Dan Lambert, CEO at PathologyWatch, Chats with Silicon Slopes Host on the Impact of Digital Pathology

Things are changing fast in the dermatology field. As more dermatologists turn to digital-based services, the options for expanding patient care services, accelerating turnaround times on diagnoses, facilitating interoperability among health services agencies, and streamlining workflow processes to better control overhead costs are transforming the dermatological patient experience. 

At the heart of some of those changes occurring in Utah’s pathology labs is PathologyWatch, a full-service dermpath lab that combines the dermpath expertise and cutting-edge technology of an academic center with the efficiency and customer service of a private lab.

Dan Lambert, CEO at PathologyWatch, met recently with Caitlin Hansen of Silicon Slopes to discuss the business side of running a series of digital pathology laboratories, the future of AI technology on patient care, and the vision Dan has for the future of PathologyWatch and digital dermatopathology. 

Here are some of the highlights from that interview. 

Caitlin Hansen: Can you give me a little more info about the technology?

Dan Lambert: Right now, you go into the dermatologist; then they take a biopsy, and that gets FedExed or couriered to a local lab where it’s cut into really thin slices and stained. A physician looks at that under a microscope, types up a report, and that report might be faxed somewhere. 

For us, we’re taking that process, which is very manual, and we’ve streamlined it. We make the slide digital, so that, for the first time, the dermatologist can look at that slide as part of the process, much like a radiologist would show you an X-ray. 

We’re enabling not only dermatologists but, down the road, other physicians as well to actually show you what your cancer looks like in the patient room. Also, the integration with EMR means it’s much faster for the dermatologist’s office. [This creates] a lot fewer errors, and it allows for multiple opinions on the same case, which has never been done before because it’s really just been glass slides. And so the transformation to digital across this industry is reducing costs, it’s making things faster, and it’s also drastically improving patient care.

CH: I’m curious how you feel like this is going to affect the accuracy of diagnosis as well.

DL: We see from major academic medical centers that, at the end of the day, recognizing cancer under a microscope or digital, it’s about pattern recognition, And computers, especially with deep learning, have gotten better and better at recognizing these patterns and will eventually greatly improve the diagnostic accuracy. 

It will help doctors for a long time. And then, at some point in the future, it will probably be accurate enough that we can start phasing out the human review of some of these cases. This stands to take out major costs from what is almost a $17-billion-a-year industry, which is pathology. And it’s one of the few innovations that I think can take out the true costs for a very overburdened healthcare system. . . .

CH: I’m curious about your specific focus as the CEO. . . . What does the day-to-day look like for you, and what do you put most of your focus on? 

DL: So we just raised the $25 million Series B. With that funding, now it’s going from the point where you have a product that has proven product market fit, but moving into scale means that you need a lot of really highly qualified people to build the business. I’m spending about 50 percent of my time just on straight recruiting; trying to bring in engineers. . . .

CH: You mentioned you just moved facilities. Where did you relocate to? 

DL: [We had to] move from one lab in Murray to a bigger lab in Murray. . . . It is exciting to grow. We employ about 50 people right now, and we’ll probably be at about 80 people by the end of next year, which is exciting to see the team [become] some of my close friends. It almost feels like family now. . . .

CH: What is on the horizon for you?

DL: The next phase for us is continuing development of AI. Learning to recognize cancer samples better, faster; finding those rare cases that frankly many, many physicians miss. Having gone through a couple of startups, I started this four years ago with the understanding of trying to leave something behind that’s like a true legacy or trying to make medicine truly better. It turns out that’s a hard journey. But so far it’s worked, and I’m really happy that I made that decision. . . .

CH: Are you in hospitals and clinics? How are you integrating to make sure that this technology is being used now?

DL: When we looked at the business early on, we could have gone two routes: We could have sold to hospitals, which is generally a longer sales cycle, or focus on outpatient clinics. They can make a decision usually in about a month. So we decided to go after the independent dermatology clinics that are primarily located in Utah. 

We now have five labs in different states, so we’ve scaled up quite a bit. If you go to a dermatologist here in Utah, we process the majority of skin cancer samples in the state and so your sample is probably going through our laboratories. And I’m really proud of that because I genuinely believe it’s a higher standard of care than what has existed in the past.

CH: So switching back to you being the CEO and running your company. I think that culture and motivation comes from the top down and leading by example. What is the kind of culture that you inspire your employees to abide by and how do you keep them motivated?

DL: I think in any company, you have to pick a set of values. That also means making sometimes hard decisions about what you prioritize. And I think, in this company, the culture of truth, transparency, and accuracy of the diagnostic process is more important than anything. . . .

I want our company to be the kind of place that you would send your family member samples to, and that means enforcing a really high standard of care. 

To view the full interview, click here.

PathologyWatch Welcomes Carlos Ricotti, MD, as a Key Addition to the Team

Dr. Ricotti brings seasoned expertise in complex dermatopathology cases to the firm.

SALT LAKE CITY—JANUARY 12, 2022—PathologyWatch, a full-service digital pathology lab, is pleased to welcome Carlos Ricotti, MD, to its clinical team.

Dr. Ricotti is a dermatologist and dermatopathologist whose expertise in complex cases—particularly basal cell carcinoma, melanoma, squamous cell carcinoma, autoimmune conditions and inflammatory skin conditions—keeps his skills in demand. His compassionate and professional methods of care align with PathologyWatch’s goals to support the most comprehensive and best-quality patient care while reducing healthcare costs.

“Dr. Ricotti’s approach to dermatopathology extends beyond the specimen slide and stays focused on the overall condition and health of the patient,” says Greg Osmond, chief medical officer and PathologyWatch cofounder. “His diverse experience in identifying and treating often aggressive malignant skin conditions is a tremendous benefit to the Florida communities we serve.”

Ricotti, who is US board certified and a diplomate in dermatology and dermatopathology, views himself as a clinician. Among his standout skills is the ability to delve into unique cases by analyzing information from different areas of a patient’s profile, in addition to the test slide, to uncover answers. “I really like complex dermatology,” says Ricotti. ”And I knew that dermpath would help me better understand complex skin diseases.”

He is often consulted to review cases where essential indicators may have been overlooked. He also shares his uniquely methodical process with residents with whom he works regularly. “I just try to stay informed because I think that’s the right way to do things,” he said.

“His keen eye for examining atypical cases by exploring the complete patient profile rather than just the slide is a major contributing factor that he brings to the PathologyWatch team,” says Michael Torno, CRO and cofounder at PathologyWatch. “That approach to dermatopathology is the future of dermatological care and will enhance the patient experience for our clients.”

Dr. Ricotti completed a fellowship in dermatopathology at the University of Texas Southwestern and his residency in dermatology at the University of Miami. He is frequently consulted for his expertise and has contributed to several publications, including peer-reviewed scientific journals and book chapters for dermatology texts.

For more information, please email [email protected] or visit us at pathologywatch.com.

About PathologyWatch
PathologyWatch is the groundbreaking leader of digital dermatopathology services. Through these services, dermatology clinics, hospitals and laboratories can improve operational efficiency by speeding up workflow and enhancing patient outcomes by utilizing the PathologyWatch expert professional team and in-house lab services. With an intuitive and easy-to-implement digital pathology solution that includes access to top-tier dermatopathologists and a streamlined clinical workflow that interfaces directly into the EMR, PathologyWatch brilliantly combines state-of-the-art technology and clinical decision-making to deliver unprecedented patient care.

PathologyWatch Raises $25M to Advance AI-Driven Skincare Research and Diagnostics

The Series B funding round will help PathologyWatch digitize biopsies, increase access to top skincare physicians and further AI research.

SALT LAKE CITY, November 16, 2021—PathologyWatch, the leading digital lab and pathology platform for dermatologists, announced today that it has raised $25M in Series B financing with participation from Ceros Capital Markets, Rock Creek Capital, SpringTide, Spark Growth Ventures, Blueprint Health, Blackbrook Management Group and existing investors.

With the new funding, PathologyWatch will broaden its outreach to dermatologists and conduct further research into skincare diagnostics and AI – allowing patients to receive faster diagnoses and more equitable access to dermatopathology services while enabling labs to work more efficiently and cost-effectively. Additionally, the funding will support operations as the business expands across the country, adding new labs in Texas, Florida and Arizona.

“We are honored that of all the digital dermpath labs available, dermatologists are increasingly choosing to partner with us,” said Dan Lambert, PathologyWatch CEO and cofounder. “As digital dermatopathology continues to grow, it has the potential to reduce the costs of pathology by billions while creating better patient care for everyone across the country. We’re thrilled to be winning so much volume so quickly.”

PathologyWatch provides fully interfaced EMR reporting and 24/7 access to digital slides for dermatology clinics. For their clients, this means more-efficient workflows and direct access to leading dermatopathologists across the country, with broad insurance coverage. PathologyWatch has successfully integrated laboratory information systems, scanners, digital viewer technology and EMRs into an end-to-end solution for dermatologists.

“PathologyWatch has been disruptive to the market and is digitally transforming the industry in unprecedented ways,” said Mark Goldwasser, CEO of Ceros. “With the need for remote health services during COVID, the distributed network of top-tier dermatopathologists alongside a digital viewer that can be accessed anytime and anywhere could not have come at a more fortuitous time.”

“For a dermatology practice to send nearly all skin biopsy volume for cancer diagnosis to PathologyWatch is a no-brainer,” said Austin Walters, founder and managing partner at SpringTide. “The company has worked hard to create a service that outperforms every other from both cost and quality perspectives.”

“Dan is a driven entrepreneur with social good in mind,” said Ryan Brooks, principal at Blackbrook Management Group. “We are part of a cause, not just an investment capital endeavor. In the past, I have been a patient waiting for pathology to come back. When you are waiting for results that could change your life dramatically, you want doctors and tech you can depend on. PathologyWatch will enhance the human experience and enable dermatopathologists to do a better job.”

“I am proud to support PathologyWatch’s mission to provide premier, accessible and affordable digital pathology services to the world,” said Rick Stratford, managing director of Rock Creek Capital. “The ability to provide top-tier pathology services to all communities regardless of location brings hope to patients in underserved areas and can save countless lives. PathologyWatch and other digital platforms like it are democratizing healthcare services and bringing hope and change to our healthcare systems.”

For more information about PathologyWatch, visit pathologywatch.com or contact [email protected]

About PathologyWatch
PathologyWatch is the groundbreaking leader of digital dermatopathology services. Through these services, dermatology clinics, hospitals and laboratories can improve operational efficiency by speeding up workflow and enhancing patient outcomes by utilizing the PathologyWatch expert professional team and in-house lab services. With an intuitive and easy-to-implement digital pathology solution that includes access to top-tier dermatopathologists and a streamlined clinical workflow that interfaces directly into the EMR, PathologyWatch brilliantly combines state-of-the-art technology and clinical decision-making to deliver unprecedented patient care.

Is Melanoma “Overdiagnosed?”

By Darren Whittemore, DO

As one of the most feared types of cancer, melanoma accounts for about 1 percent of skin cancers while contributing to over 7,000 deaths in the United States every year. And those numbers are steadily increasing, with annual incidences rising up to 4–6 percent over the last several decades.

In the age of improved preventative measures, early detection, digital technologies, and better treatments, why are cases of melanoma continuing to rise? Is it our propensity for skin cancer? Or could it be the diagnosis? Are patients receiving the most accurate and reliable information possible? Some voices in the dermatopathology industry believe the pursuit of a “definitive” diagnosis—bolstered with advancements in digital pathology—sometimes leads to biopsies that are collected and tested too soon and ultimately come back with a negative result for malignancy. 

However, others believe it is better to risk overdiagnosis than to miss cases before it is too late. As the industry-wide debate persists concerning melanoma diagnostic processes, let’s discuss points that support both sides of the argument. 

Yes: There are indicators of melanoma overdiagnosis.

“From an epidemiologic perspective, the sharp rise in the incidence of melanoma in the face of stable mortality for the past 40 years [signifies] the epidemiologic signature of overdiagnosis,” says Jason B. Lee, MD, in an article for the American Academy Dermatology Association

Lee echoed some of the concerns expressed by H. Gilbert Welch and his team’s research, which postulates that “the rapid rise in the incidence of melanoma is not due to a true rise in incidence, but it is the byproduct of increased scrutiny, which they refer to as the epidemic of inspection, surveillance, and biopsy of pigmented skin lesions.” 

Welch’s team asserts that the rapid rise in the incidence of melanoma is due to the increasing skin cancer screening activities, low threshold to biopsy, and low threshold to diagnose melanoma by dermatopathologists fueled by heightened public awareness of melanoma, financial incentive, and fear of missing melanoma that has resulted in what they refer to as the “cycle of melanoma overdiagnosis.” 

No: Testing for early detection—even if tests don’t result in malignancy—is good.

Opponents of this overdiagnosing argument—particularly Sancy A. Leachman, MD, PhD, and John D. Gray, an endowed chair in melanoma research—caution against rejecting new technologies for fear of diagnoses not resulting in malignant melanoma:

They suggest that we revert to not biopsying lesions less than 6 mm, rather than making an effort to better understand the biology (and clinical signs) that makes some 2 mm lesions deadly. Shouldn’t our call-to-action be to improve, rather than to decrease, our diagnostic scrutiny? Wouldn’t it be better to utilize the COVID “experiment of nature” to evaluate the true (data-based) impact of decreased melanoma screening, rather than keep all screening programs closed? . . . Should the SPOT Skin Cancer™ screening program be halted completely, as they suggest, or should we purposefully stratify risk and screen those with highest need?

The drive toward innovations in digital pathology and AI technology continues to improve the accuracy of tissue testing. Advances in digital pathology transform our view of the early stages of cellular behaviors. 

But how are we best utilizing this information? At PathologyWatch, we combine state-of-the-art technology and clinical decision-making to deliver optimal patient care with accurate diagnosis. Our clinical team carries extensive experience in identifying and predicting the cellular behaviors of chronic conditions and skin cancers. One of the advantages of having access to this expertise is that dermatologists can collaborate with our clinical team to discuss those factors should there be concerns about early detection. 

Call us to discuss the innovations in digital pathology that can help your practice diagnose with confidence.

6 Reasons Why Dermatological Interoperability Is the Future of Your Practice

In some ways, it took a pandemic for the healthcare industry to accelerate new ways to deliver patient care. For example, a CDC study found that using telehealth for patient visits increased by up to 154 percent from 2019 to 2020. Now, this service is a permanent option for some major healthcare organizations, and it’s just one example of how dermatological interoperability is helping providers to move closer to incorporating technology with traditional patient care. 

A recent study determined that effective interoperability and communication are essential for a primary care system to successfully prevent illness, manage care across multiple providers, and reduce health care costs.

“To address patients’ needs, primary care physicians often must communicate and exchange information with specialists, hospitals and other care settings, social service providers—and, of course, the patients themselves,” says Muhammad Chebli of NextGen Healthcare.

But what is dermatological interoperability? If it’s the future of healthcare, how can we incorporate this technology in ways that help your practice run more efficiently and grow? Let’s first gain a better understanding of interoperability. Then, we’ll explore how interoperability can scale our practice with innovation that better organizes data, expands patient care options, and streamlines billing. 

What Is Interoperability?

For doctors who have already adopted EMR technology, you are closer than you think to full interoperability. “EMR interoperability is a system architecture that allows healthcare facilities to access, analyze, and share health data between systems, medical devices, and applications at a local or cross-organizational level,” explains Ivan Dunskiey, Demigos Healthcare founder and CEO.

Almost 90 percent of healthcare providers have implemented EMR technology into their workflow processes. As dermatologists work with EMR technology, here are six ways EMR can work for them. 

1. Ensures Compliance

Under the federal government’s direction, the healthcare industry is placing patients at the center of their care and medical information. Part of the 21st Century Cures Act entitles all patients to access their complete medical file upon request. 

In other words, providers must digitize their patient records so that patients can access their information. As patients take a more active role in their care, doctors can use these opportunities to develop open, trusting patient relationships. 

2. Standardizes Data

Is it a rash? Psoriasis? A lesion? 

It’s not uncommon for patients to be treated by more than one doctor at a time. With hard-copy record keeping, a healthcare provider may use different terms to describe the same thing. Using EMR interoperability standardizes those terms, which creates more accurate, reliable patient data. 

Also, with standardized data, other health service agencies can collect and analyze data about a specific skin condition, for instance, and note higher incidences of that particular disease in specific geographic regions. That, in turn, can launch discussions on the risks and determine if an area needs more resources. 

3. Expands Access to Services

Telehealth services and self-service patient portals are promising indicators of the evolution of care delivery options with interoperability. For the dermatology field, EMR and digital slides sometimes open up life-saving treatment options for malignancy cases. Regardless of clinic size and location, doctors can obtain expert opinions on dermatology cases and discuss results via remote.

4. Allows Access to a Complete Patient Medical Record

The more information a healthcare provider has, the better the diagnosis. Since patients only remember about 49 percent of the information they receive from their doctors, medical professionals must rely on thorough medical records. With digitized patient records, a healthcare provider not only sees their notes, but they can also read through the notes shared by other doctors.

When determining treatment options, a healthcare provider can refer to reported lifestyle habits or existing conditions being treated by another physician that could interfere with certain treatment plans. Accessing a complete patient record ensures effective care that won’t interfere with other treatments, medications, etc.

5. Faster Billing 

There are several reasons why digital patient records streamline the billing process. “Technology has enabled a huge transition in streamlining medical records storage and processing,” explains Greg Dondero, business development director at Healthcare Resource Group, Inc. “Electronic recordkeeping helps ensure that patient data is accurate, up to date, and easily accessible. It allows secure sharing of information with patients, providers and other healthcare workers, which ultimately reduces costs because of reduced manual paperwork.”

6. Saves Time

At this very moment, a collective “hah!” resounds from doctors who recently implemented a new EMR system. In fact, one of the most common complaints among doctors is how much time it takes to update patient records. One study estimates that surgeons, for example, spend almost two hours per day updating electronic health records. And they often update patient files at home in their spare time. 

As EMR technology evolves (and it will, as more doctors weigh in with feedback), so should your workflow design. For example, how do you handle patient check-ins? Can the patient verify insurance and contact information through a self-service portal before their appointment? Are there redundant tasks within your office workflow that can be automated? Can you schedule time each day for communication tasks or file updates? Partnering with a full-service digital dermpath lab like PathologyWatch can fast track your workflow WITH technology to help you save time and make it easier to scale your practice in conjunction with these innovations.  

No doubt about it: Interoperability is the future of EHR and EMR systems. A better understanding of the possibilities dermatological interoperability can bring to your patient care, billing, and data management is transformative for the future of your practice.