Peninsula Health’s gastroenterology team has developed a “Post Endoscopy Pathway”, the first process of its kind in Australia, designed to ensure no concerning endoscopy or biopsy results are ever overlooked.
“The brief that we set ourselves at the beginning of this project was, ‘How can we make it as difficult as possible to miss anything important?’ Timely review of histopathology results after an endoscopic procedure such as a Gastroscopy or Colonoscopy is vital, as missed findings can delay diagnoses and in the worst case scenario lead to poorer patient outcomes. Currently, manual checking of the results is standard practice and when you are performing thousands of procedures each year, inevitably it raises the possibility that some will get missed,” explains Associate Professor Marcus Robertson, Peninsula Health’s Head of Gastroenterology.
To help minimise the risk of human error, Gastroenterologist Dr Kim Be developed a system to automate the detection of cancers in test results.
The first step of the innovation involves automatically matching a patient’s histopathology results to their endoscopy report. An automated tool then scans all of the reports and searches for carefully-selected keywords. If a possible malignancy is detected from the keywords, it automatically generates an email to the Gastroenterology staff raising an alert.
“We explored whether we could utilise modern technology – NOT artificial intelligence – to automate a time-consuming and manual process to benefit our patients,” says A/Prof Robertson.
“The system requires very little input to keep it sustainable,” he adds.
According to the Associate Professor, this process not only enables them to ensure nothing is missed, but is also detecting any concerning results more quickly, enabling treatment to start sooner. Since the project began, there has been a 43% reduction in the time taken for patients with unexpected cancers to receive specialist treatment. The Gastroenterology team is working closely with their surgical colleagues to streamline the system, so that as soon as something serious is detected, an appointment is made available for the patient at the very next specialist clinic.
The team also holds weekly virtual clinics where everything is reviewed, and a letter is generated for every patient undergoing endoscopy, which is sent to the patient and the patient’s GP, to inform them that histology has been checked and providing recommendations. A/Prof Robertson says that patients and GPs appreciate getting personalised advice after an endoscopic procedure, and he sees scope to expand this process to other specialist areas of the heath service.
The Gastroenterology Unit has also recently been awarded a grant of close to $100,000, which will enable them to hire a dedicated endoscopy nurse three days a week to further expand these innovations.
“Peninsula Health is offering a state-of-the-art Gastroenterology service to the local community,” says A/Prof Robertson. “As a unit, our goal is that, wherever possible, we can inform patients that ‘We can offer this service here’, so that patients don’t have to travel far to get the care that they need.”