Integrated Analysis of Quality Use of Pathology Program (qupp) Final Reports

eHealth Capability

The Quality Use of Pathology Program (QUPP) has enabled various eHealth capabilities through 12 projects (Table 5). The rise of the Internet and the rapid changes in the scope and capacity of Information Technology (IT) provided extra challenges to many of these projects as evidenced by the expansive Key Project Learnings for a number of these initiatives. These learnings also provided a valuable source of information and insight about conducting future projects within the eHealth paradigm.

The advent of the ability to order pathology tests electronically also required analysis to investigate any impacts on the ordering patterns of pathology. Receiving results electronically was also investigated, especially for narrative reports.
Key issues to emerge for eHealth capability included:

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  software installation issues delaying project timelines
  
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  the varied levels of IT proficiency and knowledge among treating practitioners
  
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  finding a balance between IT solutions and treating practitioner’s time and motivation to implement these solutions
  
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  different pathology terminology on pathology reports.
  

The following areas for future consideration in eHealth Capability were based around these issues. They include:

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  Identify the evidence of benefits and incentives for the electronic transmission of pathology requests.
  

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  Optional automated decision support, and standard terms for requests and results.
  
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  Standards for alerts and abnormal results (addressed in Application of Pathology Informatics to Reporting of Critical/Abnormal Results for Improved Requester/Provider Communication and Improved Patient Care on page 76) and standards that would allow for clinical data analysis.
  
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  General Practitioners (GPs) would like more patient-specific advice and are happy for this to be on pathology reports. For requesting it must be at the time of making the request.
  
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  Marketing the Royal College of Pathologists of Australasia (RCPA) Manual for Pathology Testing to GPs.
  
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  Address questions from A Study of the Impact of the Use of General Practice Computer Systems on the Ordering of Pathology on page 72 which include:
  

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  What are the relative ranks of the perceived reasons for observed increases in tests ordered per episode?
  
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  Does computer prompting help or hinder good practice in pathology ordering?
  
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  What is the relative value of pathology in GP practice?
  
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  How much testing is ordered and not done?
  

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  How much testing is perceived to be repeated unnecessarily?
  
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  Bedside access to IT for multiple purposes (laboratory, radiology, discharge summaries etc.).
  
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  Collect a larger corpora for disease categories that are more complex in their pathology testing and descriptions for synoptic reports from narrative pathology reports.
  

	Project Name	Grant Recipient/s
1	Pathology Informatics Working Party (2003)	Royal College of Pathologists of Australasia (RCPA)
2	Development of on On-line Maintenance System for the Australian Pathology Request and Result Code Sets (2003)	University of Sydney
3	Pathology and General Practice Software Integration Project (PaGSIP) (2003)	University of Ballarat and Queensland Medical Laboratory
4	Chain of Information Custody for the Pathology Request-Test-Report Cycle in Australia (Guidelines for Pathology Requesters and Pathology Providers) (2004)	RCPA
5	Supporting HL7 for Health Informatics Standards (2004)	HL7 Australasia User Group Incorporated
6	A Study of the Impact of the Use of General Practice Computer Systems on the Ordering of Pathology (2004)	Michael Legg & Assoc; IRIS Research; University of Wollongong; Dr Ian Cheong
7	Application of Pathology Informatics to Reporting of Critical/Abnormal Results for Improved Requester/Provider Communication and Improved Patient Care (2004)	Mater Misericordiae Health Services Brisbane Limited
8	Padlok On-line Pathology Ordering System (2005)	Fremantle Hospital
9	Information Extraction from Narrative Pathology Reports on Melanoma (2008)	University of Sydney
10	Automatic Compilation of Synoptic Reports from Narrative Pathology Reports (Stage 2) (2010 Submitted with the title: The Pathology Reporter)	University of Sydney
11	Automatic Population of Synoptic Reports from Narrative Pathology Reports (Stage 3) (Current)	University of Sydney
12	Standardisation of Pathology Terminology and Units (Current)	RCPA

Table 5: Projects summarised for eHealth Capability