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

Juan Xing¹, Sara E Monaco¹, Jacqueline Cuda¹

¹Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Cytopathology : Official Journal of the British Society for Clinical Cytology

|January 28, 2020

Summary

Telecytology rapid on-site evaluation (ROSE) introduces errors, primarily from pathologists and technical issues, especially early in implementation. Improving staff training and feedback can reduce these errors for better quality assurance.

Keywords:

Interpretation errors ROSE cytotechnologist errors rapid on-site evaluation technical errors telecytology

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Area of Science:

Cytopathology
Medical Informatics
Quality Improvement

Background:

Rapid on-site evaluation (ROSE) enhances diagnostic adequacy and specimen triage.
Telecytology ROSE offers a viable alternative to traditional ROSE, demonstrating high concordance.
However, telecytology introduces potential for new errors due to its complex system and personnel involvement.

Purpose of the Study:

To identify and categorize errors encountered during telecytology ROSE implementation.
To analyze the types, causes, and frequency of telecytology ROSE errors.
To provide lessons learned and recommendations for mitigating these errors.

Main Methods:

A retrospective review of telecytology ROSE errors was conducted from 2017 to 2019.
Errors were classified as technical, cytotechnologist-related, or pathologist-related.
Data collected included error type, cause, diagnoses, and corrective actions.

Main Results:

46 (1.3%) telecytology ROSE sessions had documented errors.
Pathologist interpretation errors were most common (50%), followed by cytotechnologist errors (28%) and technical errors (22%).
Most technical and cytotechnologist errors occurred within the first year; common interpretation errors involved microorganisms and tumor classification.

Conclusions:

Telecytology ROSE is susceptible to various errors, including technical, human, and interpretation-related issues.
Familiarity with the system, staff training, and prompt feedback are crucial for error reduction.
Implementing a robust quality improvement program with error documentation and action is recommended.