Implementation of Digital Pathology Offers Clinical and Operational Increase in Efficiency and Cost Savings
Implementation of Digital Pathology Offers Clinical and Operational Increase in Efficiency and Cost Savings
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DOI：
10.5858/arpa.2018-0514-oa
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发表时间：
2019-12-01
影响因子：
4.6
通讯作者：
Sirintrapun, S. Joseph
中科院分区：
文献类型：
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作者：
Hanna, Matthew G.;Reuter, Victor E.;Sirintrapun, S. Joseph
背景-基于预期操作的目标，数字病理学(DP)的实施在规模上各不相同。很少有实验室完成全面的DP实施，这可能是因为高昂的管理成本扰乱了传统的病理工作流程。尚未发布标准化标准和基准数据，显示实施DP平台后的实际投资回报。目标：提供基准数据和实用指标，以支持大型学术中心的运营效率和成本节约。设计-审查的指标包括存档的病理资产检索；复发/转移性疾病的辅助测试请求；成本分析和周转时间(TAT)；以及DP体验调查。结果-部门幻灯片档案库和非现场手术中心的玻璃幻灯片请求分别减少了93%和97%。辅助免疫组织化学订单，与2014年(52%)-实验室信息系统提供完整幻灯片图像(WSIS)之前-和2017年(21%)相比，预计每年节省11.4万美元。综合比较成本分析显示，5年内节省了130万美元。既往有WSIS的手术切除病例的TAT下降了1天。DP体验调查显示，80%的受访者同意WSIS改善了他们的临床注销体验。结论-实施DP操作显示出显著的效率和操作效用的提高。数字病理部署和操作可以通过以下指标来衡量：随着WSIS的推出，玻片请求的数量，对转移/复发疾病患者的确证测试减少，非现场病理资产成本的长期下降，以及更快的TAT。其他部门可能会使用我们的基准数据和指标来加强患者护理，并展示投资回报，以证明采用DP是合理的。
Context.-Digital pathology (DP) implementations vary in scale, based on aims of intended operation. Few laboratories have completed a full-scale DP implementation, which may be due to high overhead costs that disrupt the traditional pathology workflow. Neither standardized criteria nor benchmark data have yet been published showing practical return on investment after implementing a DP platform.Objective.-To provide benchmark data and practical metrics to support operational efficiency and cost savings in a large academic center.Design.-Metrics reviewed include archived pathology asset retrieval; ancillary test request for recurrent/metastatic disease; cost analysis and turnaround time (TAT); and DP experience survey.Results.-Glass slide requests from the department slide archive and an off-site surgery center showed a 93% and 97% decrease, respectively. Ancillary immunohistochemical orders, compared in 2014 (52%)-before whole slide images (WSIs) were available in the laboratory information system-and 2017 (21%) showed $114 000/y in anticipated savings. Comprehensive comparative cost analysis showed a 5-year $1.3 million savings. Surgical resection cases with prior WSIs showed a 1-day decrease in TAT. A DP experience survey showed 80% of respondents agreed WSIs improved their clinical sign-out experience.Conclusions.-Implementing a DP operation showed a noteworthy increase in efficiency and operational utility. Digital pathology deployments and operations may be gauged by the following metrics: number of glass slide requests as WSIs become available, decrease in confirmatory testing for patients with metastatic/recurrent disease, long-term decrease in off-site pathology asset costs, and faster TAT. Other departments may use our benchmark data and metrics to enhance patient care and demonstrate return on investment to justify adoption of DP.