scholarly journals Predicting Opportunities and Challenges Prior to Transitioning to Digital Pathology: An Interview Envisioning Study with 11 Pathologists

2019 ◽  
Vol 8 (1) ◽  
pp. 9-12
Author(s):  
Emily S. Patterson ◽  
Lauren Mansour ◽  
Metin N. Gurcan ◽  
Zaibo Li ◽  
Anil Parwani
Keyword(s):  
Digital Libraries ◽  
Medical Center ◽  
Academic Medical Center ◽  
Digital Pathology ◽  
Structured Interview ◽  
Primary Diagnosis ◽  
Whole Slide Imaging ◽  
Implementation Challenges ◽  
Academic Medical ◽  
A Current

There is growing interest in implementing whole-slide imaging (WSI) for primary diagnosis. Ten subspecialized pathologists (2-39 years of experience) were interviewed from diverse subspecialty areas in a large academic medical center. Relevant semi-structured interview questions included image quality, workflow, and usability during clinical use. Analysis revealed that WSI implementation would raise some concerns: 1) delaying turn-around time for preliminary diagnoses as well as final reports, 2) delaying access to order ancillary tests, which could impact scheduling for some patients for follow-on surgery, 3) making it hard to track what has been reviewed and at what level of magnification, 4) potentially increase wrist pain from using a mouse or neck pain while viewing the monitor, and 5) increase vulnerability when a computer, monitor, or network goes down. However, WSI implementation would enable 1) increased flexibility for slide access remotely during nights, weekends, and work trips, 2) easier consults among peers and with mentors, 3) easier detection and recovery when images are routed to the wrong person, 4) creating digital libraries, including previous slides from a current patient, and 5) giving greater access to images for presentations, publications, and to other clinical personnel. Implementing digital slides and associated workflow will introduce many challenges and barriers. Studies such as the current one are much needed to explore the pathologist’s perspective on these workflow and implementation challenges prior to and during the installation of the digital pathology systems. These perspectives are important to understand in order to improve the experience of the pathologists and lab personnel as they interact with these systems.

Establishing a Current Good Manufacturing Practice Facility for Biomaterials and Biomolecules in an Academic Medical Center

2018 ◽  
Vol 24 (6) ◽  
pp. 493-498 ◽  
Author(s):  
Alexandra J. Greenberg-Worisek ◽  
Bethany Kinseth Runge ◽  
Sarah A. Solyntjes ◽  
Juliana St. Helene-Kraft ◽  
Suzanne L. Glass ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Good Manufacturing Practice ◽  
Academic Medical ◽  
A Current

scholarly journals Telehealth for Endocrinology: Effect on Utilization in Non-Pandemic Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A844-A844
Author(s):  
Alexander Williams ◽  
Colin Walsh ◽  
Michelle Griffith
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Primary Diagnosis ◽  
Practice Variation ◽  
Policy Makers ◽  
Usual Practice ◽  
Testing Frequency ◽  
Wilcoxon Rank Sum Test ◽  
Academic Medical ◽  
Derived Data

Abstract Telehealth (TH) usage increased exponentially with the COVID-19 pandemic, aided by more permissive policies. Prior to the pandemic, policy makers and payers expressed concern that telehealth might lead to over-utilization of services. This contributed to a limited reimbursement environment. To assess evidence for this concern, we studied real-world TH at an academic medical center and hypothesized that TH would not increase utilization. We compared pre-pandemic utilization in a retrospective cohort of adult endocrinology patients with either TH (synchronous audio-visual visits) or conventional visits (CV) between 11/1/2017 - 3/16/2020. We focused on a pre-pandemic cohort to reflect usual practice. TH patients (i.e., 1+ TH visit with endocrinology in the study period) were identified using billing modifiers in EHR-derived data. CV patients were matched for provider and primary diagnosis, then selected from EHR-derived data in a 1:3 ratio. A minority of providers were performing TH visits pre-pandemic. Matching was performed to eliminate confounding from individual practice variation and to assure ability to compare patients with similar diagnoses. The majority of TH encounters in our practice during the study were clinic-to-clinic, with patients at a TH-enabled remote clinic. 75 TH and 225 CV patients were identified. 77% (55) of TH and 72% (163) of CV patients were female. The mean age was 45.2 (SD 12.4) and 49.6 (SD 16.7) years, respectively. Among TH patients, 68% (51) were white and 12% (9) were black with no statistically significant demographic differences between groups. The most common TH primary diagnoses were DM (33 patients) and thyroid disease (33 patients). Other TH diagnoses included pituitary/adrenal conditions, hyperparathyroidism, PCOS, and hypogonadism. TH patients had median follow-up of 21 months (IQR 13-25) and CV patients 18 months (IQR 11-25), p=0.613. TH patients had a range of 1 to 9 TH encounters during this time (median 2, IQR 1-3). Median TH visits per month were 0.20 (IQR 0.11-0.3). Looking at all endocrine encounters, TH patients had a median of 0.24 (IQR 0.015-0.36) encounters per month. CV patients had median of 0.20 encounters per month (IQR 0.11-0.37). Total encounters per month did not vary significantly between groups (p=0.0512, Wilcoxon rank-sum test). Patients with primary thyroid diagnoses had similar frequencies of TSH testing with TH median 4 tests (IQR 2-7); CV median 3 tests (IQR 1-5), p=0.057. A1c testing frequency was similar in patients with primary diagnosis of DM. TH patients had median 2 tests (IQR 1-3.5); CV median 3 (IQR 1-5), p=0.8012. In conclusion, TH was not associated with higher utilization of visits or lab testing in a small study of a pre-pandemic telehealth program. Coupled with larger scale and replicative studies, these findings might inform policy making and support continuation of telehealth in the post-pandemic environment.

Gender differences in career progress and satisfaction in an academic medical center

2002 ◽  
Vol 2 (3) ◽  
pp. 95-104 ◽  
Author(s):  
JoAnn Manson ◽  
Beverly Rockhill ◽  
Margery Resnick ◽  
Eleanor Shore ◽  
Carol Nadelson ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Career Progress

Mo1760 Assessment of Postoperative Complications in Patients With IBD. A Single Academic Medical Center Experience

2013 ◽  
Vol 144 (5) ◽  
pp. S-1109 ◽  
Author(s):  
Samantha J. Quade ◽  
Joshua Mourot ◽  
Anita Afzali ◽  
Mika N. Sinanan ◽  
Scott D. Lee ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients

2017 ◽  
Vol 07 (02) ◽  
pp. 115-120 ◽  
Author(s):  
Tiffany Liu ◽  
Chia Wu ◽  
David Steinberg ◽  
David Bozentka ◽  
L. Levin ◽  
...  
Keyword(s):  
Physical Examination ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Academic Medical ◽  
De Quervain ◽  
Clinical Records ◽  
Surgical Release

Background Obtaining wrist radiographs prior to surgeon evaluation may be wasteful for patients ultimately diagnosed with de Quervain tendinopathy (DQT). Questions/Purpose Our primary question was whether radiographs directly influence treatment of patients presenting with DQT. A secondary question was whether radiographs influence the frequency of injection and surgical release between cohorts with and without radiographs evaluated within the same practice. Patients and Methods Patients diagnosed with DQT by fellowship-trained hand surgeons at an urban academic medical center were identified retrospectively. Basic demographics and radiographic findings were tabulated. Clinical records were studied to determine whether radiographic findings corroborated history or physical examination findings, and whether management was directly influenced by radiographic findings. Frequencies of treatment with injection and surgery were separately tabulated and compared between cohorts with and without radiographs. Results We included 181 patients (189 wrists), with no differences in demographics between the 58% (110 wrists) with and 42% (79 wrists) without radiographs. Fifty (45%) of imaged wrists demonstrated one or more abnormalities; however, even for the 13 (12%) with corroborating history and physical examination findings, wrist radiography did not directly influence a change in management for any patient in this series. No difference was observed in rates of injection or surgical release either upon initial presentation, or at most recent documented follow-up, between those with and without radiographs. No differences in frequency, types, or total number of additional simultaneous surgical procedures were observed for those treated surgically. Conclusion Wrist radiography does not influence management of patients presenting DQT. Level of Evidence This is a level III, diagnostic study.

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