The Hitchhiker’s Guide to Pathology Informatics review

One of the sessions we attended at the RCPA Pathology Update this year was Saturday morning’s Masterclass, titled “A Pathologist Hitchhikers Guide to Informatics”. Chaired by Prof Michael Legg, it involved presentations by members of the RCPA Informatics Advisory Committee, including Dr Lawrie Bott, Dr Glenn Edwards, A/Prof David Ellis and A/Prof Ken Sikaris. In our review we highlight some of the key topics from the Masterclass:

News250315AOf particular note, was the session by Dr Lawrie Bott who outlined the many benefits laboratories obtain in the implementation of eRequesting (electronic orders) systems. One such benefit being a streamlined test ordering process, which has seen a flow on effect in improving patient care. Dr Bott’s presentation also focused on the challenges faced during implementation of electronic orders, including how to communicate the value of eRequesting to clinicians and the need for greater interoperability. Given our experience working with customers that have implemented electronic orders in New Zealand, it would appear the challenges faced are the same in both Australia and New Zealand.

Patient-centric reports
The Masterclass presentation also highlighted the need for the LIS to support reporting which integrates diagnostic results across all pathology disciplines, provides graphical elements and more sophisticated interpretive comments. Ultimately the lab should be able to enhance their reported to be more patient-centric to help guide the clinician’s role in diagnosis. “Keeping the patient in context at all times, moving on from canned comments and looking to the LIS to provide greater intelligence, will provide much greater decision support from the future LIS.”

Pathology reports delivered to other systems, such as the EHR or PMS, rely on the receiving system to present the report in the same format as it was sent form the LIS, retaining images and any textual formatting. PDF reporting from the LIS is one way to combat this obstacle. But, as the structured detail is decreased, especially in the case of cumulative numerical result trending, it also decreases the ability for data extraction and analysis.

Structured reporting protocols
The presentation also touched on the growing use of synoptic reports in surgical pathology, where all the data is structured. Synoptic pathology reporting uses an electronic report that includes a discrete data field format. This format for pathology reporting allows users and analysts to make effectively and efficiently search the database of reports.

RCPA reporting protocols provide an agreed structure for supporting synoptic reporting in the AP LIS. Sysmex’s Delphic AP product has the capability to support structured reporting protocols. But until mandated for use by pathology labs, this capability remains under-utilised.

In summary, the speakers presented thought-provoking pertinent topics on the broad area of pathology informatics. For the audience, as well as Sysmex, the Masterclass was a valuable guide and status update for future industry direction.