{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T14:06:40Z","timestamp":1762006000319,"version":"build-2065373602"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>\n            Background\u2003Failure of timely test result follow-up has consequences including delayed diagnosis and treatment, added costs, and potential patient harm. Closed-loop communication is key to ensure clinically significant test results (CSTRs) are acknowledged and acted upon appropriately. A previous implementation of the Alert Notification of Critical Results (ANCR) system to facilitate closed-loop communication of imaging CSTRs yielded improved communication of critical radiology results and enhanced adherence to institutional CSTR policies.<\/jats:p><jats:p>\n            Objective\u2003This article extends the ANCR application to pathology and evaluates its impact on closed-loop communication of new malignancies, a common and important type of pathology CSTR.<\/jats:p><jats:p>\n            Materials and Methods\u2003This Institutional Review Board-approved study was performed at a 150-bed community, academically affiliated hospital. ANCR was adapted for pathology CSTRs. Natural language processing was used on 30,774 pathology reports 13 months pre- and 13 months postintervention, identifying 5,595 reports with malignancies. Electronic health records were reviewed for documented acknowledgment for a random sample of reports. Percent of reports with documented acknowledgment within 15 days assessed institutional policy adherence. Time to acknowledgment was compared pre- versus postintervention and postintervention with and without ANCR alerts. Pathologists were surveyed regarding ANCR use and satisfaction.<\/jats:p><jats:p>\n            Results\u2003Acknowledgment within 15 days was documented for 98 of 107 (91.6%) pre- and 89 of 103 (86.4%) postintervention reports (p\u2009=\u20090.2294). Median time to acknowledgment was 7 days (interquartile range [IQR], 3, 11) preintervention and 6 days (IQR, 2, 10) postintervention (p\u2009=\u20090.5083). Postintervention, median time to acknowledgment was 2 days (IQR, 1, 6) for reports with ANCR alerts versus 6 days (IQR, 2.75, 9) for reports without alerts (p\u2009=\u20090.0351). ANCR alerts were sent on 15 of 103 (15%) postintervention reports. All pathologists reported that the ANCR system positively impacted their workflow; 75% (three-fourths) felt that the ANCR system improved efficiency of communicating CSTRs.<\/jats:p><jats:p>\n            Conclusion\u2003ANCR expansion to facilitate closed-loop communication of pathology CSTRs was favorably perceived and associated with significant improved time to documented acknowledgment for new malignancies. The rate of adherence to institutional policy did not improve.<\/jats:p>","DOI":"10.1055\/s-0038-1654700","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T22:45:36Z","timestamp":1528325136000},"page":"411-421","source":"Crossref","is-referenced-by-count":7,"title":["Semiautomated System for Nonurgent, Clinically Significant Pathology Results"],"prefix":"10.1055","volume":"09","author":[{"given":"Stacy","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Khorasani","sequence":"additional","affiliation":[{"name":"Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Pochebit","sequence":"additional","affiliation":[{"name":"Department of Pathology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronilda","family":"Lacson","sequence":"additional","affiliation":[{"name":"Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Andriole","sequence":"additional","affiliation":[{"name":"Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuj","family":"Dalal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,6,6]]},"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1654700.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T20:21:14Z","timestamp":1557174074000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1654700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2018,4,4]]},"published-print":{"date-parts":[[2018,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1654700","relation":{},"ISSN":["1869-0327"],"issn-type":[{"type":"electronic","value":"1869-0327"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}