Jul 24, 2020 | Digital Pathology
Precise and punctual communication between dermatology clinics and pathology labs is essential to provide patients with accurate results and swift turnaround times. Because over 90 percent of all tumors are confirmed by pathologists, physicians that utilize an EMR are increasingly interfacing with pathology laboratories to relay case results.
Integrating an EMR interface between your practice EHR and the lab can help increase operational efficiency, streamline staff workloads, and improve the quality of patient care and satisfaction.
Operational Efficiency
Your patients expect an organized and efficient experience every time they interact with your clinic, and you can hold your laboratory to those same standards. Relying on a laboratory with outdated means of communication can negatively impact the quality of your experience, as well as impact patient care.
Today, three out of five dermatologists have adopted an EMR into their practices. Interfacing with your laboratory’s information system takes full advantage of this record-keeping technology, creating a communication portal that instantly organizes and shares case data results. Integration into pathology reporting means clinics can use their existing EMR systems to automatically receive, review, search, and sort results on demand without additional clinic support staff involvement.
In Utah, Allen-Taintor Dermatology was used to sometimes waiting up to two weeks to receive results from the lab, which sometimes failed to send slides. Because the clinic wanted to review the slides before calling patients, this consistent issue was a concern. Once they began using PathologyWatch, Allen-Taintor Dermatology saw improved staff workflow efficiency, including a 75 percent reduction in dermatologist review time, which further improved efficiency. Patient satisfaction likewise improved because the physicians could review the results with their patients on digital slides.
System Setup
For those using an EMR in clinic, the advantages of an interface are clear. Building an interface between your EMR and the laboratory in a way that optimizes workflow efficiencies is not always straightforward and requires an experienced IT professional.
By partnering with a trusted full-service dermatopathology laboratory like PathologyWatch, clinics can rely on experienced engineers to architect their interfaces in a way that optimizes their EHR capabilities to maximize internal clinic efficiencies.
Streamline Workloads
For many clinics, paper continues to be the gold standard for documenting and sharing records. For clinics that have moved to an EHR, however, additional benefits can be realized if your laboratory is fully integrated. For example, a well-designed interface can make handwriting requisition forms and physically making carbon copies a thing of the past. You can also reduce the probability of errors by digitally sending that information to the laboratory, as clinic data must be re-entered into the LIS and attached to the sample when received on paper forms.
Patient Satisfaction
Delivering reliable and timely results to your patients should be a high priority for every dermatology clinic and dermatopathology laboratory. After patients have a biopsy taken, many experience an uneasy suspense while waiting for their results. This was the case for Allen-Taintor Dermatology. Once they were able to utilize digital biopsy images to show patients their pathology during visits, their high patient satisfaction increased even more. EMR interfaces and optimal laboratory processes can reduce the turnaround time from when a biopsy is taken to when a result is received, resulting in a better quality of care and patient satisfaction.
An additional benefit to patient safety and satisfaction is that interfaces can also improve data integrity and results delivery, decreasing the risk of a data entry error in both the clinic and laboratory.
In summary, building and utilizing a well-developed interface between the clinic EMR and laboratory system can help to improve operational efficiency, simplify staff workloads, and improve the quality of patient care and satisfaction.
Jul 22, 2020 | Digital Dermatopathology, Digital Pathology
What is the single most innovative technology you are currently delivering to health systems or medical groups?
We deliver digital pathology services and EMR integration solutions to dermatology clinics in many locations. Dermatologists are able to discuss cases with expert pathologists from many different locations in a way that has never been done before. We’re also developing AI tools that are specific to dermatopathology. Ultimately, humans and the AI working together in pathology will mean lives saved, and we’re at the beginning of this process.
How is your product or service innovating the work being done in these organizations to provide care or make systems run more smoothly?
PathologyWatch greatly reduces the amount of time spent on duplicating data between systems—the reports are accurately and automatically entered into the dermatologist systems. We’re eliminating the faxed reports and walled-garden report access. Digital pathology and EMR integration alone have streamlined clinical workflows and improved the quality of care within dermatology clinics.
What is the primary need fulfilled by the product or service?
The primary need is improved quality of care with decreased cost. We are attacking this problem in the narrow field of dermatology/dermatopathology, but the principles and technology can be expanded well outside of that area. We plan to expand from dermatology to other fields of outpatient medicine within the next two years.
What is the ROI of said product or service?
Our clients have seen up to 75 percent decrease in sample turnaround time, as well as up to 75 percent decrease in the time it takes for physicians to review pathology reports (per internal case study reports).
What are some examples of implementation and outcomes use cases?
- Improved operational efficiency with digital workflows
- Improved patient satisfaction as the physician and patient review pathology together
- Improved patient outcomes because of faster turnaround times
- Improved staff efficiency
(For more information, see the Allen-Taintor and Prairie Lakes Healthcare case studies.)
Who are some of the clients and organizations served by the company?
How has innovation advanced the field of healthcare or the practice of care?
- Increased availability to high-quality care in underserved areas: Geography is no longer a limiting factor, providing opportunities for underserved areas to receive academic-level dermatopathology reads.
- Improved speed and availability of samples for improved patient outcomes: Dermatologists are able to view their slides 24/7 digitally with a web browser (on-demand ability to correlate with pathologic findings).
- Expanded access: Forty-five percent of the world does not have access to cancer diagnostics. AI has the potential to solve this problem.
How is innovation changing lives specifically?
Through patient education, patients are now able to better understand why they do or do not need surgery, because physicians can display the digital pathology images for them. Patient diagnoses are improved, as dermatologists can more quickly and easily correlate pathologic findings with clinical features. Patients are more satisfied with their care, as they are receiving answers more quickly, especially in difficult cases where consultations would normally take additional days or sometimes weeks.
What is the company’s go-forward strategy? What’s next? Which problem is the organization working on now and in the future?
We’re focused on optimizing workflows and technology specific to dermatology and dermatopathology. We plan to expand into other areas of pathology in the future, as well as work to solve the lack of access to pathology globally through the utilization of AI. Ultimately, our goal is to provide affordable, available, and accurate diagnoses to the world’s population.
What are the most significant lessons learned by delivering the innovation, product, and/or service to health systems and/or medical groups?
- Healthcare systems are extremely difficult to work with, as they sometimes employ outdated systems with limited ability to quickly and easily adapt to current technological changes.
- Very few successful healthcare companies are “just software.” You can’t build it and expect they will come. It takes making the right relationships with payers and providers.
- As the healthcare industry continues its digital transformation, significant opportunities exist to improve patient outcomes and improve the efficiency and effectiveness of the overall healthcare system.
- There are many ways to build algorithms. Think long and hard about your end-use case when architecting it and deciding whether to take a supervised or unsupervised approach to building out your algorithms.
Jul 20, 2020 | Digital Dermatopathology
Dermatopathology turnaround time is a critical quality indicator that every lab should continuously strive to improve. Laboratories are responsible for 60 percent of the vital information on a patient’s record and play a pivotal role in helping your dermatology practice maintain high patient satisfaction.
Achieving an acceptable pathology turnaround time depends on many factors. By considering patient expectations, the transportation process, laboratory workflow, and the differences between paper and digital pathology, your clinic can be sure to partner with a dermatopathology lab that delivers timely results.
Patient Expectations
When it comes to receiving pathology results, many patients want to know the diagnoses as soon as possible. Relaying a timely diagnosis can help to reduce hours, days, or weeks of distressing uncertainty.
With this in mind, the College of American Pathologists (CAP) indicates 90 percent of routine pathology cases should meet the standard two business day turnaround time. The 48-hour turnaround does not begin until the specimen is received, or accessioned, by the lab. The process ends when the lab’s results are finalized in the laboratory—the lab documents this transaction as the report date. However, the overall turnaround time for a clinic can be much longer, due to factors affecting specimen transport, laboratory workflow, and report delivery.
Specimen Transport
Transporting specimens from the dermatology clinic is a significant factor that affects turnaround time. Working with a local lab requires the use of couriers to transport biopsy specimens. Partnering with a lab outside of your region can be relatively painless thanks to overnight shipping, though some rural locations may require additional time. Delays in transport can add significant delays in getting a report on time.
Laboratory Workflow
Once a specimen reaches the lab, staffing, experience, and workflow play a significant role in turnaround time. While many labs offer traditional weekday hours between 8 and 5, some offer night shifts or even 24/7 service. It’s also vital to confirm the dermatopathologists have the bandwidth and know-how to serve your patients properly, as turnaround time can increase by over 20 percent in complex cases. Digital pathology can save considerable time by enabling multiple remote pathologists to consult on a specimen simultaneously, which can give an accurate and expert diagnosis quicker than traditional laboratories.
Report Delivery
The lab shares the final pathology report with the requesting provider via fax, courier, or electronic interfaces. Since three out of five dermatologists have already adopted EMR technology, interfaces are the next logical step to take advantage of digital time savings.
Relying on physical paper to transfer information takes longer and opens up the possibility of human error. Going paperless with an EMR interface means that labs can instantly transfer results directly into a patient’s digital records. Clinics can also filter the digital lab results, so urgent cases appear at the top of the stack.
Digital pathology service providers like PathologyWatch manage the entire EMR interface process, leaving you with the satisfaction of instant electronic reporting from academic-level dermatopathologists.
Patient satisfaction and health outcomes can be impacted by long turnaround times, which can be ameliorated by an efficient laboratory system. When you acknowledge the patient’s expectations and recognize transportation and report delivery options, you and your lab partner can find ways to improve dermatopathology turnaround time.
Jul 17, 2020 | Digital Dermatopathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
Providing your patients with definitive diagnoses requires clear and thorough dermatopathology reports. Many clinics and healthcare groups are permitting patients to log in and view these reports. However, a recent survey indicates patients are nearly three times as likely to misinterpret a dermatopathology report and conclude they have an incorrect diagnosis over the correct diagnosis.
“As patient access to pathologic test result reports increases, it is important to consider best practices to minimize potential negative consequences for patients and clinicians,” notes Hannah Shucard, MS. With patient satisfaction as the number one priority, you want to make sure your reports are complete and easy for everyone to interpret, in addition to meeting the standard of care.
There are several sections in a dermatopathology report. Below, we’ll review the purpose of the final diagnosis, microscopic descriptions, gross descriptions, clinical information, changes and corrections, and compliance to ensure your dermatopathology reports are understandable for you and your patients.
Final Diagnosis
As the most important part of a dermatopathology report, the final diagnosis should designate the results of the disease process seen in the biopsy or tissue. Sometimes, there is a comment section that describes further clinically relevant information, such as margin status, treatment recommendations, or other studies’ results. Diagnoses should be definitive in the vast majority of cases.
Microscopic Description
In this section, we find descriptions of the morphological features of the disease process seen under the microscope. Many pathologists use standardized text descriptions that elaborate on the key features that are unique to that disease. The Microscopic Description also describes the results of stains used to assist in making the diagnosis.
Gross Description
This section describes the size, color, and texture of the tissue that was received in the laboratory. This is an important section that is used by the submitting clinic and provider to ensure that the correct specimen is being examined. The laboratory also describes any inking or cutting that was done to the tissue prior to processing it to make glass slides. Specimen orientation with inking is also included in this section.
Clinical Information/Impression
The Clinical Information provided by the clinic and provider on the pathology order form is some of the most critical data that a laboratory and pathologist can receive to generate an accurate report. The information includes clinical differential diagnosis or clinical history. The Clinical Information section is also used for quality assurance by the dermatologist to ensure that the Final Diagnosis section correlates with clinical findings.
Changes and Corrections
Sometimes, additional clinical information or discussion can lead to a revised report. If the information does not significantly affect the Final Diagnosis, the laboratory will issue an “Addendum,” a secondary report that includes the new information. Rarely, corrections need to be made to a finalized report. In this instance, an “Amendment” report is issued, outlining the corrections that have been made. Common causes for amended reports include correcting the specimen site or demographic information. However, these should be rare occurrences.
Compliance
There are several other components to a laboratory report which are necessary to comply with laboratory licensing standards outlined by CLIA (Clinical Laboratory Improvement Amendments of 1988 (CLIA 493.1291)). These include patient identifiers, the testing laboratory’s location, test report date, and specimen source. A Billing section is sometimes added for auditing purposes.
Dermatology clinics carry an essential responsibility to make sure their patients receive accurate and organized diagnoses. Ensuring that the dermatopathology laboratory provides clear and precise reports that meet the industry standards is crucial to delivering the highest quality of clinical care possible.
Jul 15, 2020 | Digital Dermatopathology
Darren Whittemore didn’t always want to be a dermatopathologist. As a child, he wanted to be an astronaut.
His education took flight at San Diego State University, where he earned a BS in aerospace, aeronautical, and astronautical/space engineering. But as his interest in medicine grew, his role serving in the US Air Force took him to Texas to complete his education.
Darren completed his anatomic and clinical pathology residency at the combined US Air Force Wilford Hall Medical Center/Brooke Army Medical Center program. He then completed his fellowship in dermatopathology at the University of Texas Health Science Center in Houston under the nationally renowned Dr. Ron Rapini. Today, Darren is US board-certified in anatomic and clinical pathology and dermatopathology.
We sat down with Darren Whittemore to learn more about his pathway to dermatopathology and what he brings to the PathologyWatch team. Here are some of the highlights of that interview.
Was there a defining moment in your professional career when you knew pathology was the right choice?
While some people experience a single defining moment that changes their course, I experienced more of a series of moments that lead me to dermatopathology. It was while I was doing my third or fourth year of medical school end-of-rotation lectures that I realized I was fascinated by the pathogenesis of disease. Through those experiences, I knew I would be happier and feel more fulfilled by understanding the disease processes and educating peers in these areas.
While part of the aerospace engineering program as an undergraduate, I came to appreciate the completion of a project, which doesn’t always happen in the real engineering market. I was drawn to watching a project come full-circle. That’s what helped me decide to move more toward a career in medicine. Those plans were confirmed when I got an Air Force scholarship for pathology at one of the biggest AF academic centers at the time.
What is the most rewarding aspect of working in pathology?
Since separating from the Air Force, I have really enjoyed the private practice and business side of dermatopathology. This environment is surrounded by exploring new ways of helping patients and finding better ways to deliver patient care. There is so much to learn and do in this field. It’s an exciting environment in which to work.
I served in the US Air Force as a general pathologist and dermatopathologist for 12 years, separating as a lieutenant colonel. Since then, I have enjoyed establishing independent roots and building a reputation in various areas of expertise. The innovation emerging from this field has a global impact, and it’s rewarding to see international opportunities and assess the needs of the dermatopathology world.
What made you want to work with PathologyWatch?
I’m drawn to the innovation of digital pathology enabling dermatopathologists at multiple locations to be linked together nationally and internationally by viewing shared images at the same time. I love how that technology brings us together as if we are all in the same room.
This is also an exciting platform for teaching. There are plenty of volume-scaled opportunities for dermatopathologists and students since we have access to experts who can direct more learning by sharing their experiences and expertise. Personally, I believe having access to these leaders heightens the capabilities of the field.
Finally, the services provided by PathologyWatch means clinicians never have to work alone with this technology. We are connecting smaller clinics in all kinds of rural areas with remote work capabilities. For example, it’s often the case that a client is one of only a few clinicians in the area, yet that client has access to people all over the world with an enormous amount of experience.
You have over a decade of dermatopathology experience. What is it about your experience and/or background that helps you bring something unique to PathologyWatch?
I think my leadership roles, both in the academic and business sectors, have helped prepare me for this opportunity. But I think my directorship experiences from serving in the military at multiple laboratory sites will also be a big contribution. It’s given me confidence in my abilities.
I hope to bring my subspecialty experience and abilities in diagnosing alopecia cases to the PathologyWatch team so that they can be an even stronger comprehensive group of highly-trained and skilled dermatopathologists.
After a long day, what are your favorite things to do?
My wife and I have nine children, so I enjoy primarily wonderful family activities. We now live in a beautiful area in Northern Idaho, so there are plenty of outdoor activities to do on the weekends. I also enjoy fitness and strength training.
Music is a big part of my family as well. Eight of my children are training in Suzuki violin. I’ve played the clarinet and saxophone since high school, playing in various bands. Even now, you’ll still catch me playing my soprano saxophone to unwind.
