The Oops Button on an AP-LIS

I have just learned that the Omnitech Labs AP module has an oops button. After a surgical pathology report is signed and released by the pathologist, it is intentionally held in reserve by the system for a predetermined amount of time prior to release to the submitting clinician. This time interval is at the discretion of the pathology department. It can be as short as a few minutes or, perhaps, as long as an hour. The basic idea here is that the pathologist is provided a grace period following a surgical pathology case sign-out during which time he or she may realize that a mistake had been made. The report can be recalled if the discovery occurs within the grace period and the necessary changes can then be made to the report. IMPAC's PowerPath AP-LIS has a similar optional feature. I know of one case, however, in which a pathology department chose not to activate this feature because it was felt that its availability could potentially lead to some degree of laxness on the part of their pathologists. In effect, they supported the mantra: take your time and do it right the first time.

Having reflected on this issue, I find myself coming down in favor of the oops button if available for an AP-LIS but establishing only a short interval such as five or ten minutes. Even the most careful surgical pathologist will get distracted from time to time, particularly in this time of multitasking. In most cases, an error will be detected within minutes of signing out a case and I can see little harm in allowing a short grace period to avoid such errors. Once a surgical pathology report has been released, substantive corrections can't be made -- it can only be amended. This is based on the idea that the clinician may have taken some irreversible action based on the incorrect data.

On the clinical pathology side, however, I can see no use for such an oops button and I do not know of a system that even offers such a feature. Most clinical pathology results are numerical and various rules can be deployed such as autoverification or interval checking to catch errors. Most CP results also are generated by automated analyzers and subject to stringent quality control measures. By way of contrast, the surgical pathologist frequently works alone, creating narrative reports not amenable to rule-checking or real-time quality control.