It is usually easy for me to find topics to write about. I need only pay attention at work. For instance, I was cutting a bloody autopsy block when I remembered the H1N1 block I had cut years ago. With all the discussion still surrounding vaccines, I thought it was a good time to share that. When I saw the supervisors digging through trash, I posted about lost specimens.
This week, everything has been great at work. No lost blocks, no bad processing, no ruined specimens. It’s refreshing but it makes me work harder to find a topic.
I was wondering what to write about when my slide printer broke. I thumped it and tried to send the command to print again but the computer lagged. It was taking ages to get one slide to cut one block. There was nothing to do but wait for the computer so I sat back with my arms crossed, annoyed, and wondered what would be a good topic for my next post.
Eventually I got a printed slide, that is a piece of glass with thermally printed case number on it. To get that slide I had to wait for the computer to stop lagging and realize it wasn’t a computer problem but a printer problem. I changed out the printer, reloaded blank slides, and then saw the computer no longer recognized the printer. Now it was an IT problem. I called IT to fix a Network error, which took about half an hour for them show up, and then, finally, I got a slide printed. I picked up the specimen I had cut, which had been floating on my water bath forever!
Thus, my topic for this post.
When computers were brought into the histology labs where I worked, they were used for billing. We had to enter the test code for everything we did.
I work in the Anatomical Pathology area of the Pathology Labs. There is another part of the Pathology Labs called the Clinical Labs. That is where they do tests on blood and urine, to name a few common things. As the Clinical Labs became more and more automated, histology stayed about the same. The Clinical Labs did more tests faster with automation and then they began reporting the test results through a computer network. This all happened while my Anatomic Pathology stayed the same.
Years went by like this. Many platforms were invented by software companies to support Clinical Labs. They all work fine. Clinical Labs could pick which software they wanted based on the cost of the product or the types of reports it generated, whatever. While those labs were outfitted with computer technology, Anatomic Pathology still used computers to bill and little else.
Then one day, someone realized a bar code could be put on a block and on a slide and then the blocks and slides could be tracked. They would never have to be lost again. They would never be mislabeled again. Anatomic Pathology came into the computer age. Anatomic Pathology and Clinical Pathology could have their tests all reported together.
There was a problem, no one had written any software that could accommodate the Clinical Pathology tests and the Anatomic Pathology tests. For many reasons I won’t go into here, the two labs do their work so differently, software engineers can’t add Anatomic Pathology to the old Clinical Pathology software. Those that try, have a devil of time making them work together.
As of the time of this post, there are three software companies who have tried. Their software platforms are fraught with problems so many histology labs shunned them.
After enough lawsuits over mislabeled cases, those who run histology labs realized they had to overcome these problems. If they could have blocks and slides labeled with a bar code, they could avoid the problems inherent in a person writing a number. If only one block was handled at a time, if it was scanned every time it was handled, and if the computer printed the slide, there should be no more mislabeled cases.
And, to make the whole idea even more attractive, histology lab results could be added to clinical lab computer reports. Pathologists shouldn’t have to get paper reports from histology ever again. They should get all test results from one place, their computer. What a great concept. But only three software companies have managed to integrate the labs. That software isn’t very good. It is incomplete for Anatomic Pathology’s needs. It works so-so.
So-so is still better than nothing. When the labs changed over from doing all labeling by hand to using bar codes, labeling errors were dramatically reduced. Loses were reduced. When a block is lost in a lab that uses bar codes, we have a better idea of where that block was last scanned and therefore handled. We know which garbage bags to search.
When a slide is mislabeled, it’s because the tech scanned a case before using the previous slide then used the wrong one or a slide got stuck in a printer and was spit it out later. A good tech will get wise to that printer error and avoid it more often than not. Errors still happen but not as often.
Before computers, when we had to write the case number on every slide by hand, there were techs who would mislabel multiple cases a day. In the past, the people who double checked slides for accuracy could generate a page full of errors in a day or two. Now, a page of errors might be generated in a month or two. It was up to a pathologist to catch the errors that got out of the lab but I’ve known pathologists who don’t look at the slides except under the microscope. They never look at the patient data on the slide. Now, they scan the slide with a bar code and the correct case is brought up on their computer.
As a patient, what does this mean? If something happens to your specimen and you learn the lab doesn’t use computers, know they could and that could have saved you the problems that come from lab errors. The software isn’t that expensive and it can be integrated with other labs. Computer tracking should be used.
Your complaints and even lawsuits can make labs that refuse to update do so. Your complaints can make them change from a terrible system to one that might save your health. Then, next time you have to use that lab, you will be safer.