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Intermountain Health Care (IHC), a nonprofit organization
comprising 20 hospital facilities in Utah and Idaho and
additional health care delivery facilities in Nevada and
Wyoming, consistently ranks as the nation's top integrated
health system. Crucial to its integration is its pathology
software system. In 1997, Y2K-non-compliance ended support for
its previous system. In an evaluation of available products,
PowerPath® emerged as the leader in satisfying IHC criteria,
according to Chris Riches, anatomical pathology information
system team lead. The first three IHC hospitals implemented the
PowerPath system in April 1999, with six more added by November.
Today, more than ten IHC hospitals are using PowerPath directly,
and the nine other IHC hospitals are served by the system as
well as ten other hospitals outside the IHC system.
User-friendly Interface
The software’s #1 feature, for Riches, is its graphical user
interface. “It’s so user-friendly, almost intuitive, that it’s
easy to train new staff in its use. A couple of keystrokes get
you where you need to go, so even the most computer-illiterate
staff quickly learn the basic functions,” he reported.
A front-runner in medical informatics since the late 1950s, IHC
has historical data from 1959 and since 1970 has stored data in
a consistent form within a central clinical database. The
College of American Pathologists (CAP) developed and published
cancer protocols for all major cancer sites in 1997. Checklist
formats of these reports were also published, which, beginning
in 2004, the American College of Surgeons, through its
Commission on Cancer, accepted for pathology reporting but
without specifying the format. Lacking CAP formats for
standardized reporting, IHC physician, Dr. Elizabeth Hammond and
informatics information team member Christine Schramm developed
macros for pathology reports on cancers which are used
throughout IHC and form the basis for clinical quality
improvement efforts in IHC cancer care.
Faster, More Reliable Reporting
“Standardized report formats mean that clinicians throughout
IHC’s four-state system can get a path report from any
department and can understand it,” noted Dr. Paul Urie, surgical
pathologist at Utah Medical Center and a team leader of the IHC
anatomical pathology information system team. Such
standardization facilitates consultation with specialists in
specific types of cancer, allowing, for example, IHC clinicians
treating patients with particular types of cancer to consult
with clinicians at other IHC facilities with special expertise
in those cancers.
To speed pathology reporting to physicians, IHC has implemented
two types of automated fax queues. As soon as a pathologist
signs off on a case, a report may be automatically faxed to the
ordering physician; or reports may be faxed to specific
physicians at scheduled times. Approximately 200 print queues go
directly to physician offices, reaching them at least two days
quicker than they did by mail distribution and faster and more
reliably than by courier service, which, noted Urie, often
resulted in reports being misplaced or mishandled. “Physicians
appreciate fast fax reports, but faster reporting also means
shorter hospital stays for patients, cutting their cost of care
and returning them sooner to their homes,” said Urie, who
estimates that automated reporting and access of IHC staff to a
central database are not only helping with diagnosis and quality
assurance but also providing IHC with annual savings “probably
in the hundreds of thousands of dollars.”
Improved Patient Care
“Patient care is IHC’s top priority, and having pathology
reports easily accessible to transplant, cardiology, and other
clinical programs as well as to oncologists is essential for
optimal care,” stated Dr. Elizabeth Hammond, director of the
Office of Research and former chairman of the pathology
department of IHC’s Urban Central Region. IHC is currently
collaborating with IMPAC to extend its tumor macros to all
PowerPath users. Added Hammond, “We are confident that IMPAC
will create formats that enable the other pathologists and
professionals involved in caring for patients to access summary
cancer reports which are concise, complete, and free from
confusing text. This is critical to improve cancer care for
patients.” |
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McKay-Dee Hospital, Ogden, Utah; part of Intermountain Health
Care.
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