Auto-filing and reviewing pathology reports
Pathology reports now get automatically filed into the patient records on SystmOne at the moment the organisation receives them from the lab.
Pathology reports then need to be reviewed in the same way by recording the result indicator and follow-up actions as normal.
For further information on the full details of this change please see the SystmOne guide available in Help > Support and FAQ's > Documents & Training Guides >SystmOne Results Auto-filing.
The auto-filing has two main benefits that we are aware of:
1. Pathology reports and results can be seen within the patient record straight away without having to go to the separate pathology reporting screen. Please note though that patients with online access will not see the results until a user has reviewed them.
2. Clinical reports and protocols can now be run against pathology reports that have not yet been reviewed, which can assist in clinical decision support.
Clinical decision support for pathology reports
Abnormal reports due to out-of-range values - These will be identified by the existing Ardens clinical reports and patients will have a ‘!!’ patient status alert icon under their name to highlight this abnormal value to the user.
Abnormal reports due to significant trends – It is not possible for Ardens on SystmOne to assist with identifying significant trends, e.g. declining Hb/eGFR/LFTs or rising HbA1c/ESR/CRP. This is because calculations based on previous values, time frames and clinical context are all required. Clinical judgement is therefore required to identify abnormal significant trends in all reports as this may prompt further management.
Normal reports - The Ardens SystmOne Clinical and Development teams have carefully considered clinical decision support resources that could aid the review of auto-filed results that are within normal parameters. Ardens have concluded that it is not possible or safe to provide resources for this. Below are some examples for this decision.
- FBC – thresholds for thrombocytosis in some laboratories are higher than the guidance stipulates for thrombocytosis and therefore ‘LEGO -C’ cancers.
- U&E – clinician would need to know the context of the test and the current medications, e.g. if on a potassium-sparing medication and needs review with potassium approaching 5, assessing subtle changes in eGFR after commencing ACEI.
- Liver function tests – with advanced liver disease may have normal liver enzyme levels, clinician may need to review subtle changes in trend.
- Lipids – usually requires the QRISK2/3 score to be calculated, or comparison with baseline to see if 40% reduction has been achieved.
- HbA1c – if diabetic already needs to know what individual target is, also if too low in a diabetic, this needs addressing too.
- PSA and other hormone profiles (e.g. TFTs, FSH, Prolactin) - need to know the context, trend and medications that could potentially affect the interpretation of this result.