44 Centralizing and Digitizing Bone Marrow Biopsy Ancillary Testing

For hematopathologists, cytogenetics, FISH, and molecular results are essential to establishing a final diagnosis and guiding appropriate treatment. In pathology departments where these tests are not performed in-house but have a significant volume of bone marrow biopsies, combining this information into a single, centralized report for clinicians is challenging. Some results are not available for up to two to three weeks after the sign-out date, and pathologists, who are likely to be on other services, may forget unless prompted. Some institutions using EPIC Beaker have leveraged the linked orders functionality to help with this task, while others use ancillary staff to monitor the completion of testing and notify the pathologist. We aimed to create a dashboard to compile all ancillary testing for bone marrow biopsies and format these results to incorporate this information into supplemental reports. We wrote a script that runs at 3 AM every day using SQL and Python to extract data from the past three months of bone marrow biopsies, along with the corresponding ancillary testing, and upload it to our SQL server. Using Tableau, we then built an interactive dashboard on top of this data table. The dashboard we built consolidates all ancillary testing into a single column, allowing users to simply copy and paste the information into their supplemental report. Previously, these results were faxed to a mailbox that fellows monitored. The fellows would identify abnormal results, create supplemental reports for those cases, and manually compile all relevant data entered into EPIC. This process could take up to 15 minutes per case and ran the risk of missing important information. With fellows handling approximately 5–10 supplemental marrow reports per day, on top of an already demanding workload, this method was unsustainable. The dashboard now enables users to compile all ancillary testing and format the report in just 15 seconds, allowing more time for interpretation rather than spending valuable time transcribing faxed documents. We built a dashboard that transformed a paper-driven process into a more efficient and effective system by leveraging existing electronic infrastructure. This saved approximately eight hours of tedious manual work per week and provided the added benefit of allowing pathologists to troubleshoot results that were taking more than three weeks to result. In the future, we plan to implement linked orders testing as part of our transition to EPIC Beaker. However, during this transition, the Tableau dashboard enables hematopathologists and fellows to easily generate supplemental reports, allowing more time for meaningful interpretation and improved patient care.