From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Arch Pathol Lab Med. 2019 Dec;143(12):1545-1555. doi: 10.5858/arpa.2018-0514-OA. Epub 2019 Jun 11.
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.
数字病理学(DP)的实施规模因预期操作目标而异。很少有实验室完成了全面的 DP 实施,这可能是由于高运营成本扰乱了传统的病理学工作流程。尚未发布标准化标准或基准数据,表明在实施 DP 平台后实际投资回报。
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。
审查的指标包括存档的病理学资产检索;用于复发性/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 经验调查。
来自部门幻灯片档案和场外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%)-在实验室信息系统中提供全幻灯片图像(WSI)之前-和 2017 年(21%)相比,预计每年节省 114,000 美元。全面的比较成本分析显示,5 年内节省了 130 万美元。具有先前 WSI 的外科切除病例的 TAT 减少了 1 天。DP 经验调查显示,80%的受访者同意 WSI 改善了他们的临床报告体验。
实施 DP 操作显示出效率和运营实用性的显著提高。DP 的部署和运营可以通过以下指标来衡量:随着 WSI 的可用,玻璃幻灯片请求的数量,用于复发性/转移性疾病患者的确认性测试的减少,场外病理学资产成本的长期减少,以及更快的 TAT。其他部门可以使用我们的基准数据和指标来改善患者护理,并证明投资回报,以证明采用 DP 的合理性。