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Updated: Mar 16, 2026
Skin Biopsy for Diagnosing Discoid Lupus Erythematosus
Published on: June 10, 2025
Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With
Lei Chen1, Kerry J Welsh2, Brian Chang2
1From the Department of Pathology and Laboratory Medicine Lei.Chen.1@uth.tmc.edu.
Objectives:
Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care.
Methods:
An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology.
Results:
Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%.
Conclusions:
Clinical pathology intervention and case triaging can improve access to care in a county health care system.
