Several factors can increase or cut down the time between receipt in the lab to a verified report. By carefully considering transportation, laboratory workflow, diagnostic hurdles, report delivery, clinical findings, slide requests, and processes in your dermatology clinic, you can improve turnaround time and your patients’ satisfaction and care.
Transportation
While The College of American Pathologists in the above-mentioned recommendation measures turnaround time from the moment a specimen reaches the lab until the result is signed out to the ordering dermatology provider, we at PathologyWatch measure turnaround time from the moment a specimen is picked up until the result is signed out. Regardless, reliable transportation is required to ensure tissue samples are delivered safely and on time.
Delays in transportation are not uncommon, as couriers may have to battle traffic or mechanical issues as they carry specimens from the dermatology clinic to a local lab. Meanwhile, overnight providers such as FedEx and UPS may face weather challenges as they move samples greater distances to labs in other parts of the country. Dermatology clinics should expect their partnering labs to provide a reliable and secure system to transport specimens on time in a consistent fashion.
Laboratory Workflow
Running a productive dermatopathology lab requires cooperation from many vital team members. While dermatopathologists read their slides, lab technicians maintain the equipment, and office managers oversee incoming and outgoing reports, they all share in the responsibility of providing acceptable turnaround times.
National holidays, vacation days, and the 2.5 sick days American professionals take every year add up to many missing hours for smaller labs to work around. However, locum tenens provide a reliable source of dermatopathology talent to keep labs working at capacity. While some labs are open 24 hours a day, seven days a week, it’s important to note the majority hold traditional weekday hours when calculating turnaround time.
Diagnostic Dilemmas
After a dermatology clinic sends out a batch of specimens, they can reasonably expect to receive results from the lab within a few days. However, since complex cases can increase turnaround time by 100 percent, it’s essential to be aware of the tissue samples that could require possible delays.
For instance, a dermatopathologist may order additional studies, like special stains, to determine if a specimen contains an infection. And if an immunohistochemical stain is needed, it can require up to two additional days, depending on the availability of the particular stain.
Intradepartmental consultations cause delays in obtaining a second colleague’s opinion on complicated specimens. However, labs using digital slides can collaborate with experts around the world in real time and avoid longer turnaround times.
Reporting
After the lab completes a diagnostic report, the priority shifts to returning the report to the dermatology clinic as efficiently as possible. Delays can occur for providers working with paper, as this requires fax, mail, or overnight couriers. Once the paper reports are received, they need to be collated in the patient files.
The majority of providers utilize electronic medical/health (EMR/EHR) systems to enhance patient care. This makes integration with digital pathology reporting the next step and a dependable time-saver offered by full-service dermpath labs like PathologyWatch. Instead of waiting for deliveries, diagnostic results and digital pathology images are transferred instantaneously from the lab to each patient’s EMR. The digital results are easy to search and convenient to share with patients on tablets and laptops.
Clinical Findings
Experienced dermatologists can quicken the turnaround time by providing detailed clinical information, impressions, and differential diagnoses on their pathology request forms before they are sent to the lab.
Because labs don’t always have access to the patient’s clinical history, providing a clinical impression on the request form is always helpful. This is particularly true for inflammatory lesions, which can be subtle and nonspecific under a microscope. Without a clinical impression, the dermatopathologist can struggle to diagnose the findings with confidence, sometimes leading to a descriptive diagnosis, which should include differential considerations, as well.
One factor that can impede clinical interpretation is the lack of access to the interpreting dermatopathologist for any questions about the interpretation. You should be able to contact your dermatopathologist directly. At PathologyWatch, for example, our dermatopathologists are directly available by cell phone or text message for consultations, which significantly speeds up the turnaround time.
Slide Requests
Many dermatologists feel that reviewing their own biopsy slides improves the quality of care they can render to their patients. Requesting traditional glass slides to be mailed can sometimes take up to two weeks for clinics to receive. Digital pathology providers such as PathologyWatch provide 24/7 access to digital slides from anywhere globally, which dramatically improves turnaround time on slide requests.
Take PathologyWatch’s partnership with Allen-Taintor Dermatology. Before collaborating with PathologyWatch, the Utah dermatology clinic waited up to two weeks for slides to return from the lab. PathologyWatch was able to deliver faster results by interfacing directly with the EMR, providing academic-level reads, and providing direct digital access to each patient’s pathology slides. The result was a 75 percent turnaround time improvement in most cases.
Improving Turnaround Time
Dermatology clinics can make an impact on dermatopathology lab turnaround time. Begin by opening the lines of communication with the lab and staying in contact about the status of your cases. Being proactive will allow the lab to identify issues with transportation or particular specimens that require additional information from the clinic to help expedite the diagnosis.
Securing accurate and timely results from the lab is better for your dermatology clinic and your patients. Identifying the cause of delays in transportation, staffing workflow, reports, slide requests, and clinical findings, while being proactive in your dermatology practice, can help you speed up dermatopathology lab turnaround time.