Laboratory News

Small Pathology Groups Can Benefit from New Digital Technology

After publication of our bi-annual list of macro trends in anatomic pathology (AP) in The Dark Report  earlier this month, a number of clients commented on the rather gloomy conclusion that the market share of community-hospital based pathologists was being eroded by a horde of competitors for the same AP specimen referrals. But several readers noted to us that digitization of pathology images and integrated informatics were tools that could allow smaller pathology groups to not only protect their access to specimens, but even expand their market share.

Dark Daily concurs with both assessments. The fact is that evolution in the anatomic marketplace, on balance, is moving against the traditional business model of the generalist pathology group practice, anchored in a community hospital. That is a major conclusion drawn from analyzing the 15 macro trends in anatomic pathology presented in the February 11 issue of The Dark Report. Yet, there is one trend that holds the potential to make these smaller pathology groups more competitive. It is digitization of pathology images and integration of pathology informatics with other sectors of healthcare. After all, if overnight delivery can transport a specimen anywhere in the world in a timely fashion, then digitization of the images and the report can allow a pathologist to read these images and issue a diagnosis from almost any location on the planet.

For example, local pathology groups can use digital technology to eliminate the need for the pathologist to travel from site to site and hospital to hospital in order to view glass slides at each location. Use of sophisticated imaging and testing equipment can also allow subspecialist pathologists in smaller groups to handle cases referred regionally or nationally.

There is steady progress in developing new pathology systems that can enable a pathologist to work remotely and view digital images hundreds of miles away, panning and zooming with a mouse while viewing the images on a computer screen-rather than viewing images under a microscope. This technology has positive implications for a pathology profession soon to face a labor shortage. That's because working remotely with digitized pathology images eliminates travel and saves shipping costs.

"A pathologist who spends his morning at one hospital and then goes across town to read slides at another facility may not have to make that drive anymore," said Ole Eichhorn, Chief Technology Officer of Aperio Technologies Inc , a company in Vista, California, that specializes in digital pathology. "Pathologists in rural areas who literally spend every day of the week in a different location don't have to do that anymore. It has the potential to have a significant impact on the lab industry as it becomes more familiar to pathologists."

This same technology can foster collaboration over the Internet just as if several pathologists were in the same laboratory using a multi-headed microscope. The only difference is that the collaborating pathologists work at some of the most prestigious universities. That's the idea being developed at Clarient Inc , in Aliso Viejo, California, says Kenneth J. Bloom, M.D., FCAP, Clarient's Chief Medical Officer and Medical Director.

"We use virtual microscopy as a tool to empower the local pathologist to become more competitive," explained Bloom. "This allows them to remain local and gives them access to expertise by connecting them to pathology experts around the country. By utilizing Clarient's laboratory services, the local pathologist doesn't have to hire more staff. That helps them solve the workforce shortage problem that many labs face today. And, because they don't have to invest in new equipment, they can conserve capital." Pathologists send specimens to Clarient, which performs and bills for the technical component (TC) while the referring pathologist interprets the results and bills for the professional component (PC).

These are just two examples that demonstrate how advances in information technology and the digitization of pathology images have the potential to restore a competitive edge to pathologists in community hospital-based pathology groups. Because healthcare remains a local business, using these types of productivity tools can help such pathologists counter the national lab sales reps that call on office-based physicians in their community. That can be a welcome equalizer in the intensively competitive market for anatomic pathology specimen referrals.

Related Information

• Powerful Trends Reshaping Anatomic Pathology Profession
  The Dark Report, Vol. XV, #2, February 11, 2008 
• Image Analysis in Healthcare: Taking the Subjectivity Out of Specimen Analysis
• IT Challenges Don't Drown the Drum of Digital