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Updated: Jan 22, 2026

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Optimizing Workflow for OncotypeDX Result Turnaround Time at a Safety Net Hospital.

Jennifer Wu1, Christie Hung2, Hye G Sin1

  • 1Laura and Isaac Perlmutter Cancer Center of NYU Langone Health, New York, NY, USA.

Global Journal on Quality and Safety in Healthcare
|January 21, 2026
PubMed
Summary
This summary is machine-generated.

A new strategy significantly reduced the OncotypeDX test turnaround time (TAT) for early-stage breast cancer patients. This faster reporting aids timely treatment decisions in a public hospital setting.

Keywords:
adjuvant chemotherapybreast cancerhealthcare accessquality improvement

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Area of Science:

  • Oncology
  • Genomic Medicine
  • Health Services Research

Background:

  • The OncotypeDX test is crucial for guiding adjuvant chemotherapy decisions in early-stage, hormone-receptor-positive, HER2-negative breast cancer.
  • Timely delivery of OncotypeDX results is essential for prompt and effective treatment planning.
  • Optimizing the workflow for OncotypeDX testing is a priority in large urban public safety-net hospitals.

Purpose of the Study:

  • To implement and evaluate a strategy aimed at reducing the turnaround time (TAT) for OncotypeDX test reports.
  • To improve the efficiency of OncotypeDX result delivery from breast surgery to the electronic medical record (EMR).
  • To foster interdisciplinary collaboration among breast surgery, pathology, vendors, and medical oncology within a public hospital system.

Main Methods:

  • A quality improvement initiative using the Plan-Do-Study-Act model was employed.
  • A smartphrase was created in the EMR to streamline OncotypeDX ordering by breast surgery for eligible patients.
  • Turnaround time (TAT) was compared before (May 2021-March 2022) and after (June 2023-February 2024) strategy implementation.

Main Results:

  • Patient demographics, including age and ethnic minority representation, were similar between the pre- and post-implementation groups.
  • A higher proportion of patients from medically underserved areas and populations (MUAs and MUPs) were observed post-implementation.
  • The average TAT for OncotypeDX results was reduced from 42 days to 30 days following the strategy's implementation.

Conclusions:

  • A collaborative strategy involving breast surgery, pathology, vendors, and medical oncology effectively reduced OncotypeDX TAT in a large safety-net health system.
  • The optimized workflow proved successful despite an increasing patient population from medically underserved areas.
  • Streamlining the OncotypeDX ordering process through EMR integration and interdepartmental communication significantly improves efficiency for breast cancer treatment decisions.