I do nearly all of mine by 'phone with clinicians: I can't understand
the clinical issues otherwise.
This should still allow us to cost this: perhaps in hours/week
For the same reasons that I prefer to do it this way I find the the
UK NEQAS scheme is of very limited value as it assumes a workflow
that I don't use.
Brian Shine and I often find that we "'phone and discuss" more and
"just 'phone results" less than our SpRegs.
Jonathan
On 16 May 2006, at 14:15, Reynolds Tim wrote:
> Personally, I do most of my comenting on the phone and not on paper
> - I get lots of GP phone calls in which we discuss the patient and
> I don't have to rely on 2 illegible words (if that) of clinical
> detail. It makes costing thins difficult / impossible.
>
> TIM
>
>
>
> **********************************************************************
> ***************
> Prof. Tim Reynolds,
> Queen's Hospital,
> Belvedere Rd,
> Burton-on-Trent,
> Staffordshire,
> DE13 0RB
>
> work tel: 01283 511511 ext. 4035
> work fax: 01283 593064
> work email: [log in to unmask]
> home email: [log in to unmask]
> **********************************************************************
> ****************
> IMPORTANT: This email is intended for the use of the individual
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>
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of Ian Bailey
> Sent: 16 May 2006 13:10
> To: [log in to unmask]
> Subject: Re: Costs of Report Comments - invitation to share info
>
>
> There are a number of difficulties here and some excellent comments.
>
> costing model proposed assumes "set based" rather than test or
> specimen based
>
> also we already use auto commenting and auto authorisation
> processes, should these be counted or not?
>
>
> our laboratory computer is APEX which is test based, so teasing out
> to a set based commenting would not be very productive.
>
> Report authorisation as already noted here is not just about
> commenting
>
> and one of our (very good service) reference centres does sometimes
> send back reports with "all results normal" - unclear if automated
> or not -and at other times very abnormal results with no comment.
>
>
> From a poster I submitted Bailey IR. Rule-based further
> requesting, interpretation, addition of comments and authorisation
> by computer. Annals of Clinical Biochemistry 1998 (suppl): 92.
> which was predominantly about thyroid auto commenting, which freed
> up time to consider the less obvious thyroid results, which
> appeared to go up in quantity and time of implementation (and there
> will be a loss of this automation process with CfH requesting as
> clinical details will not be coded, an important aspect when auto
> commenting, see Mike's point about removing inappropriate comments,
> nor is there any proposal to automatically include known chronic
> disease states of diabetes and renal failure for example in
> requests note this applies to London, I do not know elsewhere) so
> when considering further automation of commenting should this be at
> clinical end where all (?) relevant information should be available?
>
> How do we count interpretations we have been asked to add to work
> performed in the private sector?
>
> We need to be able to quantify the quality and added value aspects
> of this process, ? best done by "customers" not us!
>
> Ian
>
> Dr Ian R Bailey
> Consultant Chemical Pathologist, Bromley Hospitals NHS Trust,UK
> email: [log in to unmask]
> Tel: 01689 864281
>
>
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of Smellie Stuart (RXP)
> Consultant Chemical Pathologist
> Sent: 10 May 2006 09:35
> To: [log in to unmask]
> Subject: Re: Costs of Report Comments - invitation to share info
>
> We discussed this at ACP chem path committee and there were
> different views. One thing I would point out as a caution is that
> of equating the added cost of a consultant to the clinical comments
> reflects only a small part of the job, and risking the rest being
> forgotten, which would make commenting look expensive. The
> 'package' of added value the consultant gives is a mix of
> commenting/protocol advice/troubleshooting odd results etc. of
> which actual comment adding is only a part.
> We should be careful that by peeling off only one part of that
> package, the other bits which are less easily 'unitised' could be
> perceived as being of no added value and stripped out. In DGHs many
> feel that systematic commenting often has limited added value -
> time is spent producing logic rules so we can use a lot of
> computer generated protocols for more standard stuff - a bit like
> PBR, if comments were itemised, we could see a spurious industry of
> artificial wealth creation! It may be that a list of the activities
> which consultants do to contribute to the extra 10p cost or
> whatever per test could be produced in parallel.
>
> -----Original Message-----
> From: IT working group of the Association of Clinical Biochemists
> [mailto:[log in to unmask]] On Behalf Of JA Muir Gray
> Sent: 10 May 2006 07:29
> To: [log in to unmask]
> Subject: Re: Costs of Report Comments - invitation to share info
>
> Agree+++++++
>
> In times of danger ; stick to your principles and be bold
>
>
> On 9/5/06 17:20, "Rick Jones" <[log in to unmask]> wrote:
>
>> Yes but if we don't cost it how do you justify having expensive
>> medics
>> at
> all.
>>
>> Rick
>>
>>
>> Dr Rick Jones
>> Clinical Biochemistry & Immunology
>> Leeds Teaching Hospitals Trust
>> Leeds General Infirmary
>> Great George St
>> Leeds LS1 3EX
>> [log in to unmask]
>> [log in to unmask]
>> Trust: 0113 392 2340
>> Univ: 0113 343 8033
>> Fax: 0113 392 5174
>> LS1 3EX
>>
>> http://www.ychi.leeds.ac.uk
>> http://www.thehungersite.com
>>
>>
>>>>> [log in to unmask] 09/05/2006 09:00 >>>
>> Costing of comments is very dangerous. If for example you calculate
>> that each comment costs £10 then the PCT might decide that they don't
>> want to pay for that part of the service and will ask to strip that
>> from what they pay the lab. What happens then - redundancies?
>>
>>
>>
>> *********************************************************************
>> *
>> ********
>> *******
>> Prof. Tim Reynolds,
>> Queen's Hospital,
>> Belvedere Rd,
>> Burton-on-Trent,
>> Staffordshire,
>> DE13 0RB
>>
>> work tel: 01283 511511 ext. 4035
>> work fax: 01283 593064
>> work email: [log in to unmask]
>> home email: [log in to unmask]
>> *********************************************************************
>> *
>> ********
>> ********
>> IMPORTANT: This email is intended for the use of the individual
>> addressee(s)named above and may contain information that is
>> confidential privileged or unsuitable for overly sensitive persons
>> with low self-esteem, no sense of humour or irrational religious
>> beliefs. If you are not the intended recipient, any dissemination,
>> distribution or copying of this email is not authorized (either
>> explicitly or implicitly) and constitutes an irritating social faux
>> pas. Unless the word absquatulation has been used in its correct
>> context somewhere other than in this warning, it does not have any
>> legal or grammatical use and may be ignored. No animals were
>> harmed in
>> the transmission of this email, though the kelpie next door is living
>> on borrowed time, let me tell you. Those of you with an overwhelming
>> fear of the unknown will be gratified to learn there is no hidden
>> message revealed by reading this backwards, so just ignore that Alert
>> Notice from Macroshaft. However, by pouring a complete circle of salt
>> around yourself and your computer you can ensure that no harm befalls
>> you and your pets. If you have received this eMail in error,
>> please add
> some nutmeg and egg whites, whisk, and place in a warm oven for 40
> minutes.
>>
>>
>>
>>
>>
>> -----Original Message-----
>> From: IT working group of the Association of Clinical Biochemists
>> [mailto:[log in to unmask]] On Behalf Of Rick Jones
>> Sent: 08 May 2006 16:22
>> To: [log in to unmask]
>> Subject: Costs of Report Comments - invitation to share info
>>
>>
>> Dear ACB-IT,
>> I'm interested in working out what it costs labs to manually put
>> clinical comments on reports principally to see what the relative
>> economic value of a more automated approach might be.
>>
>> I've developed an excel model to try to work this out in relation to
>> staff time and report volumes.
>>
>> If anyone were interested in using this to capture & share data about
>> their own service or indeed in refining the model I'd be pleased
>> to hear
> from you.
>>
>> If we were to get a number of estimates I'd be happy to put them
>> together and share the info after suitable anonymisation.
>>
>> With best wishes
>>
>>
>>
>> Dr Rick Jones
>> Clinical Biochemistry & Immunology
>> Leeds Teaching Hospitals Trust
>> Leeds General Infirmary
>> Great George St
>> Leeds LS1 3EX
>> [log in to unmask]
>> [log in to unmask]
>> Trust: 0113 392 2340
>> Univ: 0113 343 8033
>> Fax: 0113 392 5174
>> LS1 3EX
>>
>> http://www.ychi.leeds.ac.uk
>> http://www.thehungersite.com
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