The feasibility of computer-aided monitoring of the workflow in surgical pathology: a five-year experience.

To explore the feasibility of computer-aided monitoring of the workflow in surgical pathology. We collected 5-year data about computer-aided monitoring of the workflow in surgical pathology and analyzed the four subprocesses in the surgical pathologic process: 1) from arranging surgical pathology examination to receipt of the examination sheet and sample by the laboratory; 2) from receipt of the sample to issuance of the pathology report; 3) from issuance of the pathology report to automatic computer forwarding of positive pathology reports by e-mail to the physician who ordered the examination; 4) from receipt of the positive report by the physician to his/her response of acknowledging receipt. A total 115,648 surgical pathological cases were reviewed in this study. The overdue rate of delivery of samples was 0.82%. The most common cause (62.92%) of overdue delivery was clinicians in the outpatient department arranging for the examination more than 1 day in advance of specimen collection. The cumulative rates of report completion within 1, 2, 3, 4 and 5 work days were 12.82%, 53.56%, 86.42%, 95.90% and 98.85%, respectively. The rate of overdue reporting was 1.15% over the 5-year study. The most common cause (56.30%) of overdue reporting was case complexity. The learning time for adapting this subprocess of report issuance was 7 months. There were 12,151 positive reports (10.51% of all cases) that required automatic computer forwarding to the physicians' e-mail boxes. A total of 113 cases (0.93%) failed in automatic computer forwarding during the 5-year period. The learning time for constructing a stable automatic computer forwarding system was 2.5 years. Of the 12,038 reports successfully forwarded, 10,107 (83.96%) were received by physicians and acknowledged by automated receipt within 120 h, and the other 1,931 (16.04%) showed no response within 120 h. The major reason for an overdue reply was that the physicians did not check their e-mail boxes (94.89%). We used a preliminary computer-aided system to monitor the workflow in surgical pathology. This system might be used as one of the methods of quality assurance in surgical pathology.