Jadee Neff, MD, PhD, and Sarah Rapisardo, PhD, have been awarded a 2023 College of American Pathologists (CAP) Foundation Genomic Testing Process Improvement Award for their project titled “Improving Precision Oncology by Maximizing Utilization and Efficiencies Across the Entire Testing Process.” The award, sponsored by LOXO@Lilly, provides up to $25,000 to fund process improvement projects that explore different approaches to genomic testing.
Genomic testing, also called DNA sequencing, involves looking at how genes interact and how those interactions affect health. Genomic testing can be used to identify cancer risk, predict which cancer treatment might work best, and pinpoint DNA changes that may be driving the growth of a specific tumor.
Their project will focus on pre-analytical and post-analytical improvements in the laboratory in order to decrease oncology testing inefficiencies and improve the overall quality of Duke Health’s cancer care. Improvements will include creating testing algorithms, triage review processes, patient-specific information tracking, and clinician education processes.
For example, they plan to develop and implement a standard operating procedure (SOP) for pre-analytical test utilization review of specific Molecular Pathology, Genetics and Genomics (MPGG) test orders, both for cases without morphological correlates (e.g. tests ordered on blood specimens) and for cases with morphological correlates (e.g. tests ordered on surgical pathology cases). This SOP will ensure that a standardized pre-analytical review of test orders is routinely performed by the team of individuals best equipped to evaluate test appropriateness.
They will measure outcomes in terms of decreased turnaround time, increased informative testing, streamlined workflow, and financial efficiency. Finally, they plan to generalize and publish these algorithms and improvement processes so that other institutions can use them as a blueprint for their own process improvement plans.
Both Neff and Rapisardo are members of the Duke Cancer Institute. Neff is an assistant professor of Hematopathology and Molecular Genetic Pathology; associate director of Medical Affairs, Molecular Pathology, Genetics and Genomics Clinical Laboratory; associate director of Genomics, BioRepository & Precision Pathology Center (BRPC); and director of the Molecular Genetic Pathology Fellowship Program. Rapisardo is director of Test Development for Duke’s Cytogenetics and Molecular Diagnostics Laboratories, and is fully engaged in case review across all disciplines there: hematologic malignancy, solid tumor, and medical genetics.