Dr. Matthew O. Leavitt is a Stanford-trained pathologist focused on innovation in digital pathology. He has 19 years of pathology experience. He founded Lumea then went on to be the founder and CEO of PathNet. His podcast episode “Tissues with Issues” is about critical but often neglected issues in genitourinary pathology, which can affect the quality of patient care. These issues are being solved by Lumea’s digital pathology solutions.
“The pathologist is there to provide information about a patient’s disease and to inform patients and their physicians as they make these critical and potentially life-changing decisions,” says Dr. Leavitt. Substandard tissue handling practices compromises the ability to provide the best information possible.
Dr. Leavitt discusses five serious problems created by suboptimal tissue handling and data handling that can harm patients. The first is discontinuous workflows, the second is core fragmentation, the third is the lack of tissue orientation, the fourth is variable formalin fixation and processing protocols, and the last is the current practice of diagnostic data silos.
Each part of the healthcare system, from the clinic to the lab to the pathologist, is usually disconnected. In many places they communicate via paper requisition forms and fax machines.
“The most devastating errors I have seen in the pathology lab are usually not interpretive errors, but rather a mislabeled specimen or container, a switched tissue block, or slide mislabeling issues. Every day in every country in the world, patients are harmed by the errors in specimen identification,” said Dr. Leavitt. “The most effective way to limit human specimen labeling errors is to eliminate human labeling.”
Core fragmentation is a common problem. It is more likely to happen the more people handle the specimen during specimen collection, transport, and processing. Fragmented specimens frequently cause errors in tumor quantification, percentage involvement, and core enumeration.
“Reporting error can misinform clinicians and lead to mismanagement of patients,” said Dr. Leavitt.
Lumea has been working on ways to improve the amount of tissue on the slide and reduce lab costs.
Lack of Tissue Orientation
Current tissue handling protocols do not provide orientation on the tissue cores. Knowing tissue orientation allows for more precise diagnostics and better-targeted treatment.
Lumea has developed technology that preserves the orientation of needle-core biopsies in a simple, efficient way. We are currently expanding this digital pathology solution to maintain the orientation of every type of specimen.
Variability in formalin fixation and processing protocols
The most commonly used tissue preservative is formaldehyde. There are things about formalin that are not ideal, but to change to a new preservative would take a long time. Much of the foundation of pathology is based on this fixative. It would be easier to change tissue handling protocols to ensure tissue is in the formalin for as short a time as possible.
Diagnostic data silos
The clinic has an EMR, the lab has a LIS, radiology has a RIS, and genetic testing companies have their lab information system. Each one has a variety of integrations but they typically communicate with each other via paper requisition forms. This disconnect causes slow ups and, occasionally, miscommunications.
“If we want to get the most out of our diagnostic intelligence, we need to bring these silos together. We need to break down the barriers between the different subspecialties and integrate clinic, lab, radiology, and genetic data. If we do this, we will own open up new worlds of understanding,” said Dr. Leavitt.
Learn how Lumea is working on fixing each one of these issues with their digital pathology solutions by requesting a free demo today!
Listen to the entire podcast episode here.