All pathology orders at Stanford Health Care are now fully digitized, enabling faster results, ease of tracking, and greater patient safety.
Since 2015, Stanford Health Care has used a software system, Epic System’s Beaker CP, to track analysis of bodily fluids such as blood and urine (CP refers to clinical pathology). Last month, it deployed Beaker AP — like AP in anatomical pathology — to track the collection and examination of tissues and fluids at the cellular level by pathologists.
Beaker AP streamlines everything about pathology at Stanford Health Care, including automatic transmission of data to the Stanford Cancer Institute research database; monitor the location and identity of tissue samples; and simplify communication between referring physicians, pathologists and patients.
“Beaker AP improves patient safety because after collection, the condition and location of samples is immediately visible and traceable as the sample goes through its many stops in a complex organization like Stanford Health Care” , said Ann Folkins, MD, associate professor of pathology. who helped lead the system installation project.
Deployment of Beaker AP took years due to the complexity of pathology at Stanford Health Care. Every sample taken during a procedure is examined by Stanford’s multi-site Clinical and Anatomical Pathology Laboratory. The Pathology Division receives more than 90,000 cases annually, with tissue or whole organ specimens from the network of hospitals and clinics that make up Stanford Health Care and Stanford Medicine Children’s Health. The lab also receives requests for expert review from medical institutions across the country.
Map the journey
To prepare for deployment, the anatomopathology division mapped the different paths of a tissue sample, from collection from a patient to its examination by a pathologist.
“For each area of the lab, we looked at how we were doing it and wrote down the steps. We evaluated all of our workflows and asked if there was anything we should change,” said Christina Kong, MD, professor of pathology and vice president of clinical affairs. “We did this at a time when it was very difficult to add more to our normal workload.” The lab was already preparing to deploy Beaker AP when the COVID-19 pandemic hit and caused unforeseen strains on the system and personnel.
Beaker AP went live on Nov. 6, 2022, and by the end of the first week, everything was going well, according to April Young, director of lab operations for anatomical pathology.
“Given the scale of the go-live – all sites were affected and we had hundreds of people on site from Epic and Stanford Health Care Information Technology for support – the collaboration was impressive. We were able to fix all the major issues so quickly,” she said.
Tissue Sample Tracking
Prior to the implementation of Beaker AP, many physicians handwritten their pathology test orders. Once the sample and accompanying documents arrived at the laboratory, orders had to be entered into the software system previously used by the pathology division.
Now each sample is labeled with a unique barcode linking it to the patient. In Beaker AP, this barcode acts like a FedEx shipment number.
Surgeons or referring physicians can submit orders directly to pathology within the same Epic software environment that has hosted Stanford Health Care’s electronic medical records since 2008. This feature is expected to speed turnaround times by eliminating the need to transcribe and confirm handwritten orders.
Pathology reports are also electronically linked to all related tests performed on the same specimen, benefiting physicians and patients.
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