Mar 12, 2021 | Digital Dermatopathology, Digital Pathology
A healthy practice relies on establishing meaningful relationships with your patients. You want them to feel special and valued. So it can be a little disconcerting when you’ve pulled the file for a pregnant patient you anticipate is getting checked for melasma only to meet a 16-year-old new patient, who arrived to discuss his acne.
Sometimes file mix-ups have more serious consequences than mistaken identities. Studies show that from the initial biopsy to the acquisition of the pathology report, a specimen may pass through the hands of more than twenty people and several workplaces.
To prevent specimen mix-ups and other errors with patient information, NIH recommends, first, standardization in work processes, and second, automating tasks wherever possible. To do this, consider digitizing your clinic and laboratory processes.
Here are three ways transitioning to electronic medical records (EMR) have helped numerous dermatology practices minimize errors and create a streamlined and error-free clinic workflow.
Patient Data Is Easy to Share
EMR technology was designed to house patient information in a location that is easy to organize and share with other healthcare providers, insurance, pharmacies, labs, other clinics, billing, etc.
The Center for Medicare and Medicaid Services (CMS) says, “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.”
At PathologyWatch, our clients appreciate easy access to digital images as well as pathology reports, patient’s HIPAA-compliant, digital medical history, etc., which are accessible on the patient’s EMR.
EMR Provides a Complete Patient Record
Did you know around one out of every 20 people who saw a doctor last year reported having to redo a test or procedure because their prior data was unavailable?
Maintaining a patient’s identity and complete medical history throughout the biopsy pathway is critical for the practice of dermatology and dermatopathology. Your patients need to trust that you can provide the best care based on a comprehensive understanding of their patient history. So while a recent study discovered 32 percent of people who visited a doctor within the past 12 months experienced a gap in information exchange, your patients shouldn’t have to worry about the quality of their care if you’ve transitioned their patient information to EMR. You can confidently address your patient’s case and concerns based on a complete and current patient record.
Add Value To Other Parts of Workflow
Surveys show that 60 percent of clinics already have implemented EMRs in their practice, but most have not yet experienced the full capabilities that an interface provides. “The exchange of information through this interface can simplify your daily workflow considerably,” explains April Larson, a practicing dermatologist and director of clinical implementation and advisory board at PathologyWatch. “By way of an HL7 interface, the lab can send reports electronically directly to your patient chart and, in certain instances, populate the diagnosis and treatment, streamlining your review and signoff.”
The adoption of EMR technology minimizes menial, time-consuming tasks for your clinical staff and allows them to participate more in patient care, which increases both staff and patient satisfaction.
Your patients depend on you to provide the best care possible. When you use an EMR system to organize patient information that’s easy to access, update, and share with health services partners, you can focus on what really matters: your patient.
Learn more about the pros and cons of an EMR interface here.
Mar 5, 2021 | Digital Pathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
If you encounter a patient with bumps, typically measuring one to two centimeters wide (though they can be larger in diameter), that formed under relatively normal-looking skin and appear predominantly on the person’s chest, upper arms, neck, face, and legs, it may be steatocystoma.
In this episode of Digital Dermpath Digest, Rajni Mandal, MD, a dermatopathologist at PathologyWatch, discusses distinct features of steatocystoma and how to identify it.
What Is Steatocystoma?
Occurring mainly in teenagers and young adults, steatocystoma is a benign and rare cyst that originates in the hair follicle or sebaceous duct, where the sebaceous gland drains into the hair follicle. When incised, a steatocystoma, often referred to as a sebaceous cyst, will secrete a thick, oily, yellowish fluid, and the area collapses when sectioned.
Signs Below the Surface
But what’s happening below the skin’s surface that makes a steatocystoma so unique?
“Viewed under a digital viewer, the multiplex variant of steatocystoma can be seen with keratin type 17 mutation,” explains Mandal.
The most notable symptom is the cyst’s epidermal lining that has a “red roof” or a “shark tooth” cuticle appearance devoid of a granular layer. “Sebaceous glands also appear in the cyst wall,” says Mandal.
Though the cysts grow slowly, most patients desire to have them removed to avoid infection and discomfort should the cyst become inflamed or burst.
To learn more about this skin condition and other common diseases, join us for each episode of Digital Dermpath Digest right here on pathologywatch.com.
Feb 26, 2021 | Digital Dermatopathology, Digital Pathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
Consider this: An elderly female patient presents with a nodule on her scalp, which has recently grown in size. It currently measures 10 cm in diameter and is ulcerated. What features would you look for in order to diagnose it as a proliferating pilar cyst?
In this episode of Digital Dermatopathology Digest, Rajni Mandal, MD, dermatopathologist at PathologyWatch, explains the characteristics of proliferating pilar cysts.
“Proliferating pilar cysts are most commonly seen in adult women in the scalp,” Mandal says. “Most cases arise from a pre-existing pilar cyst, due to unknown triggers.”
In the video, Mandal goes on to identify the defining features of two categories of proliferating pilar cysts:
Benign Proliferating Pilar Cyst
Cyst epithelium proliferates within the center of the cyst, giving it a “rolls and scrolls” appearance. The proliferating cells are trichilemmal, with small nuclei having smooth nuclear contours and a uniform chromatin pattern. The cyst lining has no granular layer, with abrupt dense, compact, pink keratin formation.
Malignant Proliferating Pilar Cyst
Also known as trichilemmal carcinoma, malignant proliferating pilar cysts differ from the benign version in key ways. In addition to the above characteristics, malignant cysts show cell crowding and cellular atypia (i.e., nuclei of varying size and shape). These cysts display mitotic activity, infiltrative growth, and cytologic atypia.
Whether you’re in residency, studying for board exams, or a practicing dermatologist looking to stay sharp, the Digital Dermatopathology Digest video series is your informational and convenient source for dermatopathology review. Find the full series here.
Feb 19, 2021 | Digital Pathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
A warty dyskeratoma is an uncommon but benign skin lesion, normally presenting as a solitary (sometimes umbilicated) papule on sun-exposed areas of the head and neck. In this episode of Digital Dermatopathology Digest, Rajni Mandal, MD, dermatopathologist at PathologyWatch, explains the common characteristics of a warty dyskeratoma.
“It is an endophytic lesion . . . growing into the skin,” says Mandal. “It can also be cup-shaped and can be centered around a follicle.”
The warty portion of the dyskeratoma presents papillomatosis and hypergranulosis. They also present villi projecting into the lesion, as well as a central keratin plug. You will also find suprabasilar clefting.
In addition to these attributes, Mandal describes the following characteristics:
Acantholytic Dyskeratosis
Warty dyskeratoma is primarily characterized by acantholytic dyskeratosis. Dyskeratosis refers to the premature keratinization of keratinocytes, characterized by dense encephalitic cytoplasm.
Corps Grain and Corp Ronds
Corp ronds are dyskeratotic cells that still have a rounded nucleus. Core grains, on the other hand, are dyskeratotic cells with a flattened nucleus. Both are present in warty dyskeratoma, giving it a similar histological appearance to Darier’s disease.
Whether you’re in residency, studying for board exams, or a practicing dermatologist looking to stay sharp, the Digital Dermatopathology Digest video series is your informational and convenient source for dermatopathology review. Find the full series here.
Feb 12, 2021 | Digital Pathology
The medical industry is turning to the convenience and efficiency of electronic medical records (EMRs) to safely share patient data, increase staff productivity, and reduce paper storage. In fact, 88 percent of providers indicate they gain clinical benefits from their EMR system.
There are specific EMR features for dermatologists that can help your practice to increase productivity and satisfaction. By examining some of these useful tools, understanding the onboarding process, and looking at ways to integrate your software, you can make the most of your EMR system and continue to focus on the health of your patients.
Helpful Features
Your EMR system uses structured data to condense and organize thousands of records into a secure and easily accessible repository. There are special features and shortcuts to help the 85 percent of the office-based physicians who use EMRs to take advantage of this framework.
Some of these features include the following:
- Built-in Templates —Tracking clinical documentation is straightforward, with built-in fields designated for each record. While the provider is free to create additional custom fields, they can also elect to follow along and enter the applicable data into the existing format.
- Body Maps — Providers can use model imagery to document patient visits and pinpoint treatment areas by using thousands of anatomical locations.
- Linking Images — An organized EMR system will keep all of your patient data at your fingertips. This includes pictures of tissue specimens and lab results, which are instantly accessible via secure cloud storage. Going one step further, displaying patient photos in your EMR records can reduce order errors by 35 percent.
- E-Prescribing — Some EMRs make their robust pharmacy software so easy to use, providers can send error-free prescriptions straight to a pharmacy. This simplifies the process for the practice, pharmacist, and, most importantly, the patient.
- Auto-Coding — Providers and staff can save time and ensure maximum reimbursements by allowing the EMR to recommend codes based on different procedures and diagnoses. Additionally, electronic billing will always be attached to the patient’s EHR to make pulling an invoice simple.
- Medical Inventory — Consistent inventory management is significant in meeting the needs of your dermatology practice and patients. Utilizing EMR business processing keeps you supplied and helps to protect revenue.
By utilizing the many built-in EMR features, dermatologists can streamline their workflow and spend more time giving their patients attention.
Onboarding
Once your clinic decides to employ a new EMR system, it’s essential to do so with calculation and precision to avoid rushing the learning process. Because physicians who claim they received inadequate EHR training are more than 3.5 times more likely to indicate their EHR does not help them deliver quality care, the initial training period can be critical to long-term success.
Remember that you’re enlisting the EMR to simplify your workload as a provider and make your staff more efficient so they can spend more time ensuring patients receive the personalized attention they require. That’s why most EMR systems are accessible by laptop or tablet, giving you the flexibility to access files from anywhere at any time. While the software vendors that produce EMR systems strive to make them user-friendly, you should plan on investing time into training to understand how it works. Doing so will enable your dermatology clinic to keep patient data precise and secure while embracing the convenience of digital records.
Integration
Your EMR system’s flexibility to integrate with other software frameworks makes them valuable administrative tools to keep your dermatology practicing running smoothly. For instance, combining with practice management software will enable you to use your EMR to schedule patients, oversee check-in, track medical billing, manage insurance, and monitor financial reporting.
At the same time, 71 percent of healthcare organizations use revenue cycle management solutions with their EMR. Designed to assess and enter accurate case information, these solutions strengthen patients’ financial outcomes and free up time for providers and staff to concentrate on patient care.
Dermatopathology labs like PathologyWatch can also integrate with your EMR to create digital communication with your dermatology clinic. As a result, the lab’s detailed reports interface directly to your patient charts, giving you 24/7 access to diagnoses and digital slides. This electronic workflow eliminates handwritten forms, which can result in fewer errors.
When you examine the EMR features for dermatologists, it’s easy to see why so many providers have made the switch from traditional health record management. With careful consideration of the beneficial features, onboarding process, and integration possibilities, your EMR system can empower you and your team to continue to make the coordination of patient care your highest priority.
Feb 5, 2021 | Digital Dermatopathology, Digital Pathology
Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.
Often mistaken clinically for a more common skin growth like an epidermoid cyst, pilomatricoma is the focus of this Digital Dermatopathology Digest episode with Rajni Mandal, MD.
Pilomatricoma is a benign skin growth that typically occurs in children and young adults. Studies show that around 40 percent of cases happen to patients under age 10, and 60 percent of cases appear before age 20. Interestingly, research also shows girls are about 50 percent more likely to develop a pilomatricoma than boys.
This growth is associated with the somatic mutation of CTNNB1 in the hair matrix cell, which leads to increased beta-catenin (decreased cell adhesion) and uncontrolled cell division through the Wnt signaling pathway.
Pilomatricomas have very distinguishing pathologic features. “The keratin within the center of pilomatricoma is quite characteristic,” explains Mandal. “You can see multiple holes, or ghosts, of the keratinocyte nuclei.”
Although pilomatricomas aren’t painful or malignant in nature, they don’t resolve on their own. Dermatologists may recommend a skin biopsy to rule out cancer—and because they continue to grow and often appear on the head and neck, most patients opt to have them removed.
To learn more about pilomatricoma and other skin conditions, click here for more episodes of PathologyWatch’s Digital Dermatopathology Digest.
