Napoleon1801

15+ Year Member
Jul 28, 2004
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Is anyone out there using Quest for their pap smears with an interfaced result through Beaker/Epic?

We recently decided to start sending out our GYN paps due to financial considerations. However, the formatted results that come across the interface look like s***. The scanned reports look great from Quest, but aren't as easily accessible by the clinicians.

Anyone else dealt with this issue? Unfortunately, our IT staff has been less than helpful.
 

icpshootyz

7+ Year Member
Sep 17, 2009
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We don't use them, but I've seen a lot of them end up in our EHR system and I agree, they're almost unreadable online.
 

WEBB PINKERTON

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Dec 16, 2010
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Ol' CAP sure is hurting those of us still attempting to do GYN cytology. Since they became the provider of proficiency testing, what have they done to give us a break on cost? Nothing. Meanwhile the field of cytopath has been reduced to rubble with new guidelines that have lead to far fewer specimens. Let's see.. fewer specimens, less reimbursement and higher costs.....Our cytopath lab is on the verge of requesting assistance from the show The Profit. I doubt Marcus Lemonis would see any light at the end of this tunnel. Anyone with any business sense would go ahead and fold. It is sad seeing gyn cytology fall into the hands of a national duopoly of corporate labs, that are the only ones with the scale to make any money.

Look at how few people are even screening Pap smears any more? It appears CMS has updated their website with the statistics a few weeks ago.

https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/Downloads/CYTO-PT-RESULTS-2005-to-2015.pdf
 

AZpath

5+ Year Member
Nov 1, 2012
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The drop in the number of cytotechs screening is smaller than I thought .
This does reflect fully the drop in paps or consolidation to larger labs.
 

WEBB PINKERTON

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Dec 16, 2010
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Looks like there is about 200 less people doing gyn cytology each year since 2005 (cytoscreeners and pathologists). 10,740 total people took last years test and 12,831 took it in 2005. You would think the numbers would be much lower than that considering the drop in specimen numbers. It is a smaller drop than I would have predicted as well. Then again, you have to take the test whether you screen one pap test or a million. I CAP inspected a VA lab recently that was still screening less than 300 a year. So they pay the cost of expensive proficiency testing for the path group just to screen one or two cases a day. Wouldn't it be a better use of resources for the VA to consolidate all their cytopath specimens to one lab? HPV primary screening is still fairly new (two years ago it got FDA approval). I bet the decline will accelerate over the course of the next decade as molecular takes over.

I guess we should be marketing the Roche HPV test. It would be easier to keep it in-house at our labs while outsourcing the morphology testing.

On a side note, they are closing some planned parenthoods in our state and the reason they cite is the new pap test intervals. The end of the pap test is affecting many people.

http://fox59.com/2016/07/14/planned-parenthood-closing-merging-central-indiana-locations/
 

WEBB PINKERTON

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Dec 16, 2010
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One problem when you outsource the Paps but keep the tissues is Pap/tissue correlation. If you request to see the Pap from Quest (or whomever) when cases don't correlate, then you MUST take the annual CAP proficiency test. I have seen labs get in trouble over this. There have been many angry discussions about this on other online path forums. CAP has a huge conflict of interest selling us proficiency testing. It needs to end.
 
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mikesheree

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Feb 27, 2010
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One problem when you outsource the Paps but keep the tissues is Pap/tissue correlation. If you request to see the Pap from Quest (or whomever) when cases don't correlate, then you MUST take the annual CAP proficiency test. I have seen labs get in trouble over this. There have been many angry discussions about this on other online path forums. CAP has a huge conflict of interest selling us proficiency testing. It needs to end.
Webb, you should retire. It ain't bad. You've got a farm. You don't need this grief.
 

WEBB PINKERTON

7+ Year Member
Dec 16, 2010
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Webb, you should retire. It ain't bad. You've got a farm. You don't need this grief.
Some of us like being miserable...Without misery, life would suck even more.

Remember what happened in the first version of the Matrix, it was a utopia but people didn't accept it. I choose to stay miserable.
 
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Ishie1013

5+ Year Member
Apr 16, 2010
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Is anyone using Beaker? We're going to swap and I fear change.
 

Torsed

Deo Vindice.
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10+ Year Member
Apr 11, 2008
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Get Quest to mail them results directly. Is your lab still getting "credit" for the testing by Quest.

Not your problem if Quest doing the testing. Make sure you tell your malpractice carrier you aren't looking at Paps any more and your premiums should fall considerably.