so how many missed pap tests lawsuits does Labcorp have right now?

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Does anyone in billing know if there is a billing code for doing blind studies. Why would QA heavily pad the daily workloads of techs who do pap tests if the lab is not being reimbursed? Don't they already QC review over 10% of the normals? Is there some kind of billing scheme going on? How else can the lab make money under these conditions? Let's see... very labor intensive test even with automation. How can the lab make any money recycling pap tests?
 






So why would they pad the workloads with recycled paps???Hmmmm. Maybe to artificially boost the volume under the pretense of doing QA? Really..?. Would make way more sense and much more cost effective/efficient to follow the new recommendations developed from studies that show a 70 slide limit within 7 hours is the ideal daily case load because at that rate, false negatives approach zero. Makes more sense than recycling a bunch of paps and overworking people. Fatigue causes errors and defeats the purpose of QA, so that cannot be the reason. 10%+ QC review of normals and recycled paps ?Hmmmm maybe there is a more nefarious reason.... . Who is paying....?
 


















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cytocells January 4, 2014 Cytology Workload Study2014-07-02T13:02:25+00:00
Cytology Workload Assessment & Measure Study

Please direct questions about the survey or time measure study to TimeMeasure@asctservices.com.

The CDC/ASCT Services, Inc. Cytology Workload Assessment & Measure Study is a continuation of a need that was identified by the ASC’s Productivity and Quality Assurance in the Era of Automated Screening Task Force and endorsed by most of the cytopathology professional societies in the US.

The Task Force’s recommendations were published in May 2012 and presented to the Clinical Laboratory Improvement Advisory Committee (CLIAC) on February 14, 2012. CLIAC recommended conducting operational studies, such as those presented to determine if the maximum workload limit using semi-automated screening instruments is appropriate. In addition, CLIAC wanted to discourage the use of maximum workload limits as productivity expectations and asked that standardized criteria be developed for use in determining workload limits for each individual performing screening.

microscopewomanThe Workload in Image-assisted Gynecologic Screening Workgroup was convened by CDC to provide CDC, CMS, and FDA with guidance on the type of operational study to conduct. The workgroup developed a survey to assess cytology laboratory practices related to workload for cytotechnologists. It will help provide information on how cytotechnologists’ workload is assessed and how laboratories establish workload limits.

Cytology Workload Practices Survey
The first part of this study was to conduct a survey of all the cytology laboratories in the United States to obtain information about cytology laboratory workload practices, including how workload limits are established and assessed, the screening methods used (manual, computer-assisted screening devices), how workload is recorded, how screening is defined and the average time spent screening various types of specimens.

The survey was an electronic survey conducted via the internet. The dates for the survey were March 10 – April 4, 2014. Information collected from the survey will be analyzed and reported in aggregate demographically. The data will be de-identified before it is given to the CDC, FDA and CMS. These agencies will use the data to evaluate current workload requirements and develop guidelines for assessing cytotechnologist workload.

Time Measure Study
The purpose of the time measure study is to measure the actual amount of time cytotechnologists spend screening Pap tests using the automated microscopes for the two FDA-approved computer-assisted screening devices in the everyday environment of the cytology laboratory.

Although the main purpose of the time measure study is to measure actual screening time, the time to perform pre-screening and post-screening activities will also be measured. The participant cytotechnologists will be asked to document the amount of time spent on these activities for one full work day, using an electronic data collection tool developed by the CDC.

The pilot study for the time measure portion of the CDC study will be conducted in the summer of 2014. The full time measure study will be conducted October 2014 – July 2015.

The collected data will be de-identified and evaluated in aggregate to assess current workload maximums. This is a unique opportunity for cytotechnologists to share their experience and provide anonymous feedback to the federal agencies that support CLIA and determine appropriate workload maximums!

References:

ASC Workload Recommendations for Automated Pap Test Screening: Developed by the Productivity and Quality Assurance in the Era of Automated Screening Task Force.

CLIAC February 14, 2012 meeting

This survey is supported by a contract (200-2013-57614) funded by the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry.
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Anonymous said:
The computerized microscope is for screening only. It doesn't sign out the report.... All the misinformation on this thread makes me wonder why the company has trouble doing anything right..
Click to expand...

Misinformation? Really?A computer has already screened the slides before the human tech gets them. The image guided microscope (computerized microscope as you put it) directs the tech to view 22 predetermined fields that an algorithm has determined to have the the greatest likelihood of having abnormal cell. Finding reactive or abnormal cells within any of these fields of view should trigger a full manual review of the slide. If no abnormal cells are seen any the 22 fields the slide is signed out as negative by the human tech. If abnormal, the slide is sent to a Pathologist to be signed out.

There are times when the imager completely misses abnormal cells and there are times when it will pick up mild reactive changes while way more severe abnormal cells are elsewhere on the slide. It is easy for an overworked human tech to overlook a rare cell in a field of view when under pressure to read 120 slides in an 8 hour period.

That's the real deal.
 












Anonymous said:
Misinformation? Really?A computer has already screened the slides before the human tech gets them. The image guided microscope (computerized microscope as you put it) directs the tech to view 22 predetermined fields that an algorithm has determined to have the the greatest likelihood of having abnormal cell. Finding reactive or abnormal cells within any of these fields of view should trigger a full manual review of the slide. If no abnormal cells are seen any the 22 fields the slide is signed out as negative by the human tech. If abnormal, the slide is sent to a Pathologist to be signed out.

There are times when the imager completely misses abnormal cells and there are times when it will pick up mild reactive changes while way more severe abnormal cells are elsewhere on the slide. It is easy for an overworked human tech to overlook a rare cell in a field of view when under pressure to read 120 slides in an 8 hour period.

That's the real deal.
Click to expand...

Imaging is nothing close to a humans performance levels. When machines screen people assume the machine caught it and management cuts corners. Years from now a imaging will get with-in 10% of the accuracy of the human train eye. Algorithms only know what they know... A human can think, reflect, check additional information, and learn.
 






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