Foundation.cap.org

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Automation and Asset Tracking in Surgical
Pathology Barcoding, Tracking, Chain of Custody
in a Small System
Edward P. Fody, MD, Chief of Pathology, Holland
Hospital Holland, Michigan
Foundation.cap.org
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Advanced Materials Processing (AMP) throughout
the pathology lab

• Accessioning
• Gross Examination
• Histology
• Microscopic Examination

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Accessioning

• Specimen labels and cassettes are printed with
  barcodes

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Specimen label on container
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Accessioning

• Specimen labels and cassettes are printed with
  barcodes
• Label is placed on specimen container(s) and
  requisition

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Accessioning

• Specimen labels and cassettes are printed with
  barcodes
• Label is placed on specimen container(s) and
  requisition
• Cassettes go with container in their own bin
  compartment

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Specimen bins, individual compartments for each
case
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Gross examination

• Bar code on container is scanned and case opens
  up in Powerpath

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Gross examination

• Bar code on container is scanned and case opens
  up in Powerpath
• Using Voicebrook dictation system, case is
  dictated and sections are submitted within
  barcoded cassettes

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Gross examination

• Bar code on container is scanned and case opens
  up in Powerpath
• Using Voicebrook dictation system, case is
  dictated and sections are submitted within
  barcoded cassettes
• If additional orders are produced (e.g. special
  stains, frozen sections), the barcode will now
  have this information attached

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Histology

• Embedding
• Computer at embedding station for embedder to
  easily mark each case as completed

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Histology

• Embedding
• Microtomy
• Cassette is scanned at the bench and slide labels
  automatically print
• Each station has its own computer, barcode
  scanner and label printer
• AMP system automatically marks each cassette as
  completed and each slide as in process

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Histology

• Embedding
• Microtomy
• Slide check out
• Each slide is scanned at our check out station
  and the AMP system marks it as completed in
  Powerpath

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Microscopic examination

• The pathologist scans a slide and the correct
  case opens up in Powerpath
• Case is dictated using Voicebrook dictation
  system
• Case is either signed out or additional tests can
  be ordered
• If additional tests are ordered, a new order
  appears in histology worklist and the histotech
  can rescan the block all new labels will now
  print

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Pathologist orders additional stains

• Ordering Special Stains/Immunohistochemical
  stains
• Ventana stainer is interfaced with Powerpath
• Case is highlighted in Ventana and labels are
  printed
• Histotech sees order in Powerpath worklist, scans
  block for Powerpath labels (which are placed over
  Ventana label after staining)

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Advantages to barcoding and AMP

• Barcoded specimen containers ensure correct case
  is being dictated
• No need to handwrite slides/cassettes, eliminates
  human error of mislabeling and smudging
• Each slide label individually prints and each
  case is handled separately, thus no mislabeling
  amongst cases
• Cassettes and slides can be followed through
  histology with AMP simply look into a case to
  see what step they are at and where to find a
  case if needed

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Internet Module

• Clinicians and their staff can easily view
  patients results via our internet module
• Website is customized
• http//pathology.hollandhospital.org

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Internet Module

• Clinicians and/or their staff can easily view
  patients results via our internet module
• With a protected user ID and password, this site
  can be accessed anywhere internet access is
  available.

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Internet Module Summary

• The internet module allows a physician to quickly
  and easily access patients pathology results
  from any computer and to view the photographs in
  color and enlarged

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Additional features of AMP since we went live
with our system

• Grossing station
• Embedding station
• Diagnostician station
• Specimen Discard Station
• Slide/Block Storage Station

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Grossing Station

• Scan cassettes to verify info matches with
  container
• Order/print additional cassettes remove unused
  extras
• Add number of pieces and special embedding
  instructions to a cassette

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Embedding Station

• Track cassettes arriving at embedding
• Verify number of pieces in cassettes
• View embedding instructions

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Diagnostician Station

• Scan a slide to receive all slides for case
• Auto load case in Powerpath

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Specimen Discard Station

• Scan a container to check if specimen can be
  discarded

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Storage

• File blocks and slides
• Check for availability from file storage
• Check out/Check in materials

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Barcodes and Patient Safety

• Right Patient
• Right Test
• Right Time

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Whats Next For Barcoding?

• Wristbands
• Lab Tests
• Blood Bank
• Pharmacy

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Advanced Materials Processing (AMP) at Holland
Hospital

• Edward P. Fody, M.D.
• Chief of Pathology
• Holland Hospital
• 602 Michigan Ave
• Holland, MI 49423
• [phone]
• efody_at_hollandhospital.org

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