{"stable_id":"f4f600d2dd9b256e","slug":"maccabi-pathology-qc","company":"Maccabi Healthcare Services","workflow_name":"Prostate Pathology Quality Control","function_code":"clinical_ops","pattern_codes":["exception_based_operations","human_quality_loop"],"changed_assumption":"Second-read quality control is too labor-intensive to perform on 100% of cases.","evidence_strength":"verified","publication_tier":"showcase","freshness":"current","reviewed_at":"2026-08-23","updated_at":"2026-08-22","source_quality_summary":"1 peer reviewed; publication outcomes are verified.","caveat_summary":"The 10% baseline is a general industry practice estimate, not Maccabi's measured prior practice. Author estimate based on alert volume.","freshness_caveat":null,"workflow_summary":{"before":[{"actor":"Pathologist","action":"Perform primary diagnosis on prostate biopsies","actor_type":"control"},{"actor":"Pathologist (Quality Control)","action":"Manually review a small sample (e.g., 10%) of cases for quality control","actor_type":"control"}],"hinge":"Second-read quality control is too labor-intensive to perform on 100% of cases.","after":[{"actor":"Pathologist","action":"Perform primary diagnosis on prostate biopsies","actor_type":"system"},{"actor":"AI System","action":"Analyze 100% of digitized slides as a second-read control and raise alerts for discrepancies","actor_type":"ai"},{"actor":"Pathologist","action":"Review AI alerts (minimal time cost) and order additional cuts/stains if necessary","actor_type":"system"}],"decision_mode":"shared","decision_marker":"AI handles the default; humans own exceptions"},"before":[{"order":1,"actor":"Pathologist","action":"Perform primary diagnosis on prostate biopsies","handoff_to":"Pathologist (Quality Control)","control":"Not published."},{"order":2,"actor":"Pathologist (Quality Control)","action":"Manually review a small sample (e.g., 10%) of cases for quality control","handoff_to":"","control":"Sample-based human QA"}],"after":[{"order":1,"actor":"Pathologist","action":"Perform primary diagnosis on prostate biopsies","handoff_to":"AI System","control":"Not published."},{"order":2,"actor":"AI System","action":"Analyze 100% of digitized slides as a second-read control and raise alerts for discrepancies","handoff_to":"Pathologist","control":"100% AI QA coverage"},{"order":3,"actor":"Pathologist","action":"Review AI alerts (minimal time cost) and order additional cuts/stains if necessary","handoff_to":"","control":"Human override and final diagnosis"}],"decision_rights":"AI raises alerts; human pathologist reviews alerts and makes the final diagnostic and procedural decisions.","exception_path":"Alerts indicating missed cancer or significant grading differences lead to additional cuts, stains, or third-opinion requests.","removed_work":["Manual screening of cases that have no discrepancies"],"outcomes":[{"metric":"Quality control coverage","baseline":"10%","result":"100%","period":"March 2018 to November 2019","scale":"941 cases / 11,429 H&E slides","attribution_caveat":"The 10% baseline is a general industry practice estimate, not Maccabi's measured prior practice.","evidence_label":"verified"},{"metric":"Time cost of quality control","baseline":"Not specified","result":"~1%","period":"March 2018 to November 2019","scale":"Pathologist time","attribution_caveat":"Author estimate based on alert volume.","evidence_label":"verified"}],"executive_lesson":"AI enables 100% quality control coverage where manual sampling was previously the only economically viable option.","anti_pattern":"Assuming 100% AI screening requires 100% human re-review.","questions_for_leaders":["What critical QA processes are currently sampled at 10% because 100% is too expensive?"],"collections":["regulated-autonomy"],"bundle_version":"1.0.0","bundle_fingerprint":"sha256:c23c6cc2b88153d008ea8fda928f632ce0011fc2d4c5036672a16e5d895bab93","canonical_url":"https://brianletort.ai/transformations/maccabi-pathology-qc"}