title: Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care.
  
  
  METHODS
  An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology.
  
  
  RESULTS
  Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%.
  
  
  CONCLUSIONS
  Clinical pathology intervention and case triaging can improve access to care in a county health care system.
authors: From the Department of Pathology and Laboratory Medicine Lei.Chen.1@uth.tmc.edu.
authors: Lei
authors: L
authors: Chen
authors: From the Department of Pathology and Laboratory Medicine.
authors: Kerry J
authors: KJ
authors: Welsh
authors: From the Department of Pathology and Laboratory Medicine.
authors: Brian
authors: B
authors: Chang
authors: From the Department of Pathology and Laboratory Medicine.
authors: Laura
authors: L
authors: Kidd
authors: From the Department of Pathology and Laboratory Medicine.
authors: Marylee
authors: M
authors: Kott
authors: Department of Family & Community Medicine, University of Texas Health Science Center at Houston; and.
authors: Mohammad
authors: M
authors: Zare
authors: Department of Family & Community Medicine, University of Texas Health Science Center at Houston; and.
authors: Kelley
authors: K
authors: Carroll
authors: From the Department of Pathology and Laboratory Medicine.
authors: Andy
authors: A
authors: Nguyen
authors: From the Department of Pathology and Laboratory Medicine.
authors: Amer
authors: A
authors: Wahed
authors: From the Department of Pathology and Laboratory Medicine.
authors: Ashok
authors: A
authors: Tholpady
authors: Department of Laboratory Services.
authors: Norin
authors: N
authors: Pung
authors: Department of Specialty Clinics, Harris Health System, Houston, TX.
authors: Donna
authors: D
authors: McKee
authors: From the Department of Pathology and Laboratory Medicine.
authors: Semyon A
authors: SA
authors: Risin
authors: From the Department of Pathology and Laboratory Medicine.
authors: Robert L
authors: RL
authors: Hunter
mesh_terms: D000465:Algorithms; D016208:Databases, Factual; D003695:Delivery of Health Care; D057286:Electronic Health Records; D006297:Health Services Accessibility; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D010338:Pathology, Clinical; D012017:Referral and Consultation; D012219:Rheumatology; D013781:Texas
keywords: Algorithmic testing; Clinical pathology; Systemic lupus erythematosus