Capturing Pathology Workload Associated With Precision Oncology.

Abstract

Background: Molecular testing for precision oncology (PO) is important in anatomic pathology (AP). As indications expand, there will be further increases in pathology workload. Research associated with AP molecular testing is significant and must be completed.

Methods: This study mapped the AP molecular testing consultation process at the Kansas City Veterans Affairs Medical Center and the average time measured for each step. AP records for 2021 through 2023 were reviewed to determine the number of AP molecular send-out tests. Cumulative time investment was collected and a theoretical number of relative value units (RVUs) was calculated using the new pathology clinical consultation Current Procedural Terminology codes (80503-80506). The theoretical number of RVUs was compared to the total AP RVUs generated.

Results: Of the 21,021 AP cases, 1338 generated AP molecular send-out test consultations. A total of 2040 hours of pathology staff time were required to complete the associated consultations. If this time were billed, it would have generated 14.8% (3847/25,920) more RVUs.

Conclusions: A significant amount of work is necessary for the pathology staff to fulfill its PO responsibilities. This is likely to increase as indications for testing expand. Additional research of pathology processes is necessary to manage increasing workload and maintain the highest quality of cancer care.