Standardized Pathology Reporting Improves Outcomes in Ontario

pathology_reportingHigh-quality, complete cancer pathology reports are important not only for contemporary oncological practice, but also for secondary users of pathological information including tumor registries, health planners, epidemiologists, and others involved in quality-improvement activities and research.

That’s the conclusion of a recent study published in the Journal of Oncology Practice. The study, entitled Closing the Quality Loop: Facilitating Improvement in Oncology Practice Through Timely Access to Clinical Performance Indicators, looked at the impact of Cancer Care Ontario’s Pathology Reporting Project. The project employs structured reporting in the form of electronic checklists to encourage more complete reporting in the clinical setting.

Over the course of the project, significant improvement in outcomes has been documented. For example:

  • colorectal lymph node retrieval rates have increased from 76% to 87%, and
  • pT2 prostatectomy margin positivity rates have decreased from 37% to 21%

 How Does Standardized Pathology Reporting Improve Outcomes?

The short answer is that structured reporting helps ensure more complete medical reports. A structured electronic report employs a template to ensure that a clinician doesn’t leave out any pertinent information. Some systems, like Synoptec™, allow for the creation of mandatory fields so that critical information can’t be inadvertently omitted from the report.

The template also imposes an order on the report that isn’t present when clinicians use free dictation, ensuring not only that the report is complete but that the data is easy to find and easily usable by administrators, researchers and other health care professionals. This is critical because previous studies had revealed significant variation in cancer-related pathology reports, mostly the result of insufficient or omitted data and medical transcription errors. The College of American Pathologists, when studying the need for implementation of structured reporting, concluded that the inconsistent reports “could not be used to accurately compare cases, treatment options, or clinical outcomes.”

The ways in which structured reporting, particularly template-based electronic reporting, can improve medical outcomes are myriad, within and outside the scope of the study. Some of the core benefits include:

  • More complete information available to follow-up care providers, and in a more timely manner, helping to ensure follow-up and optimize the care provided at that stage; and
  • Searchable data which allows both internal and large-scale tracking of outcomes based on multiple variables, offering valuable information for the improvement of processes and establishment of best practices.

Structured reporting supports better clinical outcomes at every stage. Individual patient outcomes are improved by the timely and thorough sharing of information made possible by electronic template-based reporting.  A particular facility’s outcomes are improved when that organization uses strategic search and customized reporting to understand the strengths and weaknesses of existing practices and make adjustments. And, outcomes across the field may be improved as researchers have better, more coherent access to more complete data regarding conditions, treatments, procedures and success rates.

Photo credit: University of Liverpool Health