The information contained in histopathology reports on surgical resections of cancer is fundamental for both patient treatment and cancer registries. Electronic synoptic histopathology reporting is considered superior to traditional narrative reporting with respect to both completeness and feasibility of data use. An electronic template for colorectal cancer reporting was introduced in Norway in 2005, but implementation has varied greatly between different pathology departments. In 2012, four pathology departments and the Norwegian Cancer Registry started a new initiative on electronic cancer reporting. As part of this initiative, this study was undertaken to learn more about factors influencing implementation and use.
Qualitative and quantitative data were obtained from six of the 17 public pathology departments in Norway using explorative case study methodology. Methods included document studies, semi-structured interviews with key informants, and audits on actual template use. A systematic analysis of data was conducted based on theoretical models for project management, stakeholder engagement, and individual acceptance of new information technology.
Most key informants had a positive view on synoptic reporting, and five departments had tested the electronic template. Of these, four had implemented the template while one department had decided not to implement it due to layout concerns. Of the four departments using the template in daily routine, one had compulsory use, two consensus based use, while the fourth had voluntary use. Annual average usage of the electronic template in the three departments with compulsory or consensus based use was 92% compared to 53% in the department with voluntary use.
There was a general positive attitude towards electronic synoptic reporting. Reasons for not implementing the colorectal template were specific technical and quality issues not adequately addressed by the project organization having developed the template. A formal assessment of project outcomes with a task force handling such technical issues should accordingly have been established as part of the project. After an organizational decision on implementation, perceived job relevance and practical benefits are factors important for individual template use. Consistent high long-term usage was related to a departmental environment with a consensus based decision on use.
Stakeholders are individuals, groups, or organizations that are affected by or can affect a particular action undertaken by others. Biobanks relate to a number of donors, researchers, research institutions, regulatory bodies, funders, and others. These stakeholders can potentially have a strong influence upon the organization and operation of a biobank. A sound strategy for stakeholder engagement is considered essential in project management and organization theory. In this article, we review relevant stakeholder theory and demonstrate how a stakeholder analysis was undertaken in the early stage of a planned research biobank at a public hospital in Norway.
In order to succeed in realising general health-policy goals for cancer care, they must be formulated as specific and realistic objectives. An administrative organ must be provided with the authority and funding needed to establish the technical solutions required. Reporting to national registries must take place automatically in electronic form, on the basis of ongoing structured reporting in the patient records. In our opinion the Directorate of Health should enter into cooperation with the College of American Pathologists, with a view to integrating a Norwegian version of their electronic checklists for pathology reporting of cancer into the hospitals' record systems.
Comment In: Tidsskr Nor Laegeforen. 2014 May 27;134(10):102024865709
Comment In: Tidsskr Nor Laegeforen. 2014 May 27;134(10):1019-2024865708