3 Benefits of Using Digital Pathology Services

Sep 7, 2021 | Uncategorized

Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.

Digital pathology services are expected to grow roughly 8 percent in 2021 as a result of the growing demand for its use due to COVID-19. One survey of 261 people in the pathology industry found that between 72 and 90 percent of respondents believe that the use of digital pathology education tools will remain the same or increase moving forward.

The advancement of digital pathology services has streamlined the workflow process, changing the field of dermatopathology for the better. Though there are multiple benefits to using digital pathology, we’re going to examine the most prominent potential benefits, including modernized access, better opportunities for collaboration, and improved patient care.

Modernized Access

Though digital pathology provides a number of benefits, the technology is still relatively new in the field. The Food and Drug Administration authorized the first whole-slide imaging device in the United States in 2017, followed by a second system in 2019, allowing for collected skin, hair, and nail tissue samples to be digitized.

After a sample has been digitized, dermatopathologists can analyze and pass along their findings digitally. Depending on the severity of the patient’s condition, this access can play an important part in delivering timely treatment or management options to patients.

With cases and slides organized in the digital slide viewer, like the one offered by PathologyWatch, dermatopathologists can review specimens and generate reports of their findings possibly more efficiently than traditional microscopy. Unlike handling glass slides, whole-slide images are available any place and any time with an internet connection. 

Dermatology practices also benefit from digital pathology. EMR integration means less paperwork, which can reduce hand-written errors and lighten staff burdens. Additionally, dermatologists can pull up digital slides thanks to improved access when explaining a diagnosis to a patient in order to help answer their questions.

Better Collaborative Opportunities

In the same vein as the improved accessibility, digitized slides can also be shared with colleagues more easily, potentially allowing for more collaboration between dermatopathologists. If a second opinion is required to confirm a particular condition, digital pathology can help dermatopathologists to share virtual slides with specialists anywhere in the world in an instant. In the past, this process would have required packaging, labeling, and mailing a sample to a lab, where it would then need to be received, processed, and distributed to another dermatopathologist, which could have taken days or even weeks. 

Because dermatopathologists generate digital reports detailing their interpretation of samples, this ability to collaborate more effectively allows for specialists to better ensure an accurate diagnosis. Digital samples can also be compared to catalogs of previous historical data, which can be linked in the dermatopathologist’s report as evidence to support their findings.

Improved Patient Care

Building on the first two points, the improved accessibility and greater opportunity for collaboration through digital pathology may ultimately provide better patient care. According to the National Center for Biotechnology Information, when a pathologist is able to engage directly with the treating clinician, they can reduce days of unnecessary waiting in sending their report, increasing the chances of determining an effective treatment plan for the patient. Digital pathology can bridge this gap, allowing a pathologist to make their analysis and possibly report it more efficiently.

When a patient hears that additional testing is needed, they may start to worry. In fact, in a 2020 report from the Emergency Care Research Institute, the number one concern among patients was an incorrect or delayed diagnosis, so it’s important to work both quickly and effectively to help alleviate the patient’s concerns. In the event that a dermatopathologist’s findings suggest a more intensive course of treatment, the ability to receive that information faster can potentially help a dermatologist get the patient started on their treatment regimen more quickly.

The benefits of using digital pathology services stretch well beyond this list, but now you have some idea of how it allows for better collaboration through modernized access, ultimately improving the overall patient experience. Contact PathologyWatch to learn more about how we can help you begin the process.

Are Your Billing and CPT Codes Up to Date?

Aug 26, 2021 | Digital Pathology, Pathology Business

The AMA released a list of CPT code updates and changes, notably for patient encounters, ordering tests, and discussions, among others. They reported 329 code changes in the most current CPT code edition, some of which impact dermatologists, pathologists, and dermatopathologists.

Although few dermatologists would take pride in their CPT coding skills, being proficient in billing practices can ensure the business side of your practice runs smoothly and gets reimbursed quickly. But as AMA announces major updates to their CPT coding sets, now is the time to check your CPT codes for accuracy and compliance.

There are a few factors that have impacted the need for changes: First, the shift toward value-based care; second, the Patients over Paperwork initiative launched by the US Department of Health and Human Services in 2017; and third, the onset of COVID-19, which required additional codes.

As healthcare systems transition to a VBC model, here’s why it’s important for your CPT codes to be current.  

Why Update CPT Codes?

In response to the growing concern among healthcare providers that the documentation requirements for billing weren’t benefiting patient care, the AMA set out to streamline the CPT coding process. 

According to the AMA, “The CPT code set continues to be modified to respond to the fast pace innovation among digital medicine services that can improve access to health care and improved health outcomes for patients across the country.”

By streamlining the standard for communicating healthcare procedures and services across healthcare teams and health systems, better CPT coding and billing procedures will reduce the cost of care while increasing the quality of care and expand access to it. In addition to preventing fraudulent claims and reducing the risk of monetary or legal penalties, other results may include more accurate billing and a reduction in claim denials, which can frustrate patients and impact a provider’s reputation.

“The AMA is attacking dysfunction in health care by removing obstacles and burdens that interfere with patient care,” the AMA says. “Our focus is on making technology an asset in the delivery of health care, not a burden.”

What CPT Code Changes Can We Expect for Pathology and Dermatopathology?

To focus on codes that impact the pathology, dermatology, and dermatopathology fields, APS Medical Billing released a CPT code change summary highlighting the most common CPT codes. You can access it here. 

For instance, although coding for inpatient encounters and consultations are not affected by these changes, doctors should note changes in codes 99201 through 99215 that pertain to outpatient office visits. “With these landmark changes, as approved by the CPT Editorial Panel, documentation for E/M office visits will now be centered around how physician think and take care of patients and not on mandatory standards that encouraged copy/paste and checking boxes,” says the AMA, adding that the goal of these coding changes is to decrease the overload of documentation and coding, cut down on unnecessary documentation, reduce audits, and make sure reimbursement for E/M is resource-based.

How Does EMR Technology Make It Easy to Update CPT Codes?

Fortunately, using EMR for your patients’ information makes it easy to update CPT code changes. EMR technology houses patient data in a secure location that is easy to organize and share with other healthcare providers, insurance companies, pharmacies, labs, other clinics, billing services, and more. Compared to traditional handwriting, an EMR facilitates the code assignment for billing, increases legibility to reduce errors, curtails paperwork, and eliminates duplicate tests.  

According to the Centers for Medicare and Medicaid Services, “Documenting a patient’s record with all relevant and important facts, and having that information readily available, allows providers to furnish correct and appropriate services that can improve quality, safety, and efficiency.” 

If your clinic is considering updating to digital patient records, we’ve weighed some pros and cons of using an EMR system. Check it out! 

How to Explain Dermatopathology to Your Patients

Aug 13, 2021 | Digital Dermatopathology

According to IBISWorld, there are an estimated 5,391 dermatology businesses in the United States, serving millions of individuals who understand the importance of taking care of their skin. But when it comes to the science behind diagnosing and treating skin conditions, some patients may feel lost, confused, or scared.

Explaining what dermatopathologists do can entail a lot of information for a patient, so let’s examine some simple ways to discuss what dermatopathology is, including education, training, and specialties, as well as the advancement of digital dermatopathology and how it is changing the industry.

What Is Dermatopathology?

Dermatopathology is a specialty in the field of dermatology. The term itself is a combination of dermatology and pathology, meaning the study of both the skin and diseases thereof. Pathologists work in every field of medicine, providing insight on diseases and patient care—in the field of dermatology, this is the responsibility of the dermatopathologist—or “dermpath,” as they are sometimes known in the industry.

All dermatopathologists hold a medical degree in dermatology or pathology, with a subspeciality in dermatopathology. In order to become board certified, doctors must take an exam in both their specialty and subspecialty, as well as participate in developmental exercises in order to retain that certification.

Dermatopathology Services

Rather than interacting directly with patients, dermatopathologists analyze tissue samples that are sent over by doctor’s offices to provide additional information. A nine-year study by the National Library of Medicine found an increasing trend in the complexity of dermatopathology cases after reviewing 8,173 cases at a tertiary care academic center. 

Dermpaths are able to examine not only skin samples but also hair and nail tissue samples, after which they generate a report based on their findings. This is typically done when a dermatologist or primary care physician wants to confirm an initial diagnosis made during a physical examination of the potentially affected area, and requests to have a sample tested by a dermatopathologist for more information.

In studying these samples, dermatopathologists are able to better identify a wide variety of skin conditions, including skin cancer, eczema, and psoriasis. Examining samples under a microscope allows dermatopathologists to see them on a cellular level, providing a closer perspective of a patient’s potential diagnosis.

Traditionally, dermatopathology was done using microscopes, but technological advances have led to the increasing use of digital dermatopathology, in which samples are processed and digitized, providing doctors with more readily available access to a patient’s slides. This process minimizes the time it takes to send a sample, receive the results, and make a diagnosis based on those results, which can be life-saving in more severe cases.

Uses and Benefits of Digital Dermatopathology

Digital dermatopathology helps medical professionals to continue providing patients with the level of care they require while offering clear advantages for your dermatology clinic. These include access to quality clinical care for rural markets, shorter diagnostic times than traditional microscopy, and equivalence to glass slides in terms of quality, with a major discordance rate of only 0.4 percent between whole-slide imaging and microscopy.

Digital dermatopathology can also reduce the time it takes between receiving a slide and generating a report. In some cases, hospitals staff saw an average turnaround time reduced from two weeks to two days. Elsewhere, the streamlined digital process saves the staff an hour a day on manual tasks.

Now that you have some ideas of how to explain what dermatopathology is to your patients, contact the experts at PathologyWatch to help with all your digital dermatopathology needs.

Is Your Dermlab a Good Fit? 5 Questions to Ask a Dermatopathology Lab

Aug 5, 2021 | Dermatopathology Lab, Digital Dermatopathology

5 questions to ask your pathology lab
are staff board certified
focused on the client
whole-slide image experience
promote community specialty
prioritize confidentiality
contact pathologywatch today
Are you searching for a new dermatopathology lab? With the onset of digital pathology, finding a lab that is not only equipped with this innovation but also qualified to process whole-slide images swiftly yet accurately may take some time. 

An NIH study found that three out of four respondents agreed that accurate diagnoses can be made with this technology, and over half (59 percent) agreed that the benefits of whole-slide imaging outweigh any concerns. If you plan to expand your practice to incorporate whole-slide imaging into your process, finding the right dermlab is an important first step. 

To ensure the ideal match, here are five questions to ask dermatopathology labs. 

1. Are they focused on the client? 

With more healthcare systems moving to a value-based care model, patient-centered care is essential to ensure the seamless delivery of quick results and effective treatment plans while providing as much information as possible about your patient’s condition. It’s difficult to reassure your patient that their treatment is a priority when the turnaround time for lab results takes several weeks. 

2. Are the lab techs board certified? 

Check to be sure that the lab technicians and specialists are educated and qualified to do their job. Although jobs as a general lab technician don’t require extensive college training, hands-on experience working in digital pathology is more specialized. 

As more labs implement digital technology into their lab processes, it’s important to clarify their expertise in operating the specialized equipment since it varies a great deal from handling glass slides and manually preparing lab test results.

3. Do they have experience using whole-slide imaging?

Digital technology and whole-slide imaging is expanding throughout the dermatopathology industry, with many implementing digital innovations into their processes. As mentioned earlier, make sure the lab you rely on for fast and accurate results knows how to operate this new technology. 

Research conducted by Joann G. Elmore, MD, MPH, and her team concludes that navigating digital whole-slide imaging is different from traditional microscopy. In whole-slide imaging, the pathologist is not confined to a physical microscope that requires a glass slide viewed through a lens to view the tissue sample. 

“Rather, the digitized images of the histology tissue sections are viewed on a computer screen using a pointing device such as a mouse, trackpad, or dedicated console to manipulate location and magnification of the image (pan and zoom),” says the research team. “The technology may be easily adapted to virtual reality glasses. Given these important differences between digital WSI and traditional microscopy, adoption and effective use of WSI in clinical practice requires exposure to and training using this new format.”

4. What tests do they perform?

Based on the region, some labs have more experience performing certain tests that are more pronounced in your customer base than others. For example, a dermlab in California will likely see more tests for melanoma because it has the most cases of skin cancer (11,450 new cases this year) in the nation. By comparison, Alaska has 110 melanoma cases. 

If your practice specializes in treatments more common in the area, you want to partner with a lab that is proficient in those tests.

5. Is patient confidentiality a priority?

The wave of digital technology within the dermatopathology field has provided unprecedented access to patient information. With that abundance of data comes a higher risk of HIPAA violations. Be sure to ask how the lab processes and organizes testing samples and inquire about their procedures for sharing results. 

“Using an electronic health record or EHR system offers you much better control over information security,” says Stephen O’Connor. “What’s more, the electronic version of the patient’s chart is now more convenient to share with other concerned parties.” 

To expand your practice, you need a dermlab that offers immediate and secure access to digital slides, fully interpreted pathology reports uploaded directly into your patient’s EMR, and personalized service through your own dedicated dermpath team with the flexibility to collaborate with your existing dermatopathology provider. 

To learn more about what PathologyWatch digital dermatopathology lab services can do to help expand your practice, click here. 

Digital Dermatopathology Digest: Identifying Hair Follicle Tumors

Jul 23, 2021 | Digital Dermatopathology, Digital Pathology

Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.

There are a number of different hair follicle tumors, each with its own distinguishing features. In the Digital Dermatopathology Digest series, Rajni Mandal, MD, clinical research associate in dermatopathology for PathologyWatch, discusses these different variants in greater detail.

Trichilemmal cells come from the outer root sheath of the hair follicle. The cells show abrupt keratinization and pink to clear cytoplasm with a lack of keratohyalin granules.

Trichilemmoma cells have a lobular proliferation of cells that can push into the dermis. They can also present as pink to clear due to glycogen, and there can be peripheral palisading at the periphery of the islands as well as a thick pink basement membrane deposition. Multiple trichilemmomas are associated with Cowden syndrome.

Trichoadenoma cells can have multiple epithelial islands of keratin-filled cysts in the dermis. These cysts can frequently rupture, shoring a foreign body giant cell reaction to keratin fibers. Cyst islands are lined by epithelium, and the majority of the squamous epithelium lacks keratohyalin granules.

Trichoblastoma cells typically have multiple blue islands with fibrotic stroma and are associated with nevus sebaceous.

Cells on the trichofolliculoma, fibrofolliculoma, and trichodiscoma spectrum are all different stages of the same tumor. They can present with branches of anastomosing epithelium originating out of the hair follicle and often occur in small antigen hair follicles.

  • In a fibrofolliculoma, there can be a proliferation of fibrous cells or fibrous stroma, which can have a concentric pattern around the tumor.
  • Fibrous proliferations are most prominent in a trichodiscoma.
  • Cells can show peripheral palisading, but there is no retraction artifact or myxoid stroma surrounding them, which would be seen in basal cell carcinoma.
  • Multiple fibrofolliculomas and trichodiscomas are commonly associated with Birt-Hogg-Dubé syndrome.

The Digital Dermatopathology Digest series provides educational information for both students and professionals on a number of topics. To view the complete series, click here.