Previously, patients with benign hematologic disorders were referred to hematology specialists. This was not always necessary or practical as most hematology specialists are trained to handle cancerous blood conditions. Today, primary care providers are equipped with the knowledge necessary to help their patients manage non-cancerous blood conditions, like anemia or clotting disorders.
UTMB’s John Sealy Diagnostic Center within the Department of Pathology seeks to make this even easier, leveraging its expertise and technology to provide support for primary care providers seeing these conditions. Diagnostic Management Team (DMT) consults are a service that the Diagnostic Center provides to help make accurate diagnoses and determine effective interventions.
“The DMT consults started with a recognition for the need to support primary care providers managing benign hematology cases and enabling clinicians to practice at the top of their license,” says Bradley Grant, MD, JD, Assistant Professor in the Department of Pathology.
With a benign hematology consult, entered in Epic, Dr. Grant and his teammates review a patient’s chart including lab results, employing Generative Pre-trained Transformers (GPTs) developed for diagnostics to provide a recommended diagnosis for the primary care provider.
The benefits of this approach are numerous. By supporting UTMB primary care providers with recommended diagnoses and interventions, the patients receive treatment more quickly leading to better outcomes and avoids the long wait times and higher co-pay costs associated with seeing a specialist when it is not necessary. The specialist is able to avoid unnecessary appointments and focus on those patients who need their services.
As an example, “We can assist them with things where there might be a 60-day wait time to see a hematologist. For something like iron deficiency anemia, a PCP could take care of that quite easily,” Dr. Grant says.
When the department first began offering DMT consults, the focus primarily centered on iron deficiency anemia cases. However, within the team there is the expertise and availability to support a wider spectrum of benign hematology disorders – and they welcome more consults.
“We have worked on trying to expand what we consider the service to be,” says Christopher Zahner, MD, Assistant Professor in the Department of Pathology, who helped launch the program with Department Chair Michael Laposata, MD, PhD.
Noting that a lot of hematology work is oncological, he adds, “Strictly in the benign hematology space, we can easily support the volume of cases that UTMB sees throughout our health system.”
Dr. Zahner emphasizes that the goal is not to prevent patients with complex conditions from seeking a specialist’s care, but rather to aid those whose needs can be well managed by primary care. In turn, this helps free up access to these specialists for more complex cases enabling those patients to receive more timely appointments.
Since Dr. Grant arrived at UTMB and became involved with this program last August, he has received positive and useful feedback from the physicians who have used it. Some have shared that support from medical doctors in the the lab has enabled them to feel more confident in making determinations, reinforcing information they learned in medical school but had not practiced in a while. In some cases, after a few consults, the physicians have been able to apply what they learned from the DMT without the need for further consults.
The team recognizes that their view of a patient is limited to the patient chart and the lab results they are asked to interpret, and the treating physician has access to many more data points that are taken into account in making a diagnosis and treatment plan.
“We are providing clinical decision support to the providers to enable them to practice the best medicine they can,” Dr. Grant says.
In the future, the team plans to expand their services to not only provide an interpretation to the physician, but to also include a layman’s explanation that the physician can use to help the patient better understand their results as well.
To place a consult, providers can enter the order “Anemia Panel with Consult – Benign Hematology DMT [LAB002293]” in Epic. This order triggers the appropriate laboratory testing and initiates a review by the DMT. The DMT will evaluate the lab results in the context of the patient’s chart and return a consult note with diagnostic impressions and potential next steps. This process is designed to support primary care providers in real time, allowing them to manage common benign hematologic conditions more confidently and efficiently within their own practice.
 |  | Bradley Grant, MD, JD, and Christopher Zahner, MD, are faculty members in the Department of Pathology and the John Sealy Diagnostic Center. Learn more about the John Sealy Diagnostic Center. |