CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Editor: Deborah Sesok-Pizzini, MD, MBA, chief medical officer, Labcorp Diagnostics, Burlington, NC, and adjunct professor, Department of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Multisite quality improvement study of a patient-pathologist consultation program
October 2021—Pathologists are well suited to educate patients and their caregivers about laboratory results so these individuals can better understand diseases and make informed treatment decisions. Pathologists from four institutions involved in this study participated in programs focused on patient and family-centered care. As part of the programs, they interacted with patients to determine how they and their colleagues could become more engaged in patient care. The study was a multisite performance-improvement initiative based on evaluating patients’ experiences consulting with their pathologists. Primary study outcomes included patients’ satisfaction with their interactions with their pathologists, patients’ perceptions of the utility of the information provided, and patients’ willingness to recommend to other patients that they talk to their pathologists. A secondary outcome involved rating the pathologists’ communication skills. The authors invited patients to attend private patient-centered pathology (PCP) consultations to review their pathology reports and slides and pose outstanding questions. Patients were given the option of having a friend or family member attend the session for support. A patient experience questionnaire was administered to the patients who voluntarily participated in the PCP program. Sixty-seven patients across the four institutions, 95.5 percent of whom were female and all of whom were between the ages of 18 and 84 years, completed the questionnaire. The patients primarily had breast or brain tumors, and 59.7 percent of tumors were newly diagnosed. The majority of patients reported some difficulty understanding their health condition based on written information, despite 97 percent having at least a high school education. Most respondents rated their pathologists as excellent across the communication metrics. All respondents were satisfied and reported that their consultation was useful and would recommend such interaction to other patients. The authors concluded that, based on positive feedback from participating patients, they want to expand the PCP initiative and support other institutions interested in developing similar consultation programs. One strategy for engagement is to incorporate a standardized comment on all anatomic pathology result reports inviting patients to schedule appointments with their pathologists to discuss their diagnoses. Because PCP initiatives may be time-consuming, the authors recommend committing ample time and resources to a consultation program.
Jug R, Booth AL, Buckley AF, et al. Multisite quality improvement study of a patient-pathologist consultation program. Am J Clin Pathol. 2021;155:887–894.
Correspondence: Dr. Thomas J. Cummings at thomas.cummings@duke.edu
Assessment of the value of artificial intelligence in laboratory medicine
The use of artificial intelligence in laboratory medicine is likely to pose challenges to clinical laboratories as diagnostic testing becomes more automated and digitalized. Artificial intelligence (AI) involves complex algorithms and software that are designed to emulate human cognition and analyze large amounts of data from such sources as medical records, claims, and clinical trials. AI has the potential to improve diagnostic accuracy and decision support, reduce costs, and improve efficiencies. The authors performed a Web-based survey of stakeholders in laboratory medicine in the United States to evaluate their perspectives on the value of AI in the diagnostic space and identify challenges and barriers to AI implementation. The survey participants were from the Roche Strategic Advisory Network. A total of 128 of 302 stakeholders in laboratory medicine responded to the survey. Twenty-six percent of the participants were medical practitioners and 22 percent were laboratory managers. Only 15.6 percent of respondents were from institutions using AI, and 66.4 percent stated that they might use AI in the future. Ninety (81 percent) survey respondents indicated that they believe AI will be valuable in their organization within the next five years, and 20 of those respondents indicated it would be extremely valuable. On the flipside, 21 (19 percent) respondents indicated that they believe AI will not be valuable in their organization in the next five years and cited such reasons as limited budgets, omission of AI from strategic plans, and uncertainty about the use of AI. They suggested that initial investment costs could limit the implementation of AI until there is evidence that it will provide a return on investment and clinical benefits. (Data pertaining to this question were missing for 17 participants.) The authors concluded that the survey showed that many stakeholders in laboratory medicine believe AI will add future value in terms of quality of care. However, implementation strategies focused on support systems, strategic plans, and budgets are needed. AI education and research are also needed to raise awareness and further confirm clinical evidence supporting the benefits of AI.