant change taking place in the healthcare market directly drives the need for laboratory professionals to become active in pathology informatics to contribute to improvements in patient care and safety. The rapid pace of change lends a degree of uncertainty; however, the fact that the U.S. healthcare spending trajectory is on an unsustainable path and fee-for-service reimbursements are on the way out is a reality and purports that medical care must become more efficient. Our new healthcare system needs interoperability to improve the care continuum, and the shift in this direction is changing how providers interact with lab data. This new revolution opens the door for pathologists and laboratorians with both medical and IT knowledge to delve into informatics and have a greater impact on high-quality patient care.
The field of pathology informatics involves oversight of the acquisition, management, storage and retrieval of laboratory data across numerous LIS and other IT systems involving billions of data elements. This includes oversight of the design and implementation of new systems in pathology and IT in regards to:
- hardware infrastructure,
- data models,
- result reporting and display,
- digital imaging and
- compliance with regulatory requirements – all with the underlying purpose of improving patient care while preventing errors.
Embrace the Data Tsunami
While the laboratory is advanced in efficiency and analytical processes, healthcare as a whole is behind in the IT revolution – but is in the throes of a technological disruption. Laboratories produce enormous amounts of data, and the discipline of pathology informatics manages this massive flow of information, turning it into accessible knowledge that clinicians can use. In regards to pathology informatics, Mick Glant, MD, pathologist and medical director for Orchard Software, said, “We feel that pathologists have an opportunity to become leaders in this transformation, so that their value becomes essential in the evolution of diagnostics.” To do this, pathologists “must understand that analytics is a core need and that only structured, standardized data management will facilitate automation and leverage the power of analytics in real time and retrospectively.”
What follows are three vital steps that pathologists and lab leaders can take on their pathology informatics journey.
1. Become Involved in Pathology Informatics
- Understand best practices in pathology informatics.
- Work with vendors to advance LIS and EHR functionality.
- Take a leadership role in advancing new processes and standards that improve efficiency and safety in patient care.
Standardized, Codified, Structured Data
In the new world of healthcare IT, standardized, codified, structured data has become crucial to mining and organizing medical data into valuable reports and business analytics that are quickly becoming a cornerstone of how we practice patient care. Collecting data in structured fields allows for easier searching and sorting; yet, in order to make this possible, data must be entered in such a way that it resides within the database in a structured format (e.g., drop-down menus, templates, etc.). Furthermore, for optimal function in a database, structured data is best organized in tables to allow the use of rules, indexes, and codes for automation. Embracing the input methodologies that support a structured data system and avoiding the temptation to free text allows for quick, easy access to required and essential reports.
Historically, the majority of anatomic pathologists have not been advocates for standardization or structure and few have become involved in pathology informatics. It is quite common for each anatomic pathologist to desire individualized report formats and diagnostic terminology. This can be detrimental to determining patient outcomes and limits the ability to do analytics and improve efficiency. Only through standardization and a well-designed LIS/IT structure will the functionality allow for valuable analytics. Pathology informaticists should be champions for standardizing terminology and processes, as this aids in best practices for data management. Using a “word processor” format for reporting limits the benefit of discrete standardized data, and when you lack structured data, you cannot easily mine your data for analytics and reporting requirements. The use of standardized, structured data harmonizes the communication and interoperability between systems and allows for fast, easy report creation.
Work With Vendors to Improve Functionality
Consider voice recognition as a tool to navigate and input standardized data, rather than an easy mechanism to create more non-standardized text. Ask vendors to integrate their solutions into the software so that, when large datasets (such as cancer synoptics) are needed, the LIS can input the data and provide logic rather than just providing an electronic checklist. Become involved in how your LIS and EHR communicate. “‘What gets measured gets done’ should be foremost in your mind, as analytics has become the most important factor in creating laboratory value. Without unambiguous, appropriately granular, interoperability-codified and standardized data, all analytical processes are limited in regards to outcomes, and critical real-time analytical processes imperative for patient safety are impossible,” explained Glant. When designed correctly, a fully structured system allows detailed audits, safety checks, easily-retrievable reports and reasonability logic.
2. Support & Educate Providers
- Be involved in the development of best practices.
- Educate providers and healthcare administrators about laboratory testing.
- Understand how your LIS can support analytics to improve these initiatives and drive appropriate changes.
Become the Pathology Informatics Advocate & Teacher
Armed with knowledge and commitment to informatics, you become more empowered to take advantage of what structured data and standardization can offer clinicians. Using the power of analytics, there is the opportunity to become involved in patient outcome studies. It is considered common knowledge that often clinicians do not understand many areas of laboratory testing and result interpretation.1 Review the available literature regarding common high-volume tests, and perform internal studies that can be used to educate both clinicians and administrators. Pathologists can be involved in mentorship of residents and fellows who show an interest in pathology informatics.
If it appears that your laboratory is hampered in its mission because of the LIS, become an advocate to correct the problems or replace the system. Consider how your LIS can empower your laboratory and your pathologists to become leaders in your institution. As laboratory testing becomes more sophisticated and complicated, the LIS should help the laboratory staff in educational efforts by providing a variety of tools for diagnostic workups, as well as automating analytics for clinicians and patients.
3. Improve Patient Care & Safety
- Be involved in the development of patient education regarding laboratory services.
- Be included on patient care teams.
- Educate third-party payers about laboratory testing.
- Understand how your LIS can support these initiatives.
Promote Patient Education
Becoming proficient in pathology informatics and increasing the support of clinicians will position you to improve the care and safety of patients. Get involved in patient care teams and best practice development groups within your institution and interject your knowledge of laboratory practices to aid in these efforts. As patients are being encouraged to become more active in their own healthcare plan, this is an opportune time to become involved in developing educational materials for patients, especially those with chronic diseases where self management can be most effective. Help develop new tools to improve data retrieval and management to promote safety and increase efficiency. Be a leader in helping clinicians provide appropriate point-of-care testing in situations where the most benefit is derived. Facilitating these changes allows for better control of quality, increased patient satisfaction and patient safety.
The Informatics Way
Realize that informatics is a pathway to better care through the enhanced management and use of healthcare data. IT systems, both EHRs and LISs, need to evolve in partnership with laboratory professionals who are willing to change and lead the charge in quality data management. Becoming a champion of pathology informatics will benefit you and your healthcare institution. “The statement, ‘if you want your life to change, first you need to change yourself’ applies here. So, embrace pathology informatics and ride the new wave of analytics while the opportunity is ripe,” advised Glant.
Laposata M, MD, PhD. Putting the patient first – Using the expertise of laboratory professionals to produce rapid and accurate diagnoses. Lab Medicine. Winter 2014 Volume 45, Number 1. Accessed at: labmed.ascpjournals.org/content/45/1/4.extract