Depends on who controls the specimens and the practice setting. Slide scanning can be quite fast and automated, and there doesn't have to be a capital investment on the part of a practice or a hospital. Send the slides to a scanning company and for a cost per slide they will scan and store them for remote access. At that point you could have the lowest bidding state-licensed pathologist read it. It may be cost effective for pod lab-type specimens. For small hospital systems, as you point out, it doesn't make financial sense.
Cool. Costs $5, at most, to make a glass slide taking all your fixed costs into account.
What's it going to cost to have a dedicated IT support team, site and off-site licenses for proprietary viewing software, and routine server expenses and maintenance for these very large files? In addition, what's the difference in turn around time between just making the slide and reading it the old fashioned way versus loading it into the machine to be scanned and uploaded for review? And last time I checked, you still need to make the glass slide for this big deal of a digital wonder to happen.
This is a neat concept, but won't supplant the microscope any time soon because the one time cost of a $20,000 microscope (and that's if you get fancy) over a pathologist's career is far cheaper than running a whole IT operation just to read the same slide digitally. I'd just like to see a group trying to get their hospital administrator to approve this one.
Depends on who controls the specimens and the practice setting. Slide scanning can be quite fast and automated, and there doesn't have to be a capital investment on the part of a practice or a hospital. Send the slides to a scanning company and for a cost per slide they will scan and store them for remote access. At that point you could have the lowest bidding state-licensed pathologist read it. It may be cost effective for pod lab-type specimens. For small hospital systems, as you point out, it doesn't make financial sense.
Still, most pod-lab setups require that the pathologist sign out the case at the physical location where the billing takes place. In most of those instances the TC is already outsourced to a lab somewhere, and the PC is all that happens at the pod lab office. The pod lab already essentially hires pathologists at the lowest going rate. I don't see how this would lower that rate for the PC component.
I'm being a bit ridiculous here for the sake of discussion, but if scanned slides can be used for diagnosis, then wouldn't I be billing where I am reading the slide which would be at my computer? I agree that most of those pathologists are earning only a small fraction of the revenue they generate, but it would allow an even larger cohort of pathologists to be available to sign out a given case which could possibly contribute to the "race to the bottom". If I wanted to make money a few hours on the weekend or on sleepless night, instead of being an Uber driver, I could log in and sign out a few dozen cases?
As far as creating digital slides and bypassing glass, that is not what this story is about, though I am certain it will be done in the future somehow...FDA approval for that would probably be much more challenging.
Remote reading does not benefit all pod , GI labs or other situations trying split PC. Clearly it can help some practices.
In these situations, the pathologist can only work off site if they are more less full time (at least 75% of their time is devoted to that practice).
If you intend to read MC or government cases. Otherwise they have to be on site.
I suspect a few clever business folks will now do this only for the commercial insurance. The lab makes TC and Bills.
The pathologist is merely is off site for the PC and the split the PC.
I call it the new style client billing. In some states this could be illegal especial if the are not providing space and equipment.
I'm being a bit ridiculous here for the sake of discussion, but if scanned slides can be used for diagnosis, then wouldn't I be billing where I am reading the slide which would be at my computer? I agree that most of those pathologists are earning only a small fraction of the revenue they generate, but it would allow an even larger cohort of pathologists to be available to sign out a given case which could possibly contribute to the "race to the bottom". If I wanted to make money a few hours on the weekend or on sleepless night, instead of being an Uber driver, I could log in and sign out a few dozen cases?
As far as creating digital slides and bypassing glass, that is not what this story is about, though I am certain it will be done in the future somehow...FDA approval for that would probably be much more challenging.
I've found a smartphone based whole slide imaging app, really low-cost and convenient, but what I am always concerned about is whether the whole slide image like this can be used in telepathology...
For such a long time, I've just used this app to save the slide samples for future review of these pathological cases, did save me from piled up glasses.
Still looking for better solutions...