Jun 25, 2020 | Digital Pathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
Is your dermatology practice ready for digital pathology? Most physicians feel the need to create a more efficient patient care process, but many don’t realize the far-reaching advantages of using a digital pathology workflow.
According to a 2018 survey of US healthcare consumers and physicians, up to 69 percent of physicians, including dermatologists, are interested in increasing the use of digital tools to improve patient care, among other purposes. Due to recent advances in digital pathology, there is an alternative for dermatology clinics that typically rely on microscopy and glass slides: the online access of digital slides and reads from academic-level dermatopathologists. Companies like PathologyWatch, which offers whole-slide imaging to dermatologists, are helping digital pathology quicken its pace to the forefront of dermatology patient care.
As complications like COVID-19 force healthcare providers to consider alternative options to traditional office visits, dermatologists must find a way to abide by HIPAA guidelines while remaining profitable. Experts agree that a digital system can be cost neutral and even save money for medical practices.
Three critical factors contribute to a successful dermatology practice: efficiency, accessibility, and customer satisfaction. Each of these can improve with the adoption of a digital pathology platform.
1. Digital pathology is the solution for a more efficient and profitable pathology process.
According to experts, current trends in the traditional pathology model were already facing transformation. Based on data collected by DARK Daily, between 2007 and 2017, the pathologist workforce reduced its numbers by almost 18 percent, while the pathologist’s diagnostic workload rose by 41.7 percent.
Such imbalance is a formula for potential disaster as technicians scramble to meet lab work demands while using manual processes to prepare slides, mail specimens, collect and organize test results, and input data for each patient’s specimen slide.
Those who work in labs recognize that a digital pathology system may help to reduce errors and create efficiency, even while the workload increases. Fortunately, adopting a digital workflow and imaging system reduces the risk of mistakes while inputting data, eliminates redundancy in handling slides, and speeds up the process for issuing test results. Laboratories that provide digital images of the glass slides can also result in 24/7 access to slides by clinicians.
2. Digitized slides enable collaboration among specialists.
With whole-slide images digitally cataloged, doctors can easily access a patient’s specimen themselves and securely share it anywhere and anytime with fellow pathologists. Such collaborative practices heighten the quality of care at all participating facilities rather than limiting expertise to one or two locations. “We place a lot of value in consulting, case sharing, and communicating in our practice so that each hospital receives the benefit of our combined knowledge and experience,” says Nicolas G. Cacciabeve, MD, a managing member at Advanced Pathology Associates.
Cacciabeve adds that incorporating whole-slide imaging into their practice workflow has led to an improvement in the way they do things. “It drives efficiency and improves access to expertise,” he says.
The ability to extend patient care to those who often face challenges accessing specialized care is an exciting feature of digital technology. For healthcare professionals, providing treatment to the most vulnerable communities, particularly those in rural communities, is a constant challenge.
According to the Office of Disease Prevention and Health Promotion, almost 25 percent of Americans living in rural areas do not have a primary care provider (PCP) or health center where they can receive regular medical services. And with skin cancer ranking as the most common form of cancer in the US, people living in rural, agricultural areas could particularly benefit from access to dermatopathologists, who can examine a digitalized specimen and work with a local physician to design a treatment plan. Such services wouldn’t be possible without digital pathology technology.
3. Improve customer confidence with a digital platform.
The expanded access and collaboration available with the adoption of digital pathology also results in equivalent or improved patient outcomes. Zoltan Laszik, MD, PhD, professor of clinical pathology at the University of California San Francisco School of Medicine, directed a team to collect results between 30 pathologists and 800 test slides distributed among three hospitals. “There was not a single case that was misdiagnosed because of the digital technology, and the benefits were immediate from hospital to hospital,” Laszik says. By improving access to expertise and facilitating collaboration, Laszik and Cacciabeve see digital pathology as a vehicle to increase the speed and accuracy of diagnosis while innovating the modern standard of patient care.
While digital technology isn’t new, the possibilities digital pathology creates for the dermatopathology field to streamline lab processes, expand patient access to specialized care, and improve customer satisfaction are exciting and work together to ultimately help physicians take better care of their patients.
Jun 19, 2020 | Digital Dermatopathology, Digital Pathology
You have invested valuable time and resources to ensure your dermatology clinic offers patients a professional and confidence-earning experience. As such, it’s vital to ensure your practice aligns with a qualified dermatopathology group to provide the highest level of service and help secure long-term patient loyalty.
Developing a solid reputation in your community and throughout the healthcare industry requires dedication and paying close attention to the details. Focusing that same energy into vetting the training, experience, and reporting and communication skills of dermatopathology groups will help you align with a professional group that strengthens your practice.
Appropriate Training
Verifying a dermatopathologist is certified from an accredited institution is the first and most crucial checkbox in your evaluation. In the US, there are only 53 fellowship training programs for dermatopathology. Completing one of these competitive, board-certified programs confirms a dermatopathologist is trained in all aspects of laboratory and diagnostic dermatopathology.
Certification also indicates the dermatopathologist worked with a variety and high quantity of skin specimens in training. As a result, the individual should have the ability to diagnose a variety of dermatological conditions with confidence.
While certification is a sign of proper training, it does not always signify that the dermatopathologist was exposed to world-class facilities and the latest in pathology technology. Many programs embrace the cutting-edge convenience and efficiency of digital pathology, which PathologyWatch makes available in the private sector. However, just as certification is a sign of proper training, it’s equally essential that dermatopathologists don’t let their board certification lapse, as 7 percent of practicing pathologists are not board-certified.
Measurable Experience
Once a dermatopathologist receives certification, it’s important to note where and how long she or he has practiced. While nearly 25 percent of dermatopathologists pursue careers in academia, the majority turn to the private sector to work in hospitals and pathology laboratories.
With a workload that can increase 5 to 10 percent annually, pathologists working in busy labs have experience reviewing a large number of skin biopsies that feature a broad assortment of conditions. On the other hand, an individual working at a smaller hospital may have limited experience when it comes to variety or volume.
Clear Reporting and Communication
It is also vital to determine if the dermatopathology group you are considering can communicate clearly and with scientific accuracy. While errors occur in only 1 percent of pathology reporting, that’s still enough to impact patient care and introduce legal repercussions.
Instead of long reports that don’t provide direct answers, consider dermatopathologists who convey what they know with self-assurance. In cases where they don’t feel 100 percent sure about a diagnosis, it’s equally important to know they will seek second opinions.
A valuable dermatopathology partner will be available to communicate whenever you have questions about a diagnosis. In addition to accessibility, make sure the dermatopathologist is comfortable talking about correlating diagnosis with clinical features and using correct medical terms.
The safety and satisfaction of your patients are in your hands. Seeking a qualified dermatopathology group with the right training, experience, and communication skills will help you provide the quality of care that your dermatology clinic deserves.
Jun 10, 2020 | Digital Pathology
Running a successful dermatology clinic means providing your patients with efficient and accurate care. For the almost three-quarters of the 13,847 American dermatologists practicing in offices of five or fewer physicians, having a reliable dermatopathology partner is paramount to the life of the business.
While there are many to choose from, it’s essential to understand that not all labs are alike. By knowing what to look for when it comes to diagnostic expertise, technical quality, accurate reporting, open communication, and cost-effectiveness, you can be sure to align your clinic with a qualified and reliable dermatopathology partner that can bolster the clinical quality of your practice.
Expertise in Pathology Diagnosis
Your dermatopathology partner is a virtual extension of your practice, which means your reputation is staked on how well they do their job. Take, for example, the case of a patient who had her local dermatologist run a biopsy on an atypical mole and dermatofibroma. The clinic sent the specimen to a busy laboratory for diagnosis. Due to poorly trained technicians and a subpar dermatopathology read, the lab returned an inaccurate, more malignant diagnosis, which recommended an unnecessary excision with significant morbidity.
What are the warning signs to help you avoid working with a lab that produces these kinds of results? Academically, a dermatopathologist must complete four years of medical school, plus a residency and fellowship, to acquire the proficiency to make accurate diagnoses. Don’t be shy about requesting credentials, paying close attention to reputable institutions and US board-certified accreditation in dermatopathology before making your selection.
High Technical Quality
Returning to the example from before, when the dermatologist requested to review the patient’s slides, she found the immunohistochemical stains in poor quality. A red chromogen overstained the cells and made the lesion appear more worrisome than it was.
It isn’t easy to make quality reads if the specimens don’t meet industry standards. As a practicing dermatologist, you’ve worked years to earn the trust of your patients. In return, 67 percent of patients report to trust or strongly trust their physicians. All the more reason to demand that your dermatopathology partner meet the same level of quality you strive for.
During your selection process, vet the lab to make sure it meets current laboratory accreditation standards. Nearly 70 percent of people choose their providers based on positive online reviews. You’re no different, so do your homework and see what existing and former clients have to say.
Useful Dermatopathology Reports
Back to our example, the patient’s diagnosis was missing a key component: the microscopic description. Also, the diagnosis did not correlate with the clinical findings. It took two weeks for the dermatopathologist daughter to receive the glass slides, wasting precious time.
A dermatologist requires accurate and organized information to provide patients with timely and factual results. In a 2020 study, 184 patients were presented with reports indicating a benign diagnosis. However, over 92 percent of participants were somewhat or very worried after reviewing the information based on a lack of understanding. The same misunderstanding can exist when a pathology report fails to report essential information, such as a definitive diagnosis with clinical correlation, or a microscopic description.
When considering all of the ingredients that go into a quality dermatopathology report, ease of access rises to the top. The quickest—and easiest—way to receive and manage reports is by having them sent directly into your EMR, which is another modern convenience of digital pathology. Using a digital pathology services provider like PathologyWatch results in rapid deployment of a high-quality report directly to your EMR.
Clear Communication
A reliable dermatopathology partner will effectively transmit vital data to your clinic. In a study of melanocytic lesions, 79 percent of pathologists claimed they offered collaborative suggestions to colleagues to improve patient care. In that same spirit, seek a lab that goes out of their way to ensure you’re able to provide patients with the attention to detail they deserve.
Communication from the lab should be understandable, utilizing industry-standard medical vocabulary. Dermpath labs should correlate the diagnosis with clinical findings and allow you to see the images or slides the dermatopathologist used to make the diagnosis at any time. At PathologyWatch, we give clinicians immediate, 24-7 digital access to the corresponding pathology slides.*
Cost-Effectiveness
In a final look at our example case, the patient received a bill directly from the laboratory for over $500. As it turned out, the clinic had sent her slides to a lab that was outside of her insurance network. If it were not for investigating the fact that her state has laws against surprise billing, she would have never known to contact her insurance company to get this invoice reduced to $25.
Aligning with a lab that offers efficient billing practices will help your clinic to maintain cost-effectiveness. With annual overbilling exceeding $40 billion, it’s critical to select a partner that provides varied and robust insurance contracts in the networks for the majority of your patients.
It’s not uncommon for patients to be direct-billed or even overbilled if they are out of network. Remember that patients will associate any confusion or burdens of cost from the lab as a direct reflection of your dermatology practice. Use caution to select a lab that is in-network with key insurance providers and has reasonable self-pay rates.
Your dermatopathology lab partner is a key part of your practice and an important contributor to the patient experience. By ensuring expertise in diagnosis, technical quality, detailed reports, clear communication, and efficient billing by your dermatopathology lab partner, you and your patients will have a significantly improved experience in working with your laboratory.
Jun 4, 2020 | Digital Pathology
Whole-slide imaging is a qualified alternative to traditional microscopy. With approximately 1,000 pathology labs around the world converting to digital pathology systems, the accuracy of digital pathology images compared to glass slides is no longer an obstacle.
Modern dermatologists are turning to whole-slide imaging to take advantage of remote access, portability, ease of sharing, virtual archiving, and user-friendly tools. By examining the concordance with glass slides, technology training, and intraobserver variability, we will demonstrate why clinics should embrace laboratories that have undergone a digital transformation.
Digital slides are reliable and accessible.
Ensuring every patient receives the highest quality of care means dermatologists require complete trust in the results of their reads. With diagnosis from digital slides equivalent to diagnosis from glass slides, digital pathology is a proficient, high-tech replacement for optical microscopes.
Surprisingly, less than 5 percent of global pathology sites use digitalized workflows to handle all of their primary diagnoses. Misconceptions about the barriers to entry—including cost, labor, software, and memory—prevent dermatologists from moving to whole-slide imaging. However, partners like PathologyWatch remove these barriers because they can, in the context of providing tissue processing and/or interpretation, carry the burden of cost and provide the necessary hardware, implementation, labor to digitize, and software maintenance to make it simple for clinics to access electronic records.
The only remaining hurdle is familiarity, which is essential to building confidence in any new form of technology. In a study from the Department of Pathology, University of Pittsburgh Medical Center, pathologists who received proper training interpreted digital imaging with 16 percent greater accuracy than those without training.
Digital pathology provides significant clinical benefits.
Incorporating whole-slide imaging into your practice means providing patients with industry-leading, state-of-the-art processes. “When patients come to my office I can show them the whole slide image on the computer screen, point out things of significance, and tell them what they mean,” says Sylvia Asa, MD, PhD. “Sitting with patients and reviewing their pathology is a critical element that brings us to the patient and makes patients understand the importance of what we do. And that has always been a big challenge for pathology.”
Intraobserver variability is a chance for collaboration.
Because glass slides and digital pathology images are equivalent, a challenging read on a digital device will result in the same challenges when analyzed through a microscope. For this reason, it is expected that the same dermatologists or pathologists will render a different diagnosis on a certain percentage of cases depending on the day or modality on which they are viewed.
However, digital imaging offers dermatologists an advantage when it comes to challenging reads. Unlike glass slides, specimens on a digital image viewer* can be simultaneously viewed and annotated by colleagues around the world at a moment’s notice. With the demand for pathologists in the US expected to increase 16 percent by 2030, adapting to the efficiency and collaborative offerings of digital imaging can keep your practice up to speed with a higher workload.
Aligning with a laboratory like PathologyWatch will help your dermatology practice access the performance and productivity of whole-slide imaging. By understanding the concordance between digital pathology images and traditional microscopy, the value of appropriate training, and intraobserver variability in analog and digital reads, you have the assurance that digital pathology is right for your practice.
*Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
Jun 1, 2020 | Digital Pathology
PathologyWatch cofounder and CEO Dan Lambert was recently featured by Steven Loeb on VatorNews in a conversation about series A funding, digital pathology, and AI technology.
During the interview, Loeb asked Lambert about the services PathologyWatch provides dermatologists. “PathologyWatch provides a digital display so the dermatologist can actually view the case and discuss with the pathologist when needed,” explained Lambert. “We also integrate the reports directly into the dermatology electronic medical records systems.”
Researchers estimate 5 percent of US adult patients experience diagnostic errors every year. Studies show half of those errors are potentially harmful to the patient. With this new technology, dermatologists can review pathology quickly and begin what is often life-saving treatment faster.
Right now, around 20 dermatology offices are using PathologyWatch’s services. The most notable benefits of this service include better patient care from increased case visibility, as well as “a lot of time and errors saved in the office copying reports over,” said Lambert, adding that, in some cases, the company’s model can potentially result in more revenue to the practice.
“We don’t charge the dermatologist anything as we’re reimbursed by insurance for the cases that we read. Anecdotally, the turnaround time is faster, and more cases receive enhanced clinicopathological correlation by the dermatologist since they have immediate, 24/7 access to the diagnostic digital slides,” he explained.
PathologyWatch will use this funding to do more outreach to dermatology clinics around the country, while also expanding its sales force. The company—comprised of 10 full-time employees and a number of highly specialized contractors—will expand marketing efforts and implement a channel partner strategy while investing in the development of technology and supervised artificial intelligence for various cancer lines. The ultimate goal for PathologyWatch is to implement AI technology into these services to identify certain cancer lines.
“Our AI is being used internationally right now,” said Lambert. “It’s still in the early stages, but we’re seeing that AI can help physicians move faster through certain cases and draw attention to problematic areas where the pathologist should be spending more time. It’s clear that the technology will be used in tandem with humans.”
To read the full VatorNews article, click here. To learn more about digital pathology and AI technology at PathologyWatch, click here.
