Portable Microcomputers in Pathology: Surgical Pathology in the Electronic Laboratory

Summary

Three factors favor the use of microcomputers in the hospital: (1) The development of the electronic laboratory: (2) Cost constraints in health care: (3) Increasing scarcity of trained personnel, especially clerical and secretarial persons who must handle information. In this paper we describe a microcomputer system for surgical (anatomic) pathology reporting and information handling that is low in cost; and which does not require a special computer work force for operation or maintenance. It uses commercially available software, which is inexpensive and does not require knowledge of computer programming. Standardized formatting of reports reduces pathologist time, reduces requirements for clerical personnel, and permits ready incorporation into hospital and other computer information systems. It is flexible for each patient, and it is expandable.

The electronic laboratory is one that employs the new technologies that have become widely available in the past 2 decades. A dedicated laboratory computer for information handling; automated testing equipment that contains microprocessors; electronic exchange of information with other departments: word processing; paper copiers with microprocessors:; television and audio-visual equipment; telephone systems with microprocessors; radio and cable communication; telecommunications and modems; remote status printers; nuclear medicine; electron microscopy; microcomputers; microcomputer networking; and other special equipment.

These technologies are impressive when they are operating properly, but there is a weak link in the systems. That is a scarcity of trained workers, especially clerical and secretarial personnel who must handle information. The problem is not unique to the health field, and it is predicted to increasingly become a problem both in industrialized countries (1,2) and in less well developed nations.(3)

The subdivision of the medical laboratory in which it is most difficult to improve productivity using computers is surgical (anatomic) pathology. The principal obstacle has been individualistic variability between different professionals. Among 6,000 US hospitals in 1980, only approximately 42 used a computer in surgical pathology.(4)