How would you like to receive your pathology reports? Electronically? Online? Or the old-fashioned (paper) way — by courier, fax or express mail? The need for cost containment and workflow efficiency as well as the adoption of electronic health records has led to new options for pathology report delivery and distribution. Here's help sorting though the many choices you have nowadays.

Electronically. An electronic interface between your electronic records and pathology database is the most recent arrival on the scene of pathology report delivery. Many software companies have developed interfaces with pathology labs, allowing pathology report data to be transmitted directly into the procedure report writer or electronic health record, either as data files or as documents stored in portable document format (PDF). The advantage here is that pathology data becomes an inclusive part of the patient's EHR via a scheduled interface, without the need to receive, scan or otherwise access and transfer the data. If the EHR allows access to patient records via the Internet, pathology findings are available with any Internet connection at any time. Not all path labs make this service available. Interface development can be costly and time-consuming. Also, when you purchase such software from a pathology laboratory as "value-added resellers" of the software, your facility may be required to refer specimens to that lab as a function of using specific features in the software. Such restrictions may limit physicians' choices for referral.

Virtual private networks. Use of virtual private networks and other networking solutions let you print pathology reports directly to a printer. They can be designed to print pathology reports directly from the pathology laboratory to a dedicated printer (if provided by the pathology company) or a shared printer (if provided by you) within the surgery center, similar to printers networked within the facility. Advantages include more rapid report delivery with immediate report distribution to you after the pathologist's sign out, higher report quality than facsimile copies and programmable multi-copy delivery. To ensure compliance with HIPAA, consult with information technology professionals. Standard VPN/network print methodology doesn't provide an electronic format for incorporation into electronic medical records. And compared to other options, this doesn't provide a "search records" or "print-on-demand" option.

Online. Many labs have developed Internet-based access to password-protected, encrypted repositories for pathology reports. Patient reports are available to staff and physicians from any Internet connection, 24 hours a day, 365 days a year. In most instances, patient reports may be printed on demand from a Web site or downloaded in PDF, which eliminates the need to scan documents into electronic health records. When Internet service is interrupted, patient reports provided exclusively by this method are in limbo pending an active Internet connection.

Digital media. Pathology reports are easily converted to such portable document formats as a CD or stick drive. This lets you have a physical copy of the report in the event of the loss of a paper copy or damage to EHR data. It's also inexpensive compared to other long-term data storage and retrieval methods. Keep in mind that courier or other delivery methods create significant delays (hours to days) between the pathologist's sign out and the delivery of the CD or stick drive to you.

Paper. As few as five years ago, the vast majority of surgery centers considered only three options for receiving pathology reports for their patients who had tissue removed during the surgical procedure — courier delivery of paper reports directly to the center from local or regional pathology providers; delivery of paper reports by facsimile through dedicated surgery center fax lines; and delivery of paper reports via standard or express services. Then you dealt with all the paperwork you'd received. First, the submitting physician reviewed and signed off on it. Next, you may have copied and distributed it to the "copy to" physicians of record. Finally, you charted it into a standard paper report or, for the early adopters of EHRs, scanned it into the patient's electronic chart.

Courier delivery, fax delivery and scheduled VPN "batch print" delivery of reports each offer the convenience of reports printed by someone else's staff, delivered to your facility. A drawback of direct delivery is that if the report is misplaced after delivery, you must request additional copies of the report. Again, delays are possible. Facsimile copies of reports may have poor quality transmission or experience other errors.

You have choices
Not all path labs offer all options, and each of them has advantages and drawbacks that you should consider when weighing which report delivery option best meets your needs. If your facility still assumes responsibility for distribution of the path report to "copy to" physicians, this may be an opportune time to shed this responsibility. If your lab doesn't offer the mode of delivery that would work best for your facility, it may be open to negotiation — particularly if another lab offers these services and can provide quality pathology services as well.