Factors affecting the implementation and use of electronic templates for histopathology cancer reporting

The surgical pathology report on cancer resection specimens is fundamental to providing clinicians with the information needed for adequate patient oncology treatment. Since the multi-institutional quality study on pathology reporting of colorectal cancer published by Zarbo in 1992, many other studies have shown that the use of checklists or synoptic reporting is superior to traditional narrative (free text) reporting. Using electronic health records, synoptic histopathology reporting tools can be designed to be very sophisticated with discrete data fields, drop down menus, and automated SNOMED encoding. The use of discrete data fields (’atomic data’) means that it is possible to automatically search, extract, and transmit data electronically. Despite the apparent benefits of electronic synoptic histopathology reporting, and the successful regional implementation of such a reporting system in Ontario, Canada, others have reported that the implementation and use of electronic histopathology reporting is no easy organisational task. Similar challenges have also been reported regarding the implementation and use of a web-based synoptic reporting tool for cancer surgery. From a management and organisational perspective, the list of possible causes for project failure with respect to information technology development, implementation and use is long. In our opinion, a pro-active understanding and management of key organisational issues is a requirement for successful long-term synoptic histopathology cancer reporting.