I recently returned from the Digital Management Team Conference hosted by Dr. Michael Laposata at the University of Texas Medical Branch in Galveston. It occurred to me during the conference that a major change is now occurring in the fields of anatomic pathology (AP) and clinical pathology (CP). The major change in AP is the deployment of automated tissue processing integrated with digital pathology (see: Integration and Interoperability Are Essential for Growth of Digital Pathology; Possible New Strategic Initiatives for Best-of-Breed LIS Vendors). This automation of surgical pathology will reduce the cost and increase the speed of surgical pathology diagnoses, a requirement in the shift to value-based care.
The major change that is occurring in clinical pathology is the rapidly growing interest by pathologists in collaborating with test-ordering clinicians to arrive at a better and more rapid diagnosis for complex patients. This was only uncommonly the case in the past, partly because pathologists did not want to impinge on the clinicians' turf. This attitude began to shift with the introduction of much more complex testing such as in molecular pathology and genomics. The diagnosis management team (DMT) concept, pioneered by Dr. Laposata, is an example of how to engage experts from pathology in clinical diagnostics. However, one of the barriers to the work of DMTs is the lack of a suite of apps to automate the process. This is essential as the demand for lab consultations from clinicians increases.
The two types of apps that are urgently required to promote the work of DMTs are the following: (1) an app that can query the EHR and LIS for relevant data and create a work sheet, having been supplied with a patient name and the problem precipitating the consult (e.g, liver disease, clotting diathesis, etc.); and (2) an app to auto-order a DMT consultation in specific cases such as the order of an expensive/esoteric lab test(s) or a major order of blood products indicating a surgical or medical emergency. Related to the second type of DMT app is a case-finding software tool that can search for a particular type of patient. One example of this would be a patient with a long hospital stay and no working diagnosis, indicating a diagnostic conundrum. A DMT consult might then enable a faster path to the diagnosis and discharge of the patient.
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