Other topics of keen interest at the meeting were digital pathology, whole-slide imaging, and the role of pathology informatics in healthcare ‘big data’
PITTSBURGH, PENNSYLVANIA—During their annual meeting here last week, pathologists who are members of the Association for Pathology Informatics (API) made it clear that they are prepared to support fast and radical changes to anatomic pathology and clinical pathology.
Several speakers called attention to specific threats already disrupting the long-established model of the private pathology group practice. There was also no disagreement that cuts in fee-for-service reimbursement for key anatomic pathology CPT codes were already eroding the financial stability of many pathology practices and pathology lab companies.
Urgent Need for Pathologists to Actively Sell Value of Pathology
One speaker who issued such a call to action was Michael J. Becich, M.D., Ph.D., Chairman, Department of Biomedical Informatics at the University of Pittsburgh Medical Center (UPMC). “We all recognize the value that a pathologist delivers to physicians when it comes to diagnosis, using lab test results to determine appropriate therapies, and in monitoring a patient’s progress,” he observed. “What is urgently needed is action by pathologists to be at the table and to be armed with compelling evidence about how patient outcomes can be improved, even as the healthcare system—through improved use of lab tests—is able to control and cut the overall cost of these healthcare encounters.”
Becich asked attendees to be bolder in taking this message to their parent organization’s clinical and administrative leadership. “Each of us has access to the specific data and clinical information necessary to document the power of clinical laboratory testing and anatomic pathology services—when properly utilized by clinicians—to deliver big gains in patient outcomes and the associated costs of care,” he noted. “The transformation of healthcare is already happening, which is why the time for action is now in order to preserve and enhance the role of pathologists in the clinical care continuum.”
Big Data and Digital Pathology Were High-Interest Topics
Other sources of opportunities for pathologists to add value were the subject of multiple presentations during the four days of the Pathology Informatics 2014. “Big data” was described as a trend that “plays to the strengths of pathologist-informaticists,” stated Walter H. Henricks, M.D., Director, Center for Pathology Informatics at the Cleveland Clinic. “As health systems more fully integrate their information systems, this will make it easier for pathologists to access all the clinical and patient information required to support data mining on a much larger scale than was possible just a few years ago.”
Considerable time and attention was also devoted to digital pathology. A number of speakers on this topic agreed that the pace of development and clinical acceptance of digital pathology has disappointed its advocates. Yet, advancements in technology and improvements in the performance of digital pathology systems have been regular and ongoing over the past decade.
Regulators Slow to Respond to Digital Pathology Systems
Relative to Canada and Europe, U.S. government regulators, such as the FDA, have been slow to respond to vendor applications requesting market clearance for their digital pathology products. In his presentation, Stephen M. Hewitt, M.D., Ph.D., Clinical Investigator in the Laboratory of Pathology at the National Cancer Institute, urged the profession to do two things.
“First, it is time for the digital pathology industry to publish papers in peer-reviewed journals that have the full detail and depth of evidence in precisely the areas that the FDA uses to assess new technologies,” he said. “Not only does this help educate the decision-makers within the agency, it is credible evidence in the public domain about the quality and performance of digital pathology systems in support of high-quality patient care.
“Second, the digital pathology vendors must take the initiative to file more premarket applications with the FDA,” added Hewitt. “This is helpful because a larger volume of applications creates the need for the agency to devote resources to understanding digital pathology technology, then moving these applications to a decision.”
LIS Assessment Tool Kit Available for Use by Clinical Labs
One interesting resource developed by API was showcased during Thursday’s general session. It is the “LIS Functionality Assessment Tool Kit.” Leading this presentation were Andrew R. Splitz, President and CEO of S&P Consultants, Inc., of Boston, Massachusetts, and Bruce A. Friedman, M.D., Emeritus Professor, Department of Pathology at the University of Michigan School of Medicine in Ann Arbor, Michigan.
“This LIS assessment toolkit can be used by any laboratory to match its unique needs with the features and performance of its existing laboratory information system,” stated Splitz. “More importantly, anytime a clinical laboratory is considering an upgrade or replacement for its existing LIS, this assessment toolkit has been designed specifically to help the laboratory draw up a request for proposal (RFP) that is a clear, detailed, and [provides a] complete description of the specifications they seek from their new LIS.”
Friedman noted that the LIS assessment tool kit addresses 850 specific functions, features, and performance capabilities. “Since API made this LIS assessment tool available on its website, some LIS vendors have developed responses to the functions included in this report,” he said. “In fact, McKesson was one of the first companies to post information on how its LIS relates to all 850 functions listed in the LIS assessment tool kit.”
Stewards of Lab Test Data at Nation’s Biggest Medical Centers
Many API members are the stewards of clinical lab test data at the nation’s largest and most respected academic medical centers. They are daily engaged in projects with their parent organizations’ information technology departments to support the operation of electronic health record systems, develop rules-based clinical care algorithms, and help in the analysis of clinical data to track utilization and patient outcomes.
That is why the annual API conference is a good place to see and learn how leading health systems and laboratories are using information technology to develop new ways that clinicians can use laboratory test data to develop more accurate diagnoses and improve therapeutic decisions.
Your Dark Daily Editor,
Robert L. Michel