1. Depending upon how many high risk cases are fed into the machine, yes the 25% rate would be diminished since secondary screening is required. After 3 negatives in a row these cases with significant past history no longer require secondary screening. Also, it is up the the lab whether to do more than 10% QC with includes random negatives and high risk. SmithKline for instance wants 10% random and the additional high risks totaling more the 10%. Other labs set aside high risks and then pull randoms to make up the QC to 10% total. When you have large numbers of techs working for you, you need the extra random to track their progress, sometimes techs will go along fine for awhile and then something will happen in their lives to interfere with their concentration.
A way to keep at the optimal 25% rate would be to remove the high risk cases from the autopaps load. There arent that many of them and then you would be using the machine to peak advantage.
2. The main advantage to having the autopap used for primary screening is that you eliminate a $50-60,000/yr employee with all their personal problems and complaints about life in general. Machine may break but this one can have its software problems fixed by remote modem, actually this happens most of the time without the user being aware of the problem, the computer has firstaid software and dial out capabilities to the manufacturer 24 hours/day.
The other advantage is that I have the paps ranked by probable atypia and can distribute the worst slides to be done at the beginning of the day when the screeners are fresh. This is like long distance driving, you are sharper when fresh and rested. You still have to thoroughly rescreening the remaining slides and have the same liability and responsibility for them and to be frank, it may be too much trouble to separate the most likely atypicals in the real workplace. You just divide the 75% of slides up regardless of ranking and go like we do now.
Quality control will be the random 10% of the tech screened workload
OR the high risk that you did not put through the autopap to get the full 25% signout capability plus randomly selected slides. I like the latter scenario better.
I dont know all the safeguards in place to prevent malfunction, with such a low signout rate we will find out whether our own daily findings match what the daily autopap summary for atypicals is.
The kind of news I have been waiting for is coming through;
quote.com
The most of the rest of the carriers will follow and then they will reimburse for primary screening in future.
How much does one wrongful death settlement cost the carriers? How much is a womans life worth? Lawsuits over pap smears are rampant in this country, this is the best way we have available to prevent multimillion dollar judgements against healthcare providers/labs. |
