University of Pennsylvania Health System Philadelphia, PA, United States
Shivan Mehta, MD, MBA, MSHP, Rahul Chaudhari, MD, MRCP, Frederick Nunes, MD, Mary Coniglio, MBA, Stephen Schwartz, DO, Bernadette Mucci, BS University of Pennsylvania Health System, Philadelphia, PA
Introduction: In order to effectively reduce the burden of colorectal cancer (CRC), it is important for endoscopists to communicate pathology results for screening colonoscopy to both the patient and primary care providers. We evaluated the rates of successful communication of pathology results from colonoscopies to patients and the accuracy of charted interval recall within our EHR at an academic gastroenterology division (4 endoscopy sites) from 11/2019 to 02/2020. Our goal was to assess the variability, and to identify deficiencies in communication practices of pathology results.
Methods: We first sent a division-wide survey via email to 62 gastroenterologists regarding their preferred communication methods. Then, we queried our institution’s endoscopic procedural database to obtain records from 11/2019 to 02/2020 where biopsies were obtained from a screening or surveillance colonoscopy. Out of 3,659 pathology results that met inclusion criteria, 671 encounters were analyzed by chart review. The variables that were checked for each provider included a successful letter, EHR message, telephone calls or a combination with appropriately updated interval recall. A detailed quality check was run for every missed communication and for every inaccurate interval recall.
Results: The reported communication methods among the survey respondents (n=20) in descending order were EHR generated pathology template letter (86.67%), EHR messaging system (66.67%), telephone call (33.33%), and non-template letter (26.67%). Out of total communications (n=538), letters via US mail were used for 376 (70%), EHR messaging was used for 99 (18%), and telephone calls were made for 63 communications (12%). About 80% (538/671) providers successfully communicated results via 1 of the above 3 modalities, with 69.5% (466/671) accurately charted interval recalls in EHR. Distributive data showed failure to communicate for >70% times for 13/62 providers (20.9%), and failure to document the interval for >70% times for 25/62 providers (40.3%).
Discussion: Results demonstrate variability among providers in the methods of communication regarding colonoscopy pathology. Low rates of successful communication and accurately documented recall interval are likely attributed to non-standardized workflows across sites within the health system. This study further supports need for a uniform approach to relaying pathology results and increased usage of “Smart Links” within template letters to update interval recall.
Shivan Mehta indicated no relevant financial relationships.
Rahul Chaudhari indicated no relevant financial relationships.
Frederick Nunes indicated no relevant financial relationships.
Mary Coniglio indicated no relevant financial relationships.
Stephen Schwartz indicated no relevant financial relationships.
Bernadette Mucci indicated no relevant financial relationships.
Shivan Mehta, MD, MBA, MSHP, Rahul Chaudhari, MD, MRCP, Frederick Nunes, MD, Mary Coniglio, MBA, Stephen Schwartz, DO, Bernadette Mucci, BS. P2999 - Quality Assessment of Communication and Management of Colonoscopy Pathology Results, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.