By April Larson, MD

 

The digital transformation of the field of pathology brings many advantages to dermatologists. Doctors who utilize digital pathology services may experience a 50 percent faster turnaround time and 40 percent more efficient workflow, so it’s no wonder that there is a demand for these services. But some dermatologists are reluctant to try digital pathology for a variety of reasons. Whether it’s loyalty to their current dermpath, worries about slide quality or cost, or simply a lack of exposure to digital trends, there are a variety of barriers. 

To better understand these barriers and dermatologists’ current pain points, we recently partnered with The Solution Lab and conducted a survey and in-depth interviews of licensed dermatologists across the United States. Following are some of the key findings from the study.

 

Finding Opportunities to Try New Technology

There is clearly a future for digital pathology within dermatology. The dermatologist survey found that 65 percent of respondents receive their pathology reports via fax. However, those surveyed also indicated that given the choice, the majority (64 percent) would prefer EHR integration or a web-based lab portal.

Why the gap? Dermatologists may simply need additional education regarding the availability and implementation of digital pathology. For some dermatologists, this may mean better education on the significant advances in and clinical utility of digital pathology. For dermatologists in rural areas, this may mean better awareness of EHR vendors and dermatopathology labs that provide opportunities for integration. Many dermatopathology labs have not yet embraced EHR integration and still prefer to send results via fax, so dermatologists using these labs do not have the option of integrated reporting.

whole-slide imaging Dermatologist Survey

According to the dermatologist survey, there is clearly a future for whole-slide imaging and digital pathology within dermatology.

 

Reducing Turnaround Time

Among most dermatology clinics, there are a couple of major time-saving opportunities associated with digital pathology. First, the turnaround time for 60 percent of doctors from taking a biopsy to receiving pathology reports for routine cases is five days or more. This time extends when additional stains or an outside consultation is required. Digital pathology, with the ability to share slides more widely or with an expert dermatopathology network, could help improve those turnaround times. In fact, PathologyWatch has used digital pathology to reduce turnaround times to as little as 48–72 hours from the time of biopsy.

Also, 21 of the 24 providers surveyed agreed that EHR integration could significantly reduce office staff time required to manually input data into the EHR. PathologyWatch users have seen this input time reduced by as much as 15 percent.

 

Improving Convenience

In the dermatologist survey, a majority of dermatologists reported that they would like the ability to see or search an archive of cases digitally. 

  • 80 percent of those surveyed said they would like access to digital slides to view alongside their pathology report.
  • 71 percent want the ability to see and/or search their pathology slides from anywhere, at any time. 
  • 71 percent would like the ability to send cases out digitally to other providers.

Interview respondents added context to these potential use cases:

One provider from Massachusetts had little interest in digital pathology until a patient needed slides sent to a specialist: “I didn’t have an efficient way of sending slides since this hadn’t come up before. At that moment, I wished I had the ability to send digital slides.”

“Digital slides would allow me to review more slides,” said another respondent from California. “I work in multiple offices and the slides are only in one, leading to difficulty with access.”

For dermatologists who don’t currently review their own slides, digital pathology offers the opportunity to review slides without needing other expensive equipment.

Nearly 50 percent of surveyed dermatologists would like digitized slides for cross-referencing reports. In fact, 90 percent of respondents said that the ability to cross-reference with a written report would influence them to view slides more frequently.

Whole-slide imaging Dermatologist Survey

For participants in the dermatologist survey who don’t currently review their own slides, digital pathology offers the opportunity to review whole-slide images without needing other expensive equipment.

 

Expanding Access to a Network of Experts

Patients and dermatologists alike could benefit from greater access to expert dermatopathologists. That’s one compelling reason to take advantage of digital dermatopathology. In the survey, 70 percent of respondents noted they would like their cases to be read by more experts nationwide. 

Pathology experts and Dermatologist Survey

Over 70 percent of the respondents in the dermatologist survey disclosed that they would prefer to assign cases to pathologists of their choice.

 

Over 70 percent also disclosed that they would prefer to assign cases to pathologists of their choice. That’s understandable; professional and personal relationships are strong, and it’s important for dermatologists to trust the experts with whom they consult. 

To improve clinical outcomes, it may be important to expand and connect the network of expert dermatopathologists around the country. This doesn’t mean abandoning professional and personal relationships—it means taking advantage of technology to form new relationships and collaborations. Many large dermatopathology labs use multihead microscopes to review cases with each other. Digital pathology makes it even easier for pathologists to review cases collaboratively, just like dermatologists are able to share photographs of difficult cases with each other. 

PathologyWatch’s mission is to preserve and extend life for patients while reducing the cost of healthcare, and many dermatologists share that same mission. As these dermatologist survey results suggest, while there are some barriers to adopting WSI or integrating EHR, there are significant benefits. Reducing turnaround time, improving convenience, and expanding access to experts are all benefits that can come when dermatologists adopt these technologies.