Technologies

Edward Cachay M.D ., Associate Professor of Clinical Medicine, Owen Clinic, UCSD, has developed and deployed a three dimensional anoscopy diagram to standardize nomenclature of high resolution anoscopy (HRA) findings in anal dysplasia screening procedure. Tested in the clinic, this tool has been shown to enhance communication between medical providers and patients, while also helping to establish HRA’s standardized use in clinical research.

The UCSD Anoscopy Documentation Diagram illustrates the principal landmarks of the anal canal in 3-D. The purpose of this graphical tool is to complement individual documentation practices and standardize nomenclature of HRA findings regardless of the position of the patient while undergoing HRA.

At UCSD, the Anoscopy Documentation Diagram has been incorporated into the clinical notes of UCSD’s electronic medical record system; thereby becoming permanently available to any physician involved in the care of patients.

Many institutions are implementing anal cancer screening programs modeled on procedures used in cervical cancer. Analogous to cervical colposcopy screening procedures, the high resolution anoscopy (HRA) poses additional challenges due to unique characteristics of the procedure. This includes the uneven topography and collapsing nature of anal canal, making it a more challenging procedure than cervical colposcopy. Additionally, there is considerable variability in how HRA providers position the patient and document the position of visualized lesions. HRA practitioners about to perform a HRA follow-up examination or ablative treatment typically review prior HRA images saved in free-standing image management software (i.e. image files are generally not linked to electronic medicaI record systems).

With these current limitations, there exists a need for a method to standardize how HRA results are documented in the medical record.