[Marketing] RE: [IMPROVEDX] [Marketing] Re: [IMPROVEDX] Fwd: Coverys report on diagnostic errors

Stefanie Lee stefanieylee at GMAIL.COM
Tue Mar 27 19:53:00 UTC 2018


Agree, it's very interesting to learn more about this concept of Diagnostic
Management Teams. Excerpt from attached newsletter below:

“ a group of experts who meet daily and focus on the correct selection of
laboratory tests and the interpretation of complex test results in a
specific clinical field... Within the DMT’s specific clinical context, an
expert-driven, patient-specific interpretation of the test results in a
specific clinical context is generated by the members of the DMT....This
requires the knowledge of a true expert—not someone who may have a general
idea about the meaning of a particular laboratory test result—and the
participation of someone to help that expert search the medical record for
relevant data to be included in the interpretation."

Within Radiology, many reporting systems have been developed which grade
findings along the spectrum of benign/insignificant to malignant/needs
specific action:

https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems

For example, lung cancer and breast cancer screening:

https://www.acr.org/-/media/ACR/Files/RADS/Lung-RADS/LungRADS_AssessmentCategories.pdf?la=en

https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/BIRADS-Poster.pdf (see
assessment categories at the bottom in green)

Stefanie

On 22 March 2018 at 10:38, Jackson, Brian <brian.jackson at aruplab.com> wrote:

> I think the main opportunity here is in the word “Team”.  Healthcare
> desperately needs better diagnostic teamwork.  I don’t mean to imply that
> it’s always bad everywhere.  But radiology and pathology have become
> structurally less integrated into care team decisionmaking over the years.
> Bob Wachter has a great chapter on the radiology problem in his book The
> Digital Doctor, and suggests that healthcare information systems are at
> least part of the problem.  Mike Laposata is a pathologist (actually
> department chair) down at UT Galveston, and has done a lot of work
> developing pathology-centered diagnostic management teams.  Essentially
> he’s had to create his own workflow and communication mechanisms that go
> around certain aspects of the EHR.
>
>
>
> Having said all that, you might be on to something.  Categorizing into 5
> grades of risk might be more feasible than trying to cram everything into 2
> (normal versus abnormal).  And maybe this would help the clinician to
> prioritize his/her review time.  The gatekeeper will need to be the
> treating clinician; pathologists and radiologists don’t have enough context
> and are too far from the patient to make those decisions.
>
>
>
> --Brian
>

---------- Forwarded message ----------
From: Dark Daily <info at darkreport.com>
Date: 11 January 2018 at 08:00
Subject: Pathologists Use Diagnostic Management to Improve Outcomes


Dark Daily laboratory news ebrief service

No Images? Click here <http://www.radmailer.com/t/r-e-jrdiohk-ptjjjtju-jy/>
[image: Dark Daily] <http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-r/>
[image: Precision Medicine Summit]
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-y/>
*Innovative Pathologists and Clinical Laboratory Scientists Use Diagnostic
Management Teams to Support Physicians with More Accurate, Faster Diagnoses*
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-i/>

*At institutions such as University of Texas Medical Branch, Galveston, and
Vanderbilt University Medical Center, pathologists are using diagnostic
management teams to improve patient outcomes while lowering the medical
costs*

Diagnostic Management Teams
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-d/> are a hot concept
within the medical laboratory
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-h/> profession. In fact, a
new annual DMT conference in Galveston, Texas, is the fastest-growing event
in the clinical laboratory
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-k/> industry. This
year’s Diagnostic
Management Team Conference
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-u/> will take place on
February 6-7, 2018, and is produced by the Department of Pathology at the
University of Texas Medical Branch
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-o/> (UTMB) in Galveston.

In simplest terms, a diagnostic management team (DMT) is described by
pathologist Michael Laposata, MD, PhD
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-b/>, as “involving a group
of experts who meet daily and focus on the correct selection of laboratory
tests and the interpretation of complex test results in a specific clinical
field. Typically, DMTs are led by pathologists focusing on the diagnosis of
a specific group of diseases, along with physicians and other lab experts
involved in the disease or health condition that is the focus of the DMT.”

*How Pathologists Use Diagnostic Management Teams*

“What differentiates a DMT are two changes from the classic diagnostic
pathway,” continued Laposata. “First, the ordering physician gets
assistance in selecting the correct tests. This can be done in several
ways, such as creating expert-driven algorithms that are updated regularly
to manage utilization of laboratory tests and dramatically minimize overuse
and underuse. Use of such algorithms with reflex testing makes it easy for
treating healthcare providers to order the right tests and only the right
tests.

“The second key difference in this new diagnostic pathway is that, within
the DMT’s specific clinical context, an expert-driven, patient-specific
interpretation of the test results in a specific clinical context is
generated by the members of the DMT,” he said. “This requires the knowledge
of a true expert—not someone who may have a general idea about the meaning
of a particular laboratory test result—and the participation of someone to
help that expert search the medical record for relevant data to be included
in the interpretation.

*DMTs Typically Organized to Support Specific Diseases or Health Conditions*

He pointed out that the DMT has a rather simple organization. There is a
front-end and a back-end. The front-end starts when “physicians order tests
by requesting evaluation of an abnormal screening test or clinical sign or
symptom,” explained Laposata. “Upon receiving that request, the expert
physician and colleagues in the DMT then synthesize the clinical and
laboratory data and provide a narrative interpretation based upon medical
evidence. This happens not only when specifically requested by the
referring physician, but also for every case handled by the DMT.”

* Click here for image* <http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-n/>

*Diagnostic Management Teams are making significant contributions at the
University of Texas Medical Branch (UTMB), Galveston. Pictured above, the
members of **UTMB’s coagulation DMT*
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-p/>* are (L-R): Jack
Alperin, MD; Michael Laposata, MD; Aristides Koutrouvelis, MD; Camila
Simoes, MD; Chad Botz, MD; Aaron Wyble, MD: and Jacob Wooldridge, MD.
(Photo copyright: University of Texas Medical Branch, Galveston.)*

The back-end of the process involves the DMT conducting an “expert-driven,
patient-specific interpretation of the test results in a specific clinical
context.” Here is where the participating clinical experts—supplemented by
staff who conduct an informed search of the medical record to identify and
collect data relevant to the diagnosis—sift through this much richer
quantity of information to develop the diagnosis.

*Overworked Physicians Value the Expertise, Diagnostic Accuracy of DMTs*

Laposata points out that individual physicians who already may be
overworked in their daily routines generally welcome the help of DMT
experts who are up-to-date on the current literature, and who have decades
of experience in these diseases and health conditions. He likes to point
out that, in coagulation alone, a physician could have as many as 60 to 90
tests that can be ordered. He also notes that typical primary care
physicians, for example, are generally not experts in selecting the best
coagulation test to order for every group of symptoms, nor do they know how
to order the most appropriate reflexive test to continue the diagnostic
pathway.
[image: New Dark Daily webinar]
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-x/>

Knowing how to interpret the results of the 60 to 90 different coagulation
tests is equally challenging to most physicians.

Over the course of his career, Laposata has signed out more than 50,000
cases in the field of coagulation. “Every positive case that identified a
diagnosis resulted in an earlier and more accurate diagnosis,” stated
Laposata. “Every case negative for coagulopathy
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-q/> allowed the treating
healthcare provider to focus on a diagnosis other than one related to
bleeding and thrombosis.”

*Using Clinical Laboratory Data to Improve Patient Outcomes, Reduce Costs*

There are other reasons why a growing number of medical lab administrators
and clinical pathologists believe that DMTs are the right solution at the
right time. One reason is the steady reduction in reimbursement from
Medicare and private payers. Another is the trend to measure and publish
the quality metrics of hospitals and individual physicians.

There are ever more quality metrics that include diagnostic accuracy and
total cost per healthcare encounter. Diagnostic Management Teams are proven
to improve diagnostic accuracy and ensure the patient gets the right
therapy faster. Both of these benefits contribute to substantial reductions
in the cost per healthcare encounter.

Pathologists and clinical laboratory professionals interested in learning
more about diagnostic management teams have two opportunities.

At the Galveston Island Convention Center on Feb. 6 -7, 2018, the second
annual Diagnostic Management Team Conference will take place. Last year,
several hundred-people attended. Information can be found at:
http://www.dmtconference.com/
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-a/>.

*Special Webinar on Diagnostic Management Teams on January 17*

For those interested in learning via webinar, *Dark Daily*
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-f/> is presenting Laposata
and his colleagues in a special session on Wednesday, Jan. 17 at 1:00 PM
EASTERN. It is titled, “Using Diagnostic Management Teams to Add Value with
Clinical Laboratory Tests and Pathologists’ Expertise
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-z/>.”

During this valuable webinar, you’ll hear from three experts. First to
speak will be Michael Laposata, MD, PhD. He will provide you with a
detailed overview of DMTs, including:

·       How to assemble the right team;

·       How to engage with referring physicians; and,

·       How to work through individual cases.

Laposata will introduce you to the structure and organization of effective
diagnostic management teams, organized around a specific disease or health
condition and made up of pathologists, other lab scientists, and physicians
who are expert in their particular clinical field. The objective of the DMT
is to meet daily with the goal of coming up with faster, more accurate
diagnoses in support of a patient’s care team.

*Experience from a Diagnostic Management Team Focused on the Liver*

Next to speak will be Heather Stevenson-Lerner, MD, PhD
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-v/>, a liver and
transplantation pathologist and Assistant Professor, Department of
Pathology, UTMB. She will discuss a DMT organized around diseases of the
liver. This is a useful, step-by-step description of an effective DMT,
illustrated with case studies that demonstrate how diagnostic management
teams can make a positive and substantial contribution to improving
individual patient outcomes.

The webinar’s third presenter is Christopher Zahner, MD
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-e/>, a resident
pathologist at UTMB. He will share how to pull together all the information
needed to support DMT interpretations. From the electronic health record
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-s/> (EHR) system to other
overlooked sources of useful data, Zahner will explain the most productive
ways to assemble any information that will be useful to the diagnostic
management team and that will make a positive difference in patient care.

To register for the webinar and see details about the topics to be
discussed, use this link
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-g/> (or copy and paste
this URL into your browser: https://www.darkdaily.com/webinar/using-
diagnostic-management-teams-to-add-value-with-clinical-laboratory-tests-and-
pathologists-expertise).

This is an essential webinar for any pathologist or lab manager wanting to
put the lab front and center in contributing clinical value in ways that
directly improve patient outcomes while reducing medical costs. With
hospital lab budgets shrinking and fee-for-service payments being slashed,
the time is right for your lab team to consider how organizing diagnostic
management teams can be the perfect vehicle to demonstrate why clinical lab
tests and expertise can be a diagnostic game-changer within your hospital
or health system.

And don’t forget, your participation in this webinar can be the foundation
for a highly-successful effort to collaborate with physicians and clinical
services, to the benefit of both the parent hospital and individual
patients. That makes this webinar the smartest investment you can make for
crafting your lab’s test utilization and added-value programs in support of
clinical care.

*—Michael McBride*

*Related Information:*

Webinar: Using Diagnostic Management Teams to Add Value with Clinical
Laboratory Tests and Pathologists’ Expertise
<http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-w/>

Pathologist Michael LaPosata, MD, Delivers the Message about Diagnostic
Management Teams and Clinical Laboratory Testing to Attendees at Arizona
Meeting <http://www.radmailer.com/t/r-l-jrdiohk-ptjjjtju-yd/>



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