Computer Systems - AP / LIS
What Is an Anatomic Pathology / Laboratory Information System
Author: Michael Mihalik (see Reviewers page)
Revised: 15 July 2013, last major update July 2013
Copyright: (c) 2013, PathologyOutlines.com, Inc.
Where are my slides?
How could we have mixed up the slides for two different patients?
Why are my slides difficult to read?
We lost a slide!!!
These are the types of issues an Anatomic Pathology Laboratory Information System (APLIS) should help your laboratory to address. As its core objective, an APLIS should help the laboratory to record, track, and distribute the results of the efforts of a myriad of individuals working together to produce an accurate and detailed diagnosis from the samples provided to the laboratory.
The pathologist's position in this collective effort lies at the end of the chain, and there are quite a few things that can go wrong before the pathologist views the initial case slide.
Consider a breast case where multiple samples can each yield multiple blocks, which in turn can each yield multiple slides. A patient sample that started out as two or three sample containers can result in thirty or forty related material samples. Now, multiply this by tens or hundreds of cases a day. Take into consideration that this material is handled by several different people and instruments, and it becomes quite easy to see why the typical Anatomic Pathology Laboratory is at a higher risk of error than other areas.
An APLIS should address these concerns by allowing all pertinent information to be entered into a system whereby this information is easily retrievable by the pathologist or anyone else connected to the workflow process.
What does this mean?
Consider the information needs of each person who has anything to do with a patient sample, be it the order entry clerk, the PA, the histotechnologist, the secretary, or the pathologist. What information do they need quickly and accurately in order to do their job? For instance:
This is just a sample of the types of issues an APLIS should address. Consider your workflow and consider the information requirements and each step of the process. Then, work backwards and ensure that each piece of information is available to everyone who needs that information.
- What special instructions did the requesting clinician provide?
- Call the results?
- Process the sample stat?
- Special instructions?
- When the sample was grossed, were there particular observations to be noted? Are these recorded and easily viewable to the pathologist?
- At embedding, are there any special embedding instructions?
- As the histotechnologist prepares the various slides, can they view the pathologist's instructions?
- Are the instructions easily viewable?
- Can the tech enter comments that will be easily viewable by the pathologist or anyone else?
- As slides are distributed, is it easy to determine that all slides are at hand?
- When the pathologist receives a tray of slides:
- Is it easy to determine that all slides for a case have been received?
- Is patient history easily and accurately viewable?
- Can additional stains be ordered easily?
Software functionality is certainly a large part of the equation when one considers an APLIS. However, it is far from the only consideration. Perhaps the most salient point is that you will get out of an APLIS exactly what you put into it. If you believe an APLIS is simply a necessary evil, then that's what you will get out of it. If you look at your APLIS as a tool that will pay dividends over the long run, then if you work with the software and if you work with the vendor you will be the recipient of higher quality and more accurate workflow day in and day out.
In future articles, we will discuss how to choose an APLIS and how to implement and manage an APLIS.
End of Computer Systems - AP / LIS > What Is an Anatomic Pathology / Laboratory Information System