Dec 3, 2021 | Dermatopathology Lab, Digital Pathology
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.
Nov 18, 2021 | Dermatology 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.
Nov 5, 2021 | Digital Dermatopathology, Meet The Team
Dr. George brings years of dermatopathology experience to the firm, with a special focus on melanoma.
Salt Lake City, November 4, 2021—PathologyWatch, a full-service digital pathology service, is pleased to welcome Dr. Eva Vertes George, MD, to its clinical team. A highly qualified and respected dermatopathologist, Dr. George’s expertise in melanoma, autoimmune conditions and inflammatory skin conditions aligns with PathologyWatch’s goals to support the most comprehensive and best-quality patient care while reducing healthcare costs.
“We are impressed with the enthusiasm and depth of expertise that Dr. George brings to the people of Florida and all over the United States,” says Dan Lambert, cofounder and chief executive officer of PathologyWatch.
Dr. George completed her residency in anatomic and clinical pathology at the University of Florida. Her fellowship was in dermatopathology at the University of Florida, and she is US-board certified in anatomic and clinical pathology and dermatopathology.
Although she enjoys all aspects of clinical pathology, her focus is melanoma. “I love it all, but I would say the part that grabs me is melanoma. There’s still so much that we don’t know about them. As we continue understanding the different variants, it’s about making sure we get the correct diagnosis so that patients receive the best care possible.”
As a strong supporter of digital pathology, Dr. George was drawn to PathologyWatch in part because of its commitment to opening up access to qualified patient care to the international community. “The idea that a biopsy can be done anywhere in the world, digitized, and then read by a pathologist from a different place in the world is very exciting. The possibilities are endless with that kind of instant accessibility,” said Dr. George.
“One of the most valuable parts of digital pathology is that it is going to enhance the accuracy of the diagnosis in a timely manner. It enables the transfer of information more readily and then extends that service to rural areas,” said Dr. George. “I truly believe digital pathology is the future.”
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 laboratory services. This can facilitate best-in-class reads and, in some cases, enable additional revenue to the practice by in-housing pathology. 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.
