Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus

作者：Chen Lei^*; Welsh Kerry J; Chang Brian; Kidd Laura; Kott Marylee; Zare Mohammad; Carroll Kelley; Andy Nguyen; Wahed Amer; Tholpady Ashok; Pung Norin; McKee Donna; Risin Semyon A; Hunter Robert L

来源：American Journal of Clinical Pathology, 2016, 146(3): 312-318.

DOI：10.1093/AJCP/AQW122

• Clinical pathology
• Algorithmic testing
• Systemic lupus erythematosus

Objectives: Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care.
Methods: An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology.
Results: Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%.
Conclusions: Clinical pathology intervention and case triaging can improve access to care in a county health care system.

• 出版日期2016-9-1