Development of a digital immunohistochemistry records’ management system at the Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya.

Abstract

e18075 Background: Cancer diagnosis using immunohistochemistry (IHC) is important for quality care of patients. The utility of IHC services in management of cancer patients in low- middle income countries (LMIC) has gained popularity. Paper-based IHC records storage systems have made it cumbersome to retrieve records and thus impair the management of quality care for patients. We describe here the setup of a digitised records’ management system (RMS) in a LMIC which is user friendly, easy to access, prone to minimal errors and aid in research. Methods: A spreadsheet with blank templates containing key fields was designed and populated along the process until all records to the date of completion of data collection were recorded from January 2012 to November 2017. The complete reported tests were clustered into categories based on the diagnoses reached and frequencies for each cluster were derived. Information collected included patient identifiers, gross, histology, and immunohistochemical markers tested and the diagnosis. A provision is also made to store pictures of stained slides on the RMS. Results: Using RMS, a total of 948 immunohistochemistry staining was performed between January 2012 and November 2017; 677 of these have been reported, 200 were controls and 71 were repeats. Testing for breast cancer was the most common investigation performed (39.9% [n = 270]). Anti-LANA tests for Kaposi Sarcoma closely followed at 15.1% (102), followed by Non-Hodgkin’s lymphoma at 13.4% (n = 91). The RMS brings up the IHC test to be performed after HE diagnosis is entered, helping the technician to prepare and plan for IHC staining. Conclusions: The RMS has made it easier for clinicians taking care of patients to get results and provide quality care. This system is helpful in answering research questions and data analysis. Models such as these are especially useful in LMIC as they can assist technicians to perform IHC as they await the consultant pathologist. RMS will also help incorporation of IHC in telemedicine, aiding transmission of photographs taken by mobile phones in remote setups to pathologists in distant places.