UCLA Pathologists, Radiologists Produce Combined Reports

New service integrates pathology and radiology

David Geffen School of Medicine logo - diagnostic labs

CEO SUMMARY: To simplify diagnostic reporting, the pathology and radiology departments at the David Geffen School of Medicine/UCLA Medical Center are working together to deliver integrated diagnostic information to treating oncologists. This innovative strategy is designed to improve patient care and quality while saving time and cutting costs. For five months, diagnosticians have worked together on more than 50 lung cancer cases while gathering the evidence to show this interdisciplinary approach can improve decision-making and reduce downstream treatment costs.

There’s a unique and innovative clinical collaboration happening at the David Geffen School of Medicine at the University of California Los Angeles. Pathologists and radiologists are working together to develop an integrated diagnostic service at a single diagnostic and radiology imaging center.

The value of providing a clinical service that integrates both pathology and radiology services specifically to provide a consolidated diagnostic report to the referring physician has been long-recognized by both medical specialties. But many barriers—mostly institutional—have prevented this concept from becoming a reality. THE DARK REPORT believes that UCLA is the only academic center in the United States where the departments of pathology and radiology now collaborate to provide integrated reports.

The project is still in the proof-of-concept stage. Further, the two specialty groups have jointly invested their own funds to create a stand-alone diagnostic center that will allow patients to undergo the image studies and provide tissue specimens on one visit.

Recently opened, the Diagnostic Center is located next to the UCLA Medical Center Santa Monica in a free-standing ambulatory care building.

“Our two departments have multiple goals for this project,” stated Scott Binder M.D., Senior Vice Chair of Pathology and Director of Clinical Services. “We think that combining information from both departments will simplify the reporting for physicians in ways that can improve diagnostic accuracy and shorten the time required for the physician to arrive at the correct diagnosis. We also expect to reduce the discordance when reports are produced independently by pathologists and radiologists.

“This integrated diagnostic service is designed to be patient-friendly and patient-centric,” continued Binder. “We eventually want to make it possible for the patient to get all the imaging and tissue collection steps accomplished on one visit to a single site.

“Not only would this be more convenient for the patient, but it would shorten the time required for the diagnosis,” he continued. “Our two departments believe that having
radiologists and pathologists both available during the collection and imaging stage will raise the accuracy of the resulting diagnosis, lead to a faster treatment decision while producing less expensive care in the long run because cases and procedures will not have to be repeated and because patients will get their results sooner.

More Accurate Diagnoses

“Along with the benefits to the referring physician and the patient, our expectation is that the joint diagnostic service will reduce costs,” added Binder. “We expect to realize operational cost savings, and we realize that faster and more accurate diagnoses have the potential to generate substantial savings in the overall cost of care for these patients.”

According to Binder, the joint reporting system has been in place since September. The integrated diagnostic service has been used for about 50 lung cancer patients. Binder and colleagues W. Dean Wallace, M.D., Director of Ambulatory Pathology Informatics; and Deiter Enzmann, M.D., Chair of the Department of Radiological Sciences at UCLA Medical Center, are gathering the evidence necessary to show that this system improves patient care while driving down treatment costs, in part by reducing the need for further tests to clarify otherwise uncorrelated and potentially inconsistent findings.

“Our current focus on lung cancer is specifically to help us develop ideas for faster targeting of appropriate therapies for each patient,” noted Binder. “We are identifying biomarkers for lung and other cancers, and the number of biomarkers used to identify malignancies is rising all the time.

“Since we began producing combined reports for patients with lung cancer, we’ve also begun documenting the data prospectively,” said Binder. “This will give us the evidence we need to show if this method of integrated reporting and diagnostic collaboration can have a downstream effect on healthcare quality for patients.

“At the same time, we hope to show that this strategy can improve efficiency and eliminate some of the costs associated with the more traditional approach to diagnostic reporting,” he explained.

Binder acknowledged that some medical centers have newer information systems that combine separate reports produced by radiology and pathology. But he emphasized that the radiology/pathology collaboration at UCLA is much more deeply integrated.

“What distinguishes our collaboration is that we share data even before it is time to bring together the reports from radiology, pathology, and any other departments, such as molecular testing,” explained Binder.

“By sharing the data and developing the reports the way we do, we are confronting occasional discordance between pathologists and radiologists. Confronting and eliminating that discordance makes a significant difference for treating physicians seeking to improve patient care and outcomes.”

Contact Scott Binder M.D., at 310-267-2680 or sbinder@mednet.ucla.edu; W. Dean Wallace, M.D., at 310-825-6470 or wwallace@mednet.ucla.edu.

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