Utilization review and reimbursement of cytology services in endobronchial ultrasound-guided procedures: challenge and opportunity

Miller, Ross A.; Wright, Angela M.; Satrum, Laura S.; Mody, Dina R.; Schwartz, Mary R.; Thrall, Michael J.

doi:10.1016/j.jasc.2015.07.005

Cited by 8 publications

(2 citation statements)

References 19 publications

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“…To the best of our knowledge, there is only sparse literature that reports these potential problematic issues associated with telecytology ROSE. 19,20 Hence, the intent of sharing our findings about such drawbacks is to assist other users who plan to utilise telecytology for ROSE.…”

Section: Discussionmentioning

confidence: 99%

Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

2020

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Introduction Rapid on‐site evaluation (ROSE) has been widely used to improve diagnostic adequacy and facilitate specimen triage. Telecytology ROSE has gained popularity recently and shown high concordance with traditional ROSE. However, telecytology involves multiple personnel and technical devices that could introduce additional errors. The aim of this paper is to share errors encountered and lessons learned since employing telecytology for ROSE at our institution. Methods The laboratory information system was searched for all documented telecytology ROSE errors from 2017 to 2019. These errors were subclassified as technical errors, cytotechnologist‐related errors and pathologist‐related errors. The following details were recorded for each reported event: type of error, reason for error, ROSE diagnosis, final diagnosis and actions taken to avoid future errors. Results Telecytology ROSE errors were documented in 46 (1.3%) sessions. Ten (22%) had technical errors, 13 (28%) were owing to cytotechnologist errors and 23 (50%) were attributed to pathologist interpretation errors. The majority of the technical (90%) and cytotechnologist errors (85%) occurred within the first year of implementation of telecytology. Common ROSE misinterpretation errors included missing microorganisms, misclassifying neuroendocrine tumours as other neoplasms and overcalling malignancy on gastrointestinal endoscopic procedures. Conclusions A variety of errors may occur during telecytology ROSE. While some errors are inevitable (eg, information technology downtime), certain telecytology errors can be reduced by increasing staff familiarity with the system, providing timely feedbacks and taking prompt corrective actions. We recommend establishing a mechanism to document and act upon recorded errors as part of a telecytology quality improvement programme.

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Section: Discussionmentioning

confidence: 99%

Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

2020

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“…The recommendations address variables in fine‐needle aspiration procedures, such as needle gauge, number of needle passes, and the use of ROSE for ensuring specimen adequacy for ancillary studies. This is especially relevant within the context of the time and resources that may be needed to comply with the recommendations for using ROSE in all aspiration procedures for the collection of thoracic specimens 4‐8 . Although the CAP expert panel recognizes the limitations of ROSE for all thoracic fine‐needle aspiration procedures because it may not be readily available, feasible, or practical in all situations, 3 guideline recommendations specifically focus on the use of ROSE in endobronchial ultrasound–guided transbronchial needle aspiration, transthoracic needle procedures, and bronchoscopic procedures to ensure the adequate collection and appropriate handling of these small specimens in all cases that require ancillary studies (Table 1).…”

Section: Introductionmentioning

confidence: 99%

A new guideline from the College of American Pathologists to improve the adequacy of thoracic small specimens for ancillary studies

Roy‐Chowdhuri

2020

Cancer Cytopathology

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With advancments in technology for minimally invasive sampling techniques, pathology laboratories are receiving increasing numbers of small biopsy and cytology specimens for multiple ancillary studies to help in the diagnosis and management of pulmonary diseases. A recently published evidence‐based guideline from the College of American Pathologists (CAP), in collaboration with 8 other professional medical societies, provides recommendations to clinicians for the collection of adequate material for diagnostic and ancillary testing as well as optimal handling in an attempt to prioritize ancillary testing. The primary goal of developing this CAP guideline is to assist pathologists and their clinical colleagues to better collect and handle small thoracic pathology specimens to help guide therapeutic decisions.

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Cytopreparatory Techniques and Instrumentation in Nongynecologic Cytology

2018

Diagnostic Pathology: Cytopathology

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Utilization review and reimbursement of cytology services in endobronchial ultrasound-guided procedures: challenge and opportunity

Cited by 8 publications

References 19 publications

Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

A new guideline from the College of American Pathologists to improve the adequacy of thoracic small specimens for ancillary studies

Cytopreparatory Techniques and Instrumentation in Nongynecologic Cytology

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