Here’s a summary of our interview with Bilal Ahmad, MD, Chair of Spectrum’s Digital Pathology Innovation and Compliance Committee, featured in the December 2024 issue of Laboratory Economics.
Where does Spectrum stand in its rollout of digital pathology for clinical diagnostics?
Our first whole slide imaging hospital client, Central Maine Medical Center (Lewiston, ME), installed its first high throughput scanner and our pathologists began digital sign outs last month.
CMMC has 250 beds and processes about 100,000 slides per year. Spectrum has two full-time pathologists based at CMMC.
A second client, NorDx (Portland, ME), will be installing its first scanner at its flagship Maine Medical Center (Portland, ME) within a few months followed by several more at its central location in Scarborough. MaineHealth Maine Medical Center Portland has 700 beds and NorDx processes more than 450,000 slides per year. Spectrum has 12 full-time pathologists based at MaineHealth Maine Medical Center in Portland.
Initially, slide scanning at both hospital sites will focus on prostate, breast and gastrointestinal biopsies. Our goal is to convert to 100% digital sign outs within the next 12 months.
Which type of scanners are being used?
We’re using Pramana’s SpectralHT scanners which can digitize one slide every few minutes. We chose Pramana because it has unique volumetric scanning technology that produces highly detailed fused z-stack images at the tile level with built-in quality assurance. In addition, we’re using Proscia’s image management software and Microsoft Azure for cloud-based image storage.
How are you handling intra-operative frozen sections?
We recently installed four PreciPoint iO:M8 digital live microscopes at several NorDx labs for remote interpretations of frozen sections and rapid on-site evaluation (ROSE) of cytologic preparations.
What is your estimated average cost to digitize a slide?
Somewhere in the range of $5-7 per slide, including labor, scanning, image management and storage.
What factors led Spectrum to shift to digital pathology?
Pathologist and PA shortages are a big issue in Maine and New Hampshire. Post-pandemic burnout and fatigue have led some older pathologists to accelerate their timetable for retirement or enter into modified work plans. But the potential for digital sign outs from home is enticing some of our retirement-age pathologists to continue working three or four days per week. It’s also a big draw as we compete to hire new pathologists and PAs.
What are some other benefits of switching to digital pathology?
A major portion of our return on investment (ROI) will come from the application of AI. We anticipate applying AI initially to prostate core biopsies. AI should help raise pathologist productivity in detecting and grading tumors and may also eliminate the need for a second review of all negative cases. Ultimately, pathologists using AI will have a big advantage (e.g., accuracy, productivity and turnaround time) over those that cling to the microscope.
What’s the outlook for reimbursement of digitizing slides?
It’s irrelevant. Some pathology groups are waiting for Medicare to set reimbursement for the CPT Category III add-on codes, but this could take years. You’ll be left behind if you wait too long. Start small, iterate, and get involved now.
