Standardized Synoptic Cancer Pathology Reports — So What and Who Cares?: A Population-Based Satisfaction Survey of 970 Pathologists, Surgeons, and Oncologists

Abstract

Care Ontario implemented synoptic pathology reporting across Ontario, impacting the practice of pathologists, surgeons, and medical and radiation oncologists. The benefits of standardized synoptic pathology reporting include enhanced completeness and improved consistency in comparison with narrative reports, with reported challenges including increased workload and report turnaround time.Objective.-To determine the impact of synoptic pathology reporting on physician satisfaction specific to practice and process.Design.-A descriptive, cross-sectional design was utilized involving 970 clinicians across 27 hospitals. An 11-item survey was developed to obtain information regarding timeliness, completeness, clarity, and usability. Open-ended questions were also employed to obtain qualitative comments.Results.-A 51% response rate was obtained, with descriptive statistics reporting that physicians perceive synoptic reports as significantly better than narrative reports. Correlation analysis revealed a moderately strong, positive relationship between respondents' perceptions of overall satisfaction with the level of information provided and perceptions of completeness for clinical decision making (r ¼ 0.750, P , .001) and ease of finding information for clinical decision making (r ¼ 0.663, P , .001). Dependent t tests showed a statistically significant difference in the satisfaction scores of pathologists and oncologists (t 169 ¼ 3.044, P ¼ .003). Qualitative comments revealed technology-related issues as the most frequently cited factor impacting timeliness of report completion.Conclusion.-This study provides evidence of strong physician satisfaction with synoptic cancer pathology reporting as a clinical decision support tool in the diagnosis, prognosis, and treatment of cancer patients.(Arch Pathol Lab Med. 2013;137:1599-1602; doi: 10.5858/arpa.2012-0656-OA) I n 2004, Cancer Care Ontario initiated a pathology reporting project aimed at improving the quality of cancer pathology by standardizing the content, format, and transmission of reports to the Ontario Cancer Registry. This large-scale, change-management project involved more than 400 Ontario pathologists and 100 hospitals producing more than 70 000 cancer pathology reports annually from a population of 12.9 million. Structured pathology reporting was implemented based on the nationally and provincially endorsed College of American Pathologists cancer pathology checklists, utilizing innovative electronic tools in hospital laboratory information systems linked by an electronic pathology network.Phase 1 of the project focused on the implementation of synoptic pathology reporting for resections pertaining to the 5 main disease site groups: lung, colorectal, prostate, endometrium, and breast. This accounted for approximately 70% of all surgical pathology reports and involved 33 hospitals across Ontario.High-quality, complete cancer pathology reports describing diagnostic, prognostic, and predictive elements are required for contemporary oncologic practice. Several stu...

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“…Similar to the experience in other countries, the lack of adapted and aligned informatics seems to be the major hurdle in the concrete implementation of synoptic reporting [37,38].…”

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“…Although pathologists have paid attention to all elements of the pathology report (tumor staging summaries, etc. [8]), they have not focused on the issue of report comprehension. In a study looking at surgical pathology reports, surgeons misunderstood pathologists' reports 30% of the time [9].…”

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“…Synoptic reporting can be integrated with the LIS or via Web-based tools. [21][22][23] The benefits of synoptic reports include better report standardization and allow data to be stored as discrete data fields. 23 Storing synoptic data within discrete data fields within an LIS provides ready access to the data points for downstream systems (for instance, to tumor registries).…”

“…[21][22][23] The benefits of synoptic reports include better report standardization and allow data to be stored as discrete data fields. 23 Storing synoptic data within discrete data fields within an LIS provides ready access to the data points for downstream systems (for instance, to tumor registries). The adoption of synoptic reporting can be used to replace the current narrative surgical report or as a supplement to it.…”