College of American Pathologists
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CAP Today




July 2011

News read or heard lately

UPMC to provide pathology consults to lab in China

The University of Pittsburgh Medical Center has reached a three-year agreement to provide remote second-opinion pathology consultations to KingMed Diagnostics, the largest independent medical diagnostic laboratory in China.

Using equipment that scans pathology slides and stores and transmits the images electronically, KingMed will have the ability to seek second opinions on patient diagnoses from UPMC pathologists through a secure, Web-based telepathology portal. The service is expected to start by late summer.

UPMC’s collaboration with KingMed is expected to include training at the UPMC for pathologists from China and joint academic meetings as part of ongoing medical education in China.

KingMed may in the future replace its telepathology platform with the digital pathology solutions that Omnyx, a joint venture between UPMC and GE Healthcare, is creating.

The KingMed Diagnostics network consists of 17 central labs serving more than 6,000 hospitals and clinics in 26 of 33 provincial level regions in China. KingMed Diagnostics is CAP-accredited.

For inventory management, a trial run of RFID

An article in the March issue of the Journal of the American College of Radiology reported the potential fiscal gains and quality and safety benefits that radiofrequency identification (RFID) technology might provide for Massachusetts General Hospital.

Compared in the article is the performance of MGH’s current bar-code-based inventory management system used within interventional radiology with Mobile Aspects’ RFID-enabled iRISupply units, which the hospital implemented for managing inventory for a 10-month test run in 2008.

By the time the test period had ended, interventional radiology at MGH had achieved significant financial benefits and improved patient safety and staff satisfaction.

It saw an increase in charge capture of 20 percent or $2.1 million, a 30 percent reduction in technologist non-value–added FTE per day, a 70 percent reduction in stock outs, and a 10 percent increase in patient safety through early detection and removal of expired medical devices.

The JACR article (Byers E, et al. 2011;8(3):191–198), written by those who oversaw the implementation and use of the systems firsthand, cited why success was achieved. Its authors wrote: “The ultimate benefits of implanting RFID technology are achieved when the technology itself is leveraged to sustain the aforementioned improvements by automating the communication between the hospital and supplier, and then in turn, assigning the use of a specific item to a specific patient for safety and billing purposes.”

Massachusetts General Hospital plans to continue working with Mobile Aspects to expand supplies tracking to departments outside of radiology. Mobile Aspects is a health care technology supplier focused on RFID and other advanced automation.

Two new serious reportable events

Biological specimens and test results are the subject of two new serious reportable events in the National Quality Forum’s 2011 list of 29 SREs.

Twenty-five of the events were updated from their earlier endorsement in 2006, and four new events have been added to the list. Two of the new four events are as follows:

  • Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results.
  • Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen.

A 30-day public appeals process for the full list of 29 events closed July 12.

Looking for high-grade prostate cancer in men deemed low risk

Three molecular biomarkers could be useful in detecting occult high-grade prostate cancer in men whose biopsies might categorize them as low risk for prostate cancer, according to study results presented in May at the American Urology Association’s annual meeting. The markers are GSTP1, APC, and RAR-beta.

The study was a joint effort of molecular diagnostics company MDxHealth, the National Cancer Institute’s Early Detection Research Network, Beth Israel Deaconess Medical Center, New England Baptist Hospital, and Harvard Medical School.

Results demonstrated that changes in DNA methylation patterns in adjacent benign tissue could predict the presence of prostate cancer not detected by standard histopathology.

In the study, the three biomarkers were used to evaluate all of the diagnostic biopsy cores from a series of patients with one of 12 cores positive for cancer. The objective was to look for field effects that may provide a useful index of higher-grade malignancy in the adjacent tissues. Results indicated that such field effects were detected at a distance of 1 cm or more from the edge of the histological focus of cancer. Such a marker-positive zone is large enough to allow detection of cancer in one biopsy as a biomarker signal in an adjacent normal-looking core.

In addition, GSTP1 field effects, in particular, appear to be sensitive to the grade of the adjacent cancer. This strongly suggests that these biomarkers could be useful in detecting occult high-grade prostate cancer in men whose biopsies show only one or two cores of low-grade, Gleason score six, cancer. This could be a useful test for patients for whom watchful waiting/active surveillance is being considered, and where the presence of occult high-grade cancer could increase the risk of deferring treatment.

Additional clinical studies are underway among these collaborators to further define MDxHealth’s marker panel’s clinical potential for prostate cancer detection and prediction of aggressiveness.

Atlas expands offices across U.S.

Atlas Development Corp. has opened three satellite offices in North America. It recently opened regional offices in Las Vegas and Dallas, and it relocated its North Carolina operations to larger facilities in Kernersville. The three new offices support the continuing growth of Atlas, which has its headquarters in Calabasas, Calif.

The new offices will accommodate an expansion of services and personnel. Further expansion is planned for later in the year.