Solution For The Optimization Of Pathology Case Distribution Leveraging Flexible Definition Of Policies
The adoption of digital pathology has the potential to enable significant workflow improvements leading to increased efficiency–in terms of better utilization of resources, higher throughput and lower turnaround time of cases–, and more effective collaboration. Streamlined workflow solutions make it easy to monitor both performance and quality, and help avoid errors. The policies driving the distribution of cases to pathologists (dispatching) have a large impact on the throughput and turnaround of cases in a pathology lab. Leveraging the availability of digital pathology we develop an application focused on the management of worklists of cases and their automatic dispatching for diagnosis. Our solution includes the modeling, simulation and optimization of the dispatching policies and their adaptation.
We develop applications to enable clinical users to leverage a digital pathology system for increased efficiency and better patient outcomes. The work addresses information integration requirements, and aims to identify and propose solutions for performance bottlenecks in existing processes. A process with potential for improvement is the case distribution to pathologists for diagnosis.
We implemented key components enabling to manage and retrieve case and pathologist information, to propose an optimized assignation of cases, and to visualize worklists and assign cases to pathologists.
Worklist visualization: Provides an overview of (active and completed) cases with relevant information (e.g. status, number of slides, organ, clinical question). The tool also shows for each pathologist the assigned and diagnosed cases, specialties, deadlines, etc., depicts the process of building and executing the solver to generate a suitable dispatch solution.
Dispatching optimization module: Proposes assignments based on case features (e.g. type, complexity, average diagnosis time) and on pathologist characteristics (e.g. specialty, available time) [j]. Aims at optimizing user-defined goals, such as the pathologist time and the turnover of cases. We use the OptaPlanner package [OP] of jBPM [jb] and define the domain model of the problem and the scoring rules according to policies based on the requirements of the clinical users.
Services for data management: Allow to retrieve the relevant metadata of incoming cases and the agenda information of pathologists.
Our case distribution application supports both the manual dispatching of cases to pathologists and the automatic assignation according to defined policies. The optimization component applies the policy models to send cases to pathologists for diagnosis. The schedules are generated according to the optimization goals, e.g. to improve throughput or turnaround. The configuration can be customized to apply dispatching rules and optimization goals specific to each deployment site. The visual application provides insight into the status of cases and allows users to change the assignation of cases when needed (e.g. when agenda changes occur and cases need to be reassigned).
 JBoss, OptaPlanner constraint satisfaction solver, 2015, [cited 01-01-2016]. Available from: http://www.opta-planner.com
 Juby Joseph Ninan, Integrating rules and automated planning in business processes, Eindhoven University of Technology, Master Tesis, 2014, [cited 01-01-2016]. Available from: https://www.google.nl/?gfe_rd=cr&ei=ShKYVqywK8vl-gaq-JH4Cw&gws_rd=ssl#q=Integrating+rules+and+automated+planning+in+busi- ness+processes+
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
4. In case of virtual slide publication the authors agree to copy the article in a structural modified version to the journal's VS archive.