Stanley J. Robboy, MD

December 2012

Stanley J. Robboy, MD

New solutions to ease PT, practice demands

The difference between the sense of hearing and the skill of listening is attention.
— Seth S. Horowitz, PhD

New York Times, Nov. 9, 2012

Seth Horowitz, PhD, whose comment opens this column, is a neuroscientist and assistant research professor in the Department of Ecology and Evolutionary Biology at Brown University. Dr. Horowitz is an author and musician. He knows the dance.

To start with, it’s a quick-step. Rapid advances in pathology and laboratory medicine have been a mixed blessing. The pace of the workplace is faster, and while the output is quantitatively greater, achieving the better quality we desire is certainly not easier. Staffing is leaner and demands are higher. We are all pushing the evolutionary curve.

The College is working to provide go-to solutions for members and customers that show we are listening. We know that our full attention can enable a comfort level that will allow everyone to take a step back and think about how they, in turn, can manage their environments in more optimal ways.

Infrastructure is important and it has been our first concern. For that reason, the CAP is undergoing a technological systems replacement, which is a complex (an understatement!), precise, iterative undertaking to make everything work better. Everything. And we’re getting there.

The College commissioned extensive market research in 2012, consisting of more than 2,000 blinded interviews with pathologists and laboratory professionals, to better understand your greatest challenges and needs. Our overall goal has been to use the findings from this research to guide our efforts now and in the future to provide the best solutions we can to address these challenges and needs, including how we can make it easier to interact with us. Two initiatives scheduled to launch in 2013 will do both: e-LAB Solutions Connect will simplify proficiency testing, and Evalumetrics will improve your resources for quality management and credentialing.

Most of our proficiency testing customers have been with us for a long time. Program improvements can be tested quickly and efficiently by those enrolled in the program, making it easier for the program to grow and move forward. e-LAB Solutions Connect will take that template to a new level.

Our data show that 40 percent of PT customer errors are transcription related. e-LAB Solutions Connect will automate CAP proficiency testing, thus eliminating transcription error. PT data will travel directly from your laboratory system through your computer and to the CAP. With e-LAB Solutions Connect, you will treat PT samples exactly the way you treat patient samples: Put them on the instruments, identify the samples in a prescribed manner so that patient confidentiality is secure, and watch it work. Our field test found that what had required four hours now takes two minutes, a real saving of time and costs that tells us e-LAB Solutions Connect will relieve your busy staff of a burden.

The quality of CAP lab improvement products and services is closely tied to the excellent work of our scientific resource committees. Seamless integration of science and practice creates what CAP chief marketing officer Elizabeth Usher calls the “virtuous circle” that connects, promotes, and protects excellence in practice and forward movement in the specialty. The investment that our professional community makes in CAP PT enables the CAP to offer education and services that improve quality of life in the laboratory and the quality of lab services provided to patients. That’s the virtuous circle.

Evalumetrics is a solution to a Joint Commission stipulation that all physicians—not just pathologists—meet two credentialing requirements: Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE). The CAP developed this pathology-specific online tool to help pathologists manage the practice evaluation process.

Evalumetrics is a metrics-based, total quality management system that covers anatomic and clinical pathology as well as procedural services. By managing the metrics and reports, this user-friendly application offers pathologists control of the process of professional practice evaluation related to privileging.

Evalumetrics is the brainchild of the CAP Quality Practices Committee, which worked with other scientific resource committees to create well-rounded metrics—a standardized set of professional performance measures designed by and for pathologists to enable department chiefs to collect information for credentialing, compliance, and establishment of practice benchmarks. With Evalumetrics, chiefs of pathology can set the criteria if they choose, but they won’t have to search the literature or recreate the wheel when tasked with defining benchmarks. Instead, they will have access to more than 100 different metrics in AP and CP to track such things as CME credits, turnaround times, and amended reports. You will select what you want to monitor and track, building a system, tracking the data, and creating ad hoc reports as desired. Importantly, your system will be securely anon-y-mized. Each pathologist will be known only by a numerical value that you assign.

The initial release will come early next year. Evalumetrics will live and breathe and evolve with us and, in time, allow us to collect enough data to build national benchmarks.

Modern practice places great demands on us. Your CAP has listened closely for clues to what concerns you most. We are working to provide tools and services that will help you manage inevitable sources of stress. The infrastructure piece is huge—and it takes a long time to turn a big ship—but we have been pressing hard to make your interactions with us easier. Stay with us on this, please, and give us your feedback. My e-mail address is below.

You have our attention and we like to dance. We know that your staff is dancing fast as well. Fred Astaire had nothing on us.