[Histonet] RE: Pathology Protocols

Tue Mar 11 11:50:50 CDT 2014

Toni wrote: " I'm just curious about handwritten notes. We also have Cerner Millennium, but when I tried a few years ago to find out if there would be an impact in any of the areas, the OR reminded me that some of the surgeons like to draw diagrams for margins. The pathologists also document on the paper requisition when and who was called with frozen results. Although this is a small percentage of the specimens we receive, it stalled the project. How do you get around this?"

We have Copath Plus (Cerner) and recently installed PicsPLus to capture all paperwork. Everything will be scanned into the case file for access later.

Tim Morken
Supervisor, Electron Microscopy and Neuromuscular Special Studies
UC San Francisco Medical Center
San Francisco, CA

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Rathborne, Toni
Sent: Tuesday, March 11, 2014 9:34 AM
To: 'Joe W. Walker, Jr.'; Bauer, Karen L.; 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] RE: Pathology Protocols

Joe,
I'm just curious about handwritten notes. We also have Cerner Millennium, but when I tried a few years ago to find out if there would be an impact in any of the areas, the OR reminded me that some of the surgeons like to draw diagrams for margins. The pathologists also document on the paper requisition when and who was called with frozen results. Although this is a small percentage of the specimens we receive, it stalled the project. How do you get around this?
Toni

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Joe W. Walker, Jr.
Sent: Tuesday, March 11, 2014 12:21 PM
To: Bauer, Karen L.; 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] RE: Pathology Protocols

Hi Karen,

We utilize Cerner Millennium at my institution.  We are 90% paper free.  Fortunately for us, the vast majority of our surg path orders come to us as an electronic order, either placed by the provider on the floor or through an integrated office EMR.  All op notes, office notes, radiology, etc are also available electronically to the pathologist at the time of the gross dictation.  The gross dictation is transcribed into the surg path report prior to the pathologist getting their slides the next day.  The pathologist uses either a bar code to scan the slide/accession number to bring up the surg path report with the transcribed gross dictation.  The pathologist can again access all of the op notes, etc at the time of the final report's dictation. Also, all clinical test results are available within the application the pathologist uses to view the reports.  Our transcriptionist manages the movement of cases to and from the pathologists' queue for their verification.

The 10% of paper requisitions that we receive are ordered by our administrative staff where all of the written information on the paper is transferred to the electronic order.  The paper reqs are then scanned into our system.  Once in our system, the process for the paper reports is the same as the above.  The exception is that we generally don't have office notes when we receive orders on paper.

A couple of our pathologist do utilize a dual monitor set up that allows them to have the surg path report and the clinical info like radiology on a different monitor for their comparison.  It didn't take a lot of convincing to get rid of the paper and has helped improve the accuracy of the orders and diagnostic information.  There were definitely adjustments to everyone's workflows but we have been operating this way for 2 years now with very few problems.

If you have the capability, I'd highly encourage removing the paper process,

Joe W. Walker, Jr. MS, SCT(ASCP)CM
Manager of Anatomical Pathology, Microbiology and Reference Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
P: 802.747.1790  F: 802.747.6525
Email joewalker <@t> rrmc.org    www.rrmc.org

Our Vision:
To be the Best Community Healthcare System in New England

Rutland Regional...Vermont's 1st Hospital to Achieve Both ANCC Magnet Recognition(r) and the Governor's Award for Performance Excellence

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Bauer, Karen L.
Sent: Tuesday, March 11, 2014 11:25 AM
To: 'histonet <@t> lists.utsouthwestern.edu'
Subject: [Histonet] Pathology Protocols
Importance: Low

Hi all,

Are there any AP labs that are totally paper free during slide diagnosis?

We have the Vantage system with Sunquest CoPath.  We still keep the paper specimen requisition with the specimen container during grossing.  After digital gross dictation, the req slips are given to the transcriptionists.  Transcriptionists type up the gross, print out patient histories, and place dictation and histories in a plastic sleeve.  These case protocols are then brought back to Histology to be matched up with the slides.

Slides are place in cardboard trays and matched up with the protocols.  These are then placed in the pathologist slide area for the docs to pick up.

We would really like to get rid of the paper protocols.  Having Vantage, docs are able to scan the slides at their desks to bring up the patient information.  Unfortunately, we are not doing this at this time.

If there are any labs who are doing this, could you please tell me how your computer systems are set up?  Are the specimen reqs scanned at accessioning?  Do the docs have two monitors at their desks so they can view gross dictation and patient history at the same time?  What did you do to essentially get rid of all the paper information?

Any information that anyone can share with me is greatly appreciated.  :)

Thank you,

Karen

Karen Bauer, MHA, HTL/HT (ASCP) | Histology Supervisor | Pathology | MOHS Lab Supervisor | Dermatology | Phone: 715-838-3205 | bauer.karen <@t> mayo.edu<mailto:bauer.karen <@t> mayo.edu> | Mayo Clinic Health System | 1221 Whipple Street | Eau Claire, WI 54702 | mayoclinichealthsystem.org<http://www.mayoclinichealthsystem.org/>

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