Improving Health Your Diagnosis—Precise and …

1 Improving Health Your Diagnosis Precise and Accurate 2017 annual report INTRODUCTION. Members and Staff Partner to Make People Healthier Pathologists are important to all Table of Contents of us. They run our laboratories and examine our tissue and blood under a microscope. They see us, diagnose us, and help us Advance Quality ..2. heal. They give us the definitive Mobilize Members ..10 answers that lead to better Maintain Strength ..18 Health . And because of them, we can get back to doing the things Financial report ..28. we love. We can live again! In 2017, members of the College of American Pathologists released more cancer protocols than ever before. Our members were responsible for providing accreditation checklists to ensure that every laboratory can produce accurate, quality results. They developed a registry to guarantee payment for their work CAP President R. Bruce Williams, MD, FCAP, and CEO Stephen Myers in Improving Health . And they made the impact of pathologists known in their own hospitals and in national media.

2 Pathologists are important to all of us.. The CAP is proud of its They give us the definitive answers accomplishments with members that lead to better Health . and staff working hand in hand. The voice of the membership matters, and it's time to hear from them. Whatever this organization can do to help members be better pathologists, run their practices more effectively, and give families peace of mind the CAP is here to support them. 2 | 2016 CAP annual report 2017 annual report | 1. ADVANCE QUALITY. CAP Leads in Laboratory Excellence People are healthier because of Record Number of Cancer Both members and nonmembers the CAP's commitment to ensure Protocols Released offered feedback during an open laboratory quality and set high comment period on specific More than 200 pathologists standards to improve patient elements of the protocols, such and clinicians collaborated to care. Scientific rigor underpins as the histologic type of the revise more than 52 of the CAP.

3 All Laboratory Quality Solutions tumor, its size and margins, and Cancer Protocols and electronic programs. Thousands of member all elements that impact staging Cancer Checklists (eCC) to reflect experts, including pathologists and treatment. content from the American Joint and laboratory professionals, Committee on Cancer (AJCC) More than 4,400 pathologists in volunteer their time and expertise Cancer Staging Manual, 8th the United States and Canada so patients can ultimately benefit edition. These protocols provide are now licensed to use the CAP. from external quality assurance guidance for collecting essential eCC, the electronic version of the and accreditation. The entire data elements for complete protocols developed to streamline laboratory community around the reporting on malignant tumors, reporting on surgical pathology No matter where patients world is better because of the directing effective treatment cancer cases. More than 60. important work CAP members do.

4 Are in the world, they can for patients. new sites became licensed in trust their laboratory In 2017, more than 20,000. CAP members served on review 2017. The Pathology Electronic results to be reliable and laboratories enrolled in Reporting (PERT) Committee panels and offered feedback to proficiency testing (PT) programs, and its staff continue to align accurate because of CAP and the CAP accredited more than improve the elements included with federal initiatives to help members' dedication in the protocols. One key factor 8,000 laboratories worldwide. advance cancer reporting quality, that members influenced was and expertise. CAP members are both the data sharing, and other work to timing. The AJCC originally asked designers and participants of improve patient care. pathologists to implement these laboratory improvement a whole new staging system The importance of integrated programs. The Council on in just three months. That's and aligned cancer reporting was Scientific Affairs generated more when CAP members spoke up startlingly illustrated recently: than 600 appointed positions to explain how that short time Several provinces in Canada use for pathologists to serve in.

5 The period would adversely impact the eCC exclusively and started Council on Accreditation assigned pathologists, registrars, and noticing a stage of colon cancer more than 2,000 pathologists other protocol users. Based that had higher incidence in one and laboratory professionals to on this feedback and the region of Ontario. After examining inspection teams. AJCC's agreement to delay the the data, they found it was More laboratories and Health implementation, the CAP was happening at one institution. systems are recognizing the able to release the updated A surgeon there was resecting value of integrated improvement protocols six months ahead of tumors incorrectly, leading to programs and are choosing to the AJCC implementation date incorrect staging. The data told become CAP accredited and of January 1, 2018, allowing the story, and that hospital was to exclusively use CAP PT. No pathologists, organizations, and able to educate the surgeon matter where patients are anatomic laboratory information who then improved his clinical in the world, they can trust system vendors sufficient time practice and patient care.

6 Their laboratory results to be to make necessary updates to reliable and accurate because their systems. of CAP members' dedication and expertise. 2 | 2017 annual report 2017 annual report | 3. ADVANCE QUALITY ADVANCE QUALITY. CAP Leads in Laboratory Excellence (continued from page 3) Living Our Quality Mission Another significant effort in 2017 CAP accreditation programs on In a first for both organizations, involved the Cancer Committee, requirements from laboratories the CAP partnered with the PERT, and staff working to on IT interpretation of laboratory American Society of Hematology develop a single source of truth accreditation program checklist (ASH) to develop an evidence- for producing the CAP's cancer requirements. In addition, the based guideline to improve reporting products. Both the committee's active participation care for leukemia patients. Cancer Protocols and the eCC in standards development This work underscores the will be produced from the same ensured that the needs of the essential steps for coordination content using a newly developed laboratory were incorporated into and communication between electronic tool that speeds up laboratory information systems.

7 Pathologists and treating the release cycle and reduces the Center Guidelines Improve physicians for ensuring optimal 8,027. chance of errors. patient outcomes. CAP-accredited laboratories Patient Care Data Drives Patient Care Also in 2017, the Center The CAP's Pathology and Decisions published a critically needed Laboratory Quality Center guideline to ensure accurate With laboratories supplying (the Center) expanded its testing and targeted treatment the majority of data contained impact in 2017, enhancing for patients with certain types of in a patient's record, it is powerful new collaborations important for pathologists to that benefit clinicians and head and neck cancers. 2,371. pathologists participating in understand the opportunities patients. With the release of on-site inspections for data analysis within their an evidence-based guideline organizations. The Informatics for the evaluation of molecular Committee continued to develop biomarkers in colorectal cancer, resources for members, including the CAP collaborated with both numerous education courses clinical and laboratory partner focused on informatics and organizations.

8 This pivotal work information technology topics as guides targeted therapy decisions well as a revision to the Clinical and advances personalized Informatics Resource Guide. care for patients with colorectal The Informatics Committee also cancer, which is the second- worked closely in 2017 with leading cause of cancer-related deaths for women and men combined in the US. 22,480. laboratories using CAP proficiency testing 4 | 2017 annual report 2017 annual report | 5. SPOTLIGHT: Council on Scientific Affairs A patient's Health depends A patient can't be treated A patient can't be treated optimally if important pathology on pathologists making the optimally if important pathology staging elements are not reported.. right diagnosis. And for cancer staging elements are not Raouf E. Nakhleh, MD, FCAP. patients, a pathologist must reported, said Raouf E. Nakhleh, accurately report all the MD, FCAP, chair of the Council on pathological staging elements Scientific Affairs.

9 We're working to guide the most effective to perfect the cancer protocols treatment. In June 2017, the because they help pathologists CAP released 52 updated cancer ensure they are reporting all protocols, the largest single the staging elements needed release in the CAP's protocol for optimal patient care in a history. These updated protocols format that can be easily read reflect mandatory changes from by clinicians. Pathologists are the 8th edition of the AJCC Cancer getting the worldwide-recognized Staging Manual. standard, and they can have confidence in what they're doing.. Some pathologists have told us this is disruptive, but they're Patients will often receive appreciative that we released treatment at multiple facilities the cancer protocols early during their course of cancer Raouf E. Nakhleh, MD, FCAP. enough, giving institutions time care, and they need the right to implement them in their pathology information to get the cancer reporting systems, said appropriate care.

10 Thomas P. Baker, MD, FCAP, As cancer care evolves and chair of the Cancer Committee. requires more information about We're listening to feedback and the tumor, a gap in pathology updating the cancer protocols information may potentially based on input from pathologists delay care, said Dr. Baker. As and clinical stakeholders.. pathologists, we're focused on The CAP's Cancer Protocol how our protocols benefit the Oversight Project Team looked patient.. at the cancer protocols in Because of the dedication of totality to ensure consistency CAP members and partners, the among different tumor types cancer protocols have become and streamline the content de facto clinical guidelines for for reporting electronically the appropriate reporting of or with manual systems. The pathologic features necessary for CAP offers electronic cancer the treatment of cancer patients. checklists and text versions of the cancer protocols at , allowing Thomas P. Baker, MD, FCAP pathologists to integrate the content into their institution's cancer reporting system.