The Delivery Rates of Pathology Test Results to Patients: A Single-Center Experience in a Secondary Referral Center

Abstract

BackgroundDelivery of pathology reports to the patient is a key step in the biopsy pathway, which is important for patient safety in dermatology. Automated systems for facilitating such medical process began in 2010 in our hospital, sending short message service to scheduled patients.ObjectiveThe purpose of this study was to evaluate the delivery of pathology reports to patients and investigate factors that influence this process and annual trends.MethodsWe retrospectively reviewed the medical records of all outpatients (n=2,452) who underwent skin biopsy at our department of dermatology in 2009 and 2014. In each year group, we analyzed the proportion of revisiting patients in terms of year, sex, age, season, biopsy method and diagnosis.ResultsIn 2009, a smaller proportion of patients (205; 91.5%) who had undergone shave or excisional biopsy than of those who had undergone punch biopsy returned (781; 98.0%; p<0.001). This trend was not significant in 2014. Whereas there was no significant difference of return visit ratio between men and women in 2009, a higher proportion of women (754; 98.0%) than men (633; 95.6%) re-visited after skin biopsy to confirm their diagnosis in 2014 (p=0.008). Three patients with either a malignant tumor or suspected malignant lesion that required complete excision did not return to our clinic.ConclusionPathology report delivery rates were fairly satisfactory, regardless of year, age, season, and diagnosis. Sex and biopsy method influenced the return visit ratio. More organized follow-up protocols are required to strengthen patient safety and prevent critical patient drop-out.

Technology-Based Closed-Loop Tracking for Improving Communication and Follow-up of Pathology Results

“…In addition to the aforementioned Veterans Affairs study, other studies of systems with in-house laboratories have also reported lack of fail-safe follow-up of test results and communication of test results. 11,12 Several features of the RFID technology facilitate accountability, automate order tracking, and reduce the likelihood of results getting lost or unnecessarily delayed. These features can complement and improve contemporary electronic health record systems, which continue to have safety concerns.…”

“…Radio frequency identification technology can also be potentially useful to multispecialty groups or academic institutions with in-house pathology laboratories. In addition to the aforementioned Veterans Affairs study, other studies of systems with in-house laboratories have also reported lack of fail-safe follow-up of test results and communication of test results 11,12 . Several features of the RFID technology facilitate accountability, automate order tracking, and reduce the likelihood of results getting lost or unnecessarily delayed.…”

Analysis of Judicial Precedents Cases Regarding Skin Cancer from 1997 to 2017 in Republic of Korea

“…In case #3, the histopathologic findings of the skin cancer were found in the third biopsy specimen, but the medical staff did not confirm the results. One study in Korea reported that in 3% of the cases, the patients did not visit the hospital after the biopsy for checking the result, many of which included findings of malignancy 19 . As a plan of prevention, it is necessary to make an automated notification system and deliver the abnormal findings such as malignant tumors to the medical staff or patients 19 20 .…”

“…One study in Korea reported that in 3% of the cases, the patients did not visit the hospital after the biopsy for checking the result, many of which included findings of malignancy 19 . As a plan of prevention, it is necessary to make an automated notification system and deliver the abnormal findings such as malignant tumors to the medical staff or patients 19,20 . Physicians should consider the possibility of interpretation error while specimen processing 16,18 .…”

Assessment of Raman Spectroscopy for Reducing Unnecessary Biopsies for Melanoma Screening

“…During skin screening, experienced dermatologists assess a concerning skin lesion visually and determine whether to conduct a skin biopsy, which involves surgical excision of the skin lesion. Then, the excised lesion is sent to a histopathology lab for analysis, and it may take up to two weeks to get the final diagnosis result for the biopsied lesion [ 3 ]. This process is invasive, time-consuming, and costly.…”