Errors in Oncology Pathologies

Ted.E.Palen at KP.ORG Ted.E.Palen at KP.ORG
Tue Aug 13 22:07:32 UTC 2013


One of the issues of cross platform transfer of data, i.e. from the CPOE 
in the EMR to the lab or radiology system, is that often times the 
clinical information entered into the EMR CPOE order is not relayed to the 
lab or radiology system because of incompatibility in interfaces and data 
transmission formatting.
Is other cases even though the information is transmitted formatting 
difference between the systems actually truncate the information, so the 
pathologist or radiologist only get part of the information.
The other issue is that the pathologist, lab tech, and radiologist do 
their work in a different computer information systems than the ordering 
provider.  Even if they are in an integrated system (which most of the 
time they are not and therefore do not have access to the source data EMR) 
they do not "log-in" to the source EMR because it is not their system of 
record.


Ted E. Palen, PhD MD, MSPH | Physician Investigator | Institute for Health 
Research | Kaiser Permanente Colorado
Physician Manager for Clinical Reporting | Medical Cost Management| 
Colorado Permanente Medical Group
( 303-614-1215 | 7 303-614-1305 | * ted.e.palen at kp.org

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From:   Robert Bell <rmsbell at ESEDONA.NET>
To:     IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Date:   08/13/2013 03:36 PM
Subject:        Re: [IMPROVEDX] Errors in Oncology Pathologies



In general I have been amazed at the lack of information provided for 
laboratory requests, and also to radiologists, and pathologists, etc. 

Should the EMR overcome this in time and could the different pertinent 
information for each specialist be extracted for ease. Is that being done 
already in some facilities?

Rob

Sent from my iPad

On Aug 13, 2013, at 12:43 PM, "Giltnane, Jennifer M" 
<jennifer.giltnane at VANDERBILT.EDU> wrote:

> Peggy Zuckerman writes, "Clinicians can assist pathologists with more 
accurate analysis of underlying disease by providing pertinent clinical 
information and radiologic testing to the pathologists. 4" As a junior 
pathologist, I am ever so grateful that she included this simple 
statement. All of the missed and delayed diagnoses I have encountered so 
far (thankfully, few, but more than I imagined) had a significant 
component of minimal to no supporting clinical information, or even 
misleading information. I insist that all of my family and friends get a 
second oncology and/or pathology opinion when a major treatment decision 
is based on a limited biopsy. Thankfully, referral pathology is often a 
"package deal" when a patient seeks a second oncology opinion, and so this 
may be the best route for patients to pursue. It works best, however, when 
the pathology material can be received and reviewed with ample time before 
the patient's visit. 
> 
> Best regards, Jena
> Jennifer M. Giltnane, MD, PhD
> Dept. of Pathology, Microbiology, and Immunology
> Division of Investigative Pathology
> Arteaga Lab @ Vanderbilt University School of Medicine
> jennifer.giltnane at vanderbilt.edu
> 
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> 
> Moderator: Lorri Zipperer Lorri at ZPM1.com, Communication co-chair, 
Society for Improving Diagnosis in Medicine
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