Enterprise imaging is poised to transform healthcare. The impact that unifying patient records and streamlining collaboration for every care team member, regardless of his or her physical location, is likely to be significant. Widespread adoption of enterprise imaging in fields like radiology have already begun to change the way we think about patient care while quietly setting the stage for the incorporation of new tools like big data analysis.
Despite the advancements in enterprise imaging, a glaring gap persists: pathology. Cancer care is perhaps the largest challenge facing healthcare today. Pathologists provide the definitive diagnosis in cancer cases, yet pathology has been left to practice in isolation, disconnected from the rest of the care team. Incorporating digital pathology into the enterprise imaging mix—along with molecular and genomic testing—could mean that all of the benefits we expect to see in enterprise imaging facilitate advancements in the way we diagnosis and treat cancer.
When the healthcare industry discusses enterprise imaging and digital pathology, we too often summarize the benefits of this change as being more efficient. That word, efficient, carries a lot of weight for those of us within the industry. We understand the potential impact that eliminating the delay of shipping glass slides or having to wait for a remote facility to package and send patient files could have on care.
However, if an individual has never had to evaluate the big picture view of patient care—the dozens of moving parts, people, and locations that can go into treating any single patient—discussing enterprise imaging in terms of efficiency could woefully undersell the true value that this transformation represents.
Cancer care is the perfect example because of how high the stakes can be at every stage of care, from diagnosis to treatment. Dozens of experts contribute to the care of any single patient, generating a staggering volume of records, notes, and test results.
Without imaging, pathology is limited to evaluating glass slides and managing physical case files, leaving a glaring gap in the digital patient record. If the care team wants to discuss a slide, the slide either needs to be viewed through an awkward video microscope set-up or hand-mailed to another location. Files can be lost. Details can be overlooked. And the pathologist, the source of the definitive diagnosis in cancer care, cannot easily participate in conversations about the patient and his or her care. Even if a lab adopts digital pathology to escape analog challenges, much of the potential of digital pathology is not realized if enterprise imaging is not part of the solution.
Digital pathology fills a gap in enterprise imaging, especially with respect to cancer care. Slide images can easily be annotated and shared. The pathologist can quickly access the patient’s full medical history (because all other aspects of the patient record are accounted for as well in enterprise imaging). And the care team can access all of this information in real time when they meet, either in person or remotely, to discuss a case.
In this context, efficiency can potentially mean a more accurate diagnosis and treatment plan. We already know that Tumor Boards of Multidisciplinary Medical Teams (MDTs) lead to a change in 9 percent of surgical plans.1 We also know that 7 percent of radiological and pathology reports on the same patient state discordant findings, suggesting a significant need for collaboration and conversation between care team members.2
These differences and changes are not a result of uncovering ineptitude within care teams. In actuality, they result from identifying missed opportunities or gleaning new insights that are only possible when multiple specialists dialog. Each specialist brings a unique context to the table resulting in a care team experience that is far greater than the sum of its parts.
Jan Beger, who works within GE Healthcare IT’s Europe Enterprise Imaging organization, described the value and function of MDTs in his recent blog, saying. “One of the main functions of MDT meetings is to offer patients the best care available from the consensus of the numerous specialists while following clinical guidelines. In other words, the MDT meeting helps to enhance dependability for the patient care pathway.”
Beger goes on to say that, according to the research, 70 to 80 percent of errors in healthcare can be attributed to poor communication,3 highlighting a clear and urgent need for improving collaboration overall to the level that we see in MDTs.
This is the true potential of improving efficiency with enterprise imaging and digital pathology. Accelerating workflows, managing more cases, reducing costs—these efficiencies matter and translate to real value for patients, but the ultimate end-game culmination to these improvements is enhanced outcomes. The more we can talk about efficiency in those terms, the more we can illustrate the potential and urgency of adopting digital pathology across the enterprise.
- Lee J-M, Kaplan JB, Murray MP, et al. Imaging Histologic Discordance at MRI-Guided 9-Gauge Vacuum-Assisted Breast Biopsy. American Journal of Roentgenology. October 1, 2007 2007;189(4):852-859
- Newman EA, Guest AB, Helvie MA, et al. Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board. Cancer. 2006;107:2346–2351.
- Arnaudova and Jakubowski. Eighth futures forum on governance of patient safety. World Health Organization Regional Office for Europe. 2005.