Establishing priorities for implementation of large language models in pathology and laboratory medicine.

Artificial intelligence and machine learning have numerous applications in pathology and laboratory medicine. The release of ChatGPT prompted speculation regarding the potentially transformative role of large-language models (LLMs) in academic pathology, laboratory medicine, and pathology education. Because of the potential to improve LLMs over the upcoming years, pathology and laboratory medicine clinicians are encouraged to embrace this technology, identify pathways by which LLMs may support our missions in education, clinical practice, and research, participate in the refinement of AI modalities, and design user-friendly interfaces that integrate these tools into our most important workflows.

Direct Secure Messaging in Practice: Addressing Workflow Challenges.

Direct Secure Messaging (DSM) is a sender-initiated communication technology for exchanging patient-specific information among clinicians and disparate healthcare organizations. As DSM adoption increases it becomes more difficult for clinicians and staff to manage the volume and variety of external data received. This can lead to information hazards that can produce cognitive overload and decrease the ability of clinicians to process patient data when reviewing multiple sources.

Governance of Electronic Health Record Modification at U.S. Academic Medical Centers.

Objectives: A key aspect of electronic health record (EHR) governance involves the approach to EHR modification. We report a descriptive study to characterize EHR governance at academic medical centers (AMCs) across the United States.

Methods: We conducted interviews with the Chief Medical Information Officers of 18 AMCs about the process of EHR modification for standard requests.

Laboratory Results Release to Patients under the 21st Century Cures Act: The Eight Stakeholders Who Should Care.

A major aim of the 21st Century Cures Act is to support patients' access to their electronic health data and to prevent information blocking practices by health care organizations and health information technology developers. Prior to the Cures Act, significant variation existed in patient access to laboratory test results, key pieces of health data which enable timely self-management and engagement in care. Although many health care systems began releasing test results immediately through patient portals because of the Cures Act, implementation remains challenging due to variations in state regulations around electronic results release, local interpretations of allowable exceptions to Cures information blocking, concerns about privacy of sensitive laboratory results, and technological limitations.

Development and Implementation of a Standard Format for Clinical Laboratory Test Results.

Objectives: Surprisingly, laboratory results, the principal output of clinical laboratories, are not standardized. Thus, laboratories frequently report results with identical meaning in different formats. For example, laboratories report a positive pregnancy test as "+," "P," or "Positive.

Searching Full-Text Anatomic Pathology Reports Using Business Intelligence Software.

Although the laboratory information system has largely solved the problem of storing anatomic pathology reports and disseminating their contents across the healthcare system, the retrospective query of anatomic pathology reports remains an area for improvement across laboratory information system vendors. Our institution desired the ability to query our repository of anatomic pathology reports for clinical, operational, research, and educational purposes. To address this need, we developed a full-text anatomic pathology search tool using the business intelligence software, Tableau.

The 21st Century Cures Act and Multiuser Electronic Health Record Access: Potential Pitfalls of Information Release.

Although the Office of The National Coordinator for Health Information Technology's (ONC) Information Blocking Provision in the Cures Act Final Rule is an important step forward in providing patients free and unfettered access to their electronic health information (EHI), in the contexts of multiuser electronic health record (EHR) access and proxy access, concerns on the potential for harm in adolescent care contexts exist. We describe how the provision could erode patients' (both adolescent and older patients alike) trust and willingness to seek care. The rule's preventing harm exception does not apply to situations where the patient is a minor and the health care provider wishes to restrict a parent's or guardian's access to the minor's EHI to avoid violating the minor's confidentiality and potentially harming patient-clinician trust.

Clinical and Biologic Characteristics and Outcomes in Young and Middle-Aged Patients With Laryngeal Cancer: A Retrospective Cohort Analysis.

Objective: To describe the clinical and biologic characteristics and outcomes of young and middle-aged (YMA; <65 years) patients according to the presence or absence of traditional risk factors for laryngeal cancer.

Study Design: Retrospective cohort analysis.

Setting: Single-institution academic medical center.

Survey of Hospital Chargemaster Transparency.

Background: In January 2019, the Centers for Medicare & Medicaid Services (CMS) required hospitals to list their standard charges (chargemasters) publicly in an effort to increase price transparency in health care. Surveying hospital chargemasters may be informative to assess the implementation of this rule and its utility to consumers.

Objective: We aimed to compare hospital chargemaster data within a local hospital market where patients would reasonably try to shop or compare services.

Medicare Trends in Pathologist Participation, Service Utilization, and Payments.

Objectives: Quantifying pathologist participation in Medicare services may be informative for the prediction of future workforce needs and reimbursement.

Methods: A retrospective examination was performed of pathologist professional (Part B) Medicare billings and payments from 2012 to 2017. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File was the primary data source.

What the Coronavirus Disease 2019 (COVID-19) Pandemic Has Reinforced: The Need for Accurate Data.

The COVID-19 pandemic has challenged the United States’ existing national public health informatics infrastructure. This report details the factors that have contributed to COVID-19 data inaccuracies and reporting delays and their effect on the modeling and monitoring of the COVID-19 pandemic.

Smart Glasses as a Surgical Pathology Grossing Tool.

Context.—: Smart glasses are a wearable technology that enable hands-free data acquisition and entry.

Objective.

Palatine Tonsilloliths and : A Multi-institutional Study of Adult Patients Undergoing Tonsillectomy.

Objective: To better characterize associations between and tonsillolith versus nontonsillolith tonsillectomy specimens.

Study Design: Bi-institutional retrospective case-case study.

Setting: University and county hospital.

A Cross-Sectional Study Evaluating the Use of Free Clinics in Syracuse, NY: Patient Demographics and Barriers to Accessing Healthcare in Traditional Settings.

Free clinics provide healthcare to underserved patient populations, playing a critical role in the medical safety-net. Syracuse, New York has notable racial, socioeconomic, and educational disparities and is home to four free clinics. Little is known about these clinics' patient population.