Practical APLIS- based Structured/Synoptic Reporting David L Booker, MD Friday, August 18, 2006 Vancouver, British Columbia Impediments and Solutions ADVANCING PRACTICE, INSTRUCTION AND INNOVATION THROUGH INFORMATICS

“Blame Canada” Resistance to change “Narrative” reports – who’s really telling stories?

Top Four Obstacles to Structured Reporting? APLIS Physician resistance to change

Top Four Obstacles to Structured Reporting Perception – extra work –Generally true! –Cancer cases only – two work flows! Inflexible tools –Cannot customize at point of care To hard to set up and maintain Benefits to most pathologists?

Reality Pathology It has to play in Peoria General, not just Mass. General Obstacles

Solutions Must improve workflow –For pathologists! –Same workflow for every case Must be customizable and easy to set up and maintain –At the point of care, on live patient reports! Helpful to show other benefits –Automate billing and enhanced reporting

“Side” Benefits of Structured Reporting Structured Pathologic Data – XML and/or database(s) for query –Much more efficient and accurate –QC at the point of care –Decision support Requires Common Data Elements –For internal maintenance –For data sharing across institutions/systems –HL7 effort underway

Extreme Workflow Makeover Patient Safety –Ideally, requisition forms, blocks, slides, and reports should match

Patient Safety People make mistakes

Extreme Workflow Makeover Pre-accessioned biopsy kit (patent pending) Error prevention Decreases processing time and labor

Extreme Workflow Makeover 2D bar-coding –Generate correct report template with defaults –Match slides, blocks, reports – chain of custody –No dictation

Extreme Workflow Makeover Beyond Cancer Protocols –Automate reporting of all specimen types –Automate reporting of special studies

Extreme Workflow Makeover Enhanced Reporting –Tables –Diagrams –Images –Standardized report formats

Extreme Workflow Makeover Other technologies –Internet reports, notifications, and slide consultation

Extreme Workflow Makeover Advantages –Diagnosis within one day of receipt –Patient Safety –Efficiencies

Solutions Examples of Synoptic Reporting using SoftPath® (SCC Soft Computer Consultants)