Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service

Background: Advances in digital pathology are accelerating integration of this technology into anatomic pathology (AP). To optimize implementation and adoption of digital pathology systems within a large healthcare organization, initial assessment of both end user (pathologist) needs and organizatio...

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Main Authors: Jonhan Ho, Orly Aridor, David W Glinski, Christopher D Saylor, Joseph P Pelletier, Dale M Selby, Steven W Davis, Nicholas Lancia, Christopher B Gerlach, Jonathan Newberry, Leslie Anthony, Liron Pantanowitz, Anil V Parwani
Format: Article
Language:English
Published: Elsevier 2013-01-01
Series:Journal of Pathology Informatics
Subjects:
Online Access:http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2013;volume=4;issue=1;spage=32;epage=32;aulast=Ho
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author Jonhan Ho
Orly Aridor
David W Glinski
Christopher D Saylor
Joseph P Pelletier
Dale M Selby
Steven W Davis
Nicholas Lancia
Christopher B Gerlach
Jonathan Newberry
Leslie Anthony
Liron Pantanowitz
Anil V Parwani
author_facet Jonhan Ho
Orly Aridor
David W Glinski
Christopher D Saylor
Joseph P Pelletier
Dale M Selby
Steven W Davis
Nicholas Lancia
Christopher B Gerlach
Jonathan Newberry
Leslie Anthony
Liron Pantanowitz
Anil V Parwani
author_sort Jonhan Ho
collection DOAJ
description Background: Advances in digital pathology are accelerating integration of this technology into anatomic pathology (AP). To optimize implementation and adoption of digital pathology systems within a large healthcare organization, initial assessment of both end user (pathologist) needs and organizational infrastructure are required. Contextual inquiry is a qualitative, user-centered tool for collecting, interpreting, and aggregating such detailed data about work practices that can be employed to help identify specific needs and requirements. Aim: Using contextual inquiry, the objective of this study was to identify the unique work practices and requirements in AP for the United States (US) Air Force Medical Service (AFMS) that had to be targeted in order to support their transition to digital pathology. Subjects and Methods: A pathology-centered observer team conducted 1.5 h interviews with a total of 24 AFMS pathologists and histology lab personnel at three large regional centers and one smaller peripheral AFMS pathology center using contextual inquiry guidelines. Findings were documented as notes and arranged into a hierarchal organization of common themes based on user-provided data, defined as an affinity diagram. These data were also organized into consolidated graphic models that characterized AFMS pathology work practices, structure, and requirements. Results: Over 1,200 recorded notes were grouped into an affinity diagram composed of 27 third-level, 10 second-level, and five main-level (workflow and workload distribution, quality, communication, military culture, and technology) categories. When combined with workflow and cultural models, the findings revealed that AFMS pathologists had needs that were unique to their military setting, when compared to civilian pathologists. These unique needs included having to serve a globally distributed patient population, transient staff, but a uniform information technology (IT) structure. Conclusions: The contextual inquiry method helped reveal similarities and key differences with civilian pathologists. Such an analysis helped identify specific instances that would benefit from implementing digital pathology in a military environment. Employing digital pathology to facilitate workload distribution, secondary consultations, and quality assurance (over-reads) could help the AFMS deliver more accurate, efficient, and timely AP services at a global level.
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spelling doaj.art-100671c163ea48d28d7ef1fab26f73772022-12-22T03:22:05ZengElsevierJournal of Pathology Informatics2153-35392153-35392013-01-0141323210.4103/2153-3539.122388Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical ServiceJonhan HoOrly AridorDavid W GlinskiChristopher D SaylorJoseph P PelletierDale M SelbySteven W DavisNicholas LanciaChristopher B GerlachJonathan NewberryLeslie AnthonyLiron PantanowitzAnil V ParwaniBackground: Advances in digital pathology are accelerating integration of this technology into anatomic pathology (AP). To optimize implementation and adoption of digital pathology systems within a large healthcare organization, initial assessment of both end user (pathologist) needs and organizational infrastructure are required. Contextual inquiry is a qualitative, user-centered tool for collecting, interpreting, and aggregating such detailed data about work practices that can be employed to help identify specific needs and requirements. Aim: Using contextual inquiry, the objective of this study was to identify the unique work practices and requirements in AP for the United States (US) Air Force Medical Service (AFMS) that had to be targeted in order to support their transition to digital pathology. Subjects and Methods: A pathology-centered observer team conducted 1.5 h interviews with a total of 24 AFMS pathologists and histology lab personnel at three large regional centers and one smaller peripheral AFMS pathology center using contextual inquiry guidelines. Findings were documented as notes and arranged into a hierarchal organization of common themes based on user-provided data, defined as an affinity diagram. These data were also organized into consolidated graphic models that characterized AFMS pathology work practices, structure, and requirements. Results: Over 1,200 recorded notes were grouped into an affinity diagram composed of 27 third-level, 10 second-level, and five main-level (workflow and workload distribution, quality, communication, military culture, and technology) categories. When combined with workflow and cultural models, the findings revealed that AFMS pathologists had needs that were unique to their military setting, when compared to civilian pathologists. These unique needs included having to serve a globally distributed patient population, transient staff, but a uniform information technology (IT) structure. Conclusions: The contextual inquiry method helped reveal similarities and key differences with civilian pathologists. Such an analysis helped identify specific instances that would benefit from implementing digital pathology in a military environment. Employing digital pathology to facilitate workload distribution, secondary consultations, and quality assurance (over-reads) could help the AFMS deliver more accurate, efficient, and timely AP services at a global level.http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2013;volume=4;issue=1;spage=32;epage=32;aulast=HoAir forceanatomic pathologyconsultationcontextual inquirydigital pathologyinformaticsworkflowworkload distribution
spellingShingle Jonhan Ho
Orly Aridor
David W Glinski
Christopher D Saylor
Joseph P Pelletier
Dale M Selby
Steven W Davis
Nicholas Lancia
Christopher B Gerlach
Jonathan Newberry
Leslie Anthony
Liron Pantanowitz
Anil V Parwani
Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
Journal of Pathology Informatics
Air force
anatomic pathology
consultation
contextual inquiry
digital pathology
informatics
workflow
workload distribution
title Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
title_full Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
title_fullStr Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
title_full_unstemmed Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
title_short Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service
title_sort needs and workflow assessment prior to implementation of a digital pathology infrastructure for the us air force medical service
topic Air force
anatomic pathology
consultation
contextual inquiry
digital pathology
informatics
workflow
workload distribution
url http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2013;volume=4;issue=1;spage=32;epage=32;aulast=Ho
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