Jul 22, 2020 | Digital Dermatopathology, Digital Pathology
What is the single most innovative technology you are currently delivering to health systems or medical groups?
We deliver digital pathology services and EMR integration solutions to dermatology clinics in many locations. Dermatologists are able to discuss cases with expert pathologists from many different locations in a way that has never been done before. We’re also developing AI tools that are specific to dermatopathology. Ultimately, humans and the AI working together in pathology will mean lives saved, and we’re at the beginning of this process.
How is your product or service innovating the work being done in these organizations to provide care or make systems run more smoothly?
PathologyWatch greatly reduces the amount of time spent on duplicating data between systems—the reports are accurately and automatically entered into the dermatologist systems. We’re eliminating the faxed reports and walled-garden report access. Digital pathology and EMR integration alone have streamlined clinical workflows and improved the quality of care within dermatology clinics.
What is the primary need fulfilled by the product or service?
The primary need is improved quality of care with decreased cost. We are attacking this problem in the narrow field of dermatology/dermatopathology, but the principles and technology can be expanded well outside of that area. We plan to expand from dermatology to other fields of outpatient medicine within the next two years.
What is the ROI of said product or service?
Our clients have seen up to 75 percent decrease in sample turnaround time, as well as up to 75 percent decrease in the time it takes for physicians to review pathology reports (per internal case study reports).
What are some examples of implementation and outcomes use cases?
- Improved operational efficiency with digital workflows
- Improved patient satisfaction as the physician and patient review pathology together
- Improved patient outcomes because of faster turnaround times
- Improved staff efficiency
(For more information, see the Allen-Taintor and Prairie Lakes Healthcare case studies.)
Who are some of the clients and organizations served by the company?
How has innovation advanced the field of healthcare or the practice of care?
- Increased availability to high-quality care in underserved areas: Geography is no longer a limiting factor, providing opportunities for underserved areas to receive academic-level dermatopathology reads.
- Improved speed and availability of samples for improved patient outcomes: Dermatologists are able to view their slides 24/7 digitally with a web browser (on-demand ability to correlate with pathologic findings).
- Expanded access: Forty-five percent of the world does not have access to cancer diagnostics. AI has the potential to solve this problem.
How is innovation changing lives specifically?
Through patient education, patients are now able to better understand why they do or do not need surgery, because physicians can display the digital pathology images for them. Patient diagnoses are improved, as dermatologists can more quickly and easily correlate pathologic findings with clinical features. Patients are more satisfied with their care, as they are receiving answers more quickly, especially in difficult cases where consultations would normally take additional days or sometimes weeks.
What is the company’s go-forward strategy? What’s next? Which problem is the organization working on now and in the future?
We’re focused on optimizing workflows and technology specific to dermatology and dermatopathology. We plan to expand into other areas of pathology in the future, as well as work to solve the lack of access to pathology globally through the utilization of AI. Ultimately, our goal is to provide affordable, available, and accurate diagnoses to the world’s population.
What are the most significant lessons learned by delivering the innovation, product, and/or service to health systems and/or medical groups?
- Healthcare systems are extremely difficult to work with, as they sometimes employ outdated systems with limited ability to quickly and easily adapt to current technological changes.
- Very few successful healthcare companies are “just software.” You can’t build it and expect they will come. It takes making the right relationships with payers and providers.
- As the healthcare industry continues its digital transformation, significant opportunities exist to improve patient outcomes and improve the efficiency and effectiveness of the overall healthcare system.
- There are many ways to build algorithms. Think long and hard about your end-use case when architecting it and deciding whether to take a supervised or unsupervised approach to building out your algorithms.
Jul 13, 2020 | Digital Dermatopathology, Digital Pathology
Dermatology patients rely on their physicians to provide accurate diagnoses and effective treatment plans. With three out of four providers indicating electronic medical/health (EMR/EHR) systems enhance patient care, integration with pathology reporting is a valuable transition every clinic should consider.
You want the most cost-effective and reliable method to link information between your dermatology clinic and the laboratory’s lab information system (LIS). By breaking down the limitations of traditional paper communication, learning about interfaces, examining the two types of integration, and understanding the interface challenges, we’ll cover all of the basics you need to know about integrating an electronic interface to elevate your practice and improve patient care.
Traditional Paper
Many dermatology clinics continue to rely on traditional paper when it comes to lab correspondence. When ordering tests, these practices handwrite requisition forms and manually create carbon copies, so a record stays in the office. Once received by the lab, the requisition information is typed into the LIS and matched to the biopsy. When the lab completes the patient report, the paper is attached and sent back to the clinic via fax, mail, or courier.
The exchange of paper between clinics and labs is tried and true for many; however, it does open the door to certain errors that can impact patient care, such as the amount of time it takes to write out forms and re-enter the same data into the LIS. The longer it takes to process and receive information, the longer it will take a patient to receive a diagnosis. It also increases the chance for errors to occur during user translation. Repeatedly entering the same data into patient records invites opportunities for human error. Despite these drawbacks, many clinics continue to use paper as a standard, especially if an efficient electronic health record is not being utilized.
Interface Benefits
While working with paper can lead to inaccuracies or delays, an electronic interface can decrease turnaround times and errors. These benefits appeal to tech-savvy dermatologists, who have a 63 percent adoption rate of EHR technology.
A significant benefit of integrating the clinic EHR with pathology reporting is that fields and data entered into one system can communicate with an entirely different system. As a result, users from the clinic and the lab can search the same patient data or perform quality lookbacks through their EMR using their current systems. This reduces data entry errors and can also allow for identification of improperly labeled specimens, reducing patient risk.
Types of Interfaces
Choosing the right electronic interface can help increase a lab’s efficiency and workflow.
There are two types of interface for you to consider: unidirectional and bidirectional. A unidirectional interface can only transmit information one way. It can either send orders from the clinic to the lab or receive results from the lab to the clinic. The latter requires clinics to continue to submit paper orders.
Using a bidirectional interface provides a convenient two-way line of communication between the clinic and the lab. Sending and receiving digital orders can reduce time and mistakes, though a bidirectional interface requires programming for both locations. Both types of interfaces are utilized with success, depending on the unique workflow of each practice.
System Setup
Once an electronic interface is selected, real work is required before it can be activated. As more than half of dermatologists see over 50 patients per day, the initial investment of time and effort will pay off in the long run with productivity and dependability.
Interfaces are not simple plug-and-play systems. Individually coded, they require IT support to set up a secure line using a unique virtual private network (VPN) or other similar structure. Programmers use health language 7 (HL7) to reliably transfer patient records and study orders between the clinic and the lab. Full-service dermpath labs like PathologyWatch are designed to shoulder the burden of integrating an electronic interface into your practice.
Today’s EMR systems are full of complexities and functionality, with one leading vendor providing 3,100 automated treatment plans and procedures for dermatologists. By looking at the differences between a paper and digital workflow, exploring different types of integration, and understanding installation, you can assess whether integration with pathology reporting can help you get the most out of your EMR and your practice.
Jun 29, 2020 | Digital Pathology, Meet The Team
April Larson received her medical degree from the University of Utah and completed a research fellowship at the Tom C. Mathews Familial Melanoma Research Clinic at the Huntsman Cancer Institute. Since completing a dermatology residency at Dartmouth-Hitchcock Medical Center over ten years ago, she has devoted herself to patient care. April, who is currently director of the clinical advisory board and clinical implementation at PathologyWatch, always had a desire to pursue medicine; both her father and older brother are plastic surgeons. While she was itching for a career in medicine, her first choice was family practice. It wasn’t until she met an intern during her first rotation in her third year of medical school that she changed her mind about dermatology—and the connection was instantaneous.
Can you describe that defining moment when you knew dermatology was the right choice?
I heard a lecture by Sancy Leachman, MD, PhD—this charismatic, amazing physician-scientist—as she described how the first melanoma gene was identified. She told this compelling story of everyday events and interactions that led to an advance in the understanding of melanoma cancer genomics. The impact of that discovery struck me. It was my first encounter with academic medicine. I eventually worked as a research fellow for Dr. Leachman in her melanoma clinic.
How did that experience impact your work with PathologyWatch?
This opportunity is helping me get back to my roots in academic medicine: to use science to improve our diagnosis and treatment of patients. When we are talking about patients’ lives, can we be satisfied with 75, 80, or even 95 percent success? In medicine, we will always be searching for better ways of taking care of patients. That’s the idea: trying to push forward the knowledge we have to improve patient care. It’s how you can have a more significant impact on people. As the director of the clinical advisory board and clinical implementation at PathologyWatch, I am focused on advancing patient care and access by using technological solutions to enhance the laboratory services offered to dermatologists and their patients, both nationally and globally.
Based on your experience as a former client, how do you believe PathologyWatch is instrumental in helping dermatologists improve patient care?
We achieve this in two ways. First, I see digital pathology as a key to improving dermatology diagnostics through the enhanced correlation of microscopic and clinical skin findings. We provide digital slide images that are easily reviewed in real-time as dermatologists are making critical decisions for their patients.
Second, we help improve dermatology processes by integrating with many EMRs, which streamlines the clinical workflow. Sometimes, the technology that is supposed to help us ends up slowing us down or gets in the way of patient interaction. I understand the stresses and pressures that regularly happen in these dermatology clinics. And I know dermatologists and their staff are trying to provide the best care in a fast-paced environment. I want to help my specialty get it right 100 percent of the time.
This ultimately translates to providing optimized care and spending more time with patients, where we feel the most joy and connection in our jobs. This is what drives me.
My favorite part of being a dermatologist is the relationship I develop with my patients. You learn to trust each other. It’s a unique relationship as you help them make decisions for their care.
As a dermatologist, what are the rewards of working at PathologyWatch?
I feel fortunate to be a part of this fantastic team and to be surrounded by intelligent, kind, hard-working individuals, each using his or her expertise toward a common goal. I am learning so much about all these different aspects of medicine and business and computer science. It’s exciting to see what the combination of technological advances and human intelligence can do for medicine, which before was just science fiction. I also love interacting with other dermatologists, helping them find what works for them and improves their practice, which I hope leads to more success and joy in their work lives.
What do you do when you are not working?
I live with my husband and four children in southern Utah. My family spends a lot of time boating and playing outdoors.
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.
