Pathology Post COVID-19 / Patologia dopo COVID-19
Pathology Post COVID-19 / Patologia dopo COVID-19
Segnalato dal Dott. Giuseppe Cotellessa / Reported by Dr. Giuseppe Cotellessa
The COVID-19 pandemic has resulted in several disruptions to pathology over the last few months. Changes in caseloads and workflows are likely to continue for some time, and pressures could increase further with an influx of delayed cancer diagnoses once screening programs resume and people who have been holding off making appointments go to see their doctors.
To learn more about the impact the COVID-19 pandemic is having on pathology, what the future of pathology might look like, and how digital pathology could help to ease some of the challenges, we spoke to Mark Lloyd, Founder and Executive Vice President of Inspirata.
Anna MacDonald (AM): What sort of pressures has the COVID-19 pandemic exacerbated or brought to pathologists?
Mark Lloyd (ML): The core challenges relate to
To learn more about the impact the COVID-19 pandemic is having on pathology, what the future of pathology might look like, and how digital pathology could help to ease some of the challenges, we spoke to Mark Lloyd, Founder and Executive Vice President of Inspirata.
Anna MacDonald (AM): What sort of pressures has the COVID-19 pandemic exacerbated or brought to pathologists?
Mark Lloyd (ML): The core challenges relate to
1) the work pathologists were doing pre-COVID,
2) the changes asked of the profession during the crisis, and
3) how we aim to get back to a level of “new normalcy”.
Prior to the pandemic, anatomic pathologists evaluated tissues for disease. The crisis put an abrupt halt on elective surgeries and most organizations experienced drops in cases to a fraction of their previous tissue volumes. Pathologists at such organizations were either furloughed or asked to work from home where couriers delivered their cases, or moved to the Clinical Pathology lab, when appropriate, to meet the increasing demand for serological tests (primarily COVID-19 testing). As elective surgeries are starting to recover to pre-pandemic levels in many locations, this “backlog” of cases will be very demanding for the anatomic pathologists with limited capacity. It will require late hours, staffing increases and other measures. Digital pathology is here to help pathologists working remotely. It can also increase their productivity and facilitate case sharing to address the backlog of cases.
AM: What changes can pathologists expect to face over the next few months in terms of their working environments and workflows?
ML: Many pathologists can continue to work remotely with digital pathology which can help them avoid challenges related to physically being in the hospitals.Digitization also gives them the tools to sign out cases in the evening and over weekends to help them catch up with backlogs of cases. A strong digital platform enables their workflows to remain intact, even as their environment is changing. In situations that previously required many pathologists to be in a single room looking through a multi-headed microscope, digitization facilitates social distancing without changing how many pathologists interact to sign out challenging cases.
AM: The FDA issued guidance on April 24, 2020, for the use of remote digital pathology devices. Could this relaxation of regulations continue once the pandemic is over?
ML: Many pathology thought leaders are pointing to the success pathologists have had with digital pathology during this period of relaxed enforcement.They argue that Pandora is out of her box and pathologists simply will not accept these regulations returning. Regulatory experts argue that the successful relaxation of the regulations is evidence that digital pathology was over-regulated to begin with. While we will need to wait to see how the CMS and FDA will react, what is abundantly clear is that a lot of real-world data accumulated for the use of digital pathology during this period supports the ongoing relaxation of regulations for digital pathology once the pandemic is over.
AM: Greater adoption of digital pathology has been contemplated for some time. What objections have prevented wider use of it so far? How has the COVID-19 pandemic changed perspectives?
ML: Change takes time; particularly in medicine. Users in the medical and scientific worlds are often evidence-based. Once users see how something can help them, they are willing to try it. The COVID-19 crisis has been a powerful catalyst to show pathologists they don’t need to be huddled around a multi-headed scope. Instead, they can work remotely, without the need to wait for glass to be delivered. Under the new circumstances, pathologists who were in waiting mode regarding new technology because what they have been used to was “good enough”, now realize that digital pathology has many advantages that are valuable to them during this crisis and beyond.
AM: What do you think pathology will look like post COVID-19?
ML: Pathology will rebound with the rest of our healthcare systems globally.But it has, and will continue to, experience pain. Digital was once thought of as a curiosity. More recently, it was considered a technology that was coming, and the question was “no longer a matter of if, but when”. Presently, it has become clear that digital pathology has a great deal of value in a nimble, responsive, modern society that is often challenged in very fundamental and impactful ways. COVID-19 has shone a spotlight on what was previously known only to a smaller group of early adopters. Digitization is our future and the quicker we can get there, the quicker we can reap the benefits.
AM: What changes can pathologists expect to face over the next few months in terms of their working environments and workflows?
ML: Many pathologists can continue to work remotely with digital pathology which can help them avoid challenges related to physically being in the hospitals.Digitization also gives them the tools to sign out cases in the evening and over weekends to help them catch up with backlogs of cases. A strong digital platform enables their workflows to remain intact, even as their environment is changing. In situations that previously required many pathologists to be in a single room looking through a multi-headed microscope, digitization facilitates social distancing without changing how many pathologists interact to sign out challenging cases.
AM: The FDA issued guidance on April 24, 2020, for the use of remote digital pathology devices. Could this relaxation of regulations continue once the pandemic is over?
ML: Many pathology thought leaders are pointing to the success pathologists have had with digital pathology during this period of relaxed enforcement.They argue that Pandora is out of her box and pathologists simply will not accept these regulations returning. Regulatory experts argue that the successful relaxation of the regulations is evidence that digital pathology was over-regulated to begin with. While we will need to wait to see how the CMS and FDA will react, what is abundantly clear is that a lot of real-world data accumulated for the use of digital pathology during this period supports the ongoing relaxation of regulations for digital pathology once the pandemic is over.
AM: Greater adoption of digital pathology has been contemplated for some time. What objections have prevented wider use of it so far? How has the COVID-19 pandemic changed perspectives?
ML: Change takes time; particularly in medicine. Users in the medical and scientific worlds are often evidence-based. Once users see how something can help them, they are willing to try it. The COVID-19 crisis has been a powerful catalyst to show pathologists they don’t need to be huddled around a multi-headed scope. Instead, they can work remotely, without the need to wait for glass to be delivered. Under the new circumstances, pathologists who were in waiting mode regarding new technology because what they have been used to was “good enough”, now realize that digital pathology has many advantages that are valuable to them during this crisis and beyond.
AM: What do you think pathology will look like post COVID-19?
ML: Pathology will rebound with the rest of our healthcare systems globally.But it has, and will continue to, experience pain. Digital was once thought of as a curiosity. More recently, it was considered a technology that was coming, and the question was “no longer a matter of if, but when”. Presently, it has become clear that digital pathology has a great deal of value in a nimble, responsive, modern society that is often challenged in very fundamental and impactful ways. COVID-19 has shone a spotlight on what was previously known only to a smaller group of early adopters. Digitization is our future and the quicker we can get there, the quicker we can reap the benefits.
ITALIANO
La pandemia COVID-19 ha provocato diverse interruzioni della patologia negli ultimi mesi. È probabile che i cambiamenti nei casi di lavoro e nei flussi di lavoro continuino per un po 'di tempo e le pressioni potrebbero aumentare ulteriormente con un afflusso di diagnosi ritardate di cancro una volta che i programmi di screening riprendono e le persone che si sono trattenute dal fissare appuntamenti vanno a vedere i loro medici.
Per saperne di più sull'impatto che la pandemia COVID-19 sta avendo sulla patologia, su come potrebbe essere il futuro della patologia e su come la patologia digitale potrebbe aiutare ad alleviare alcune delle sfide, abbiamo parlato con Mark Lloyd, fondatore e vice presidente esecutivo di inspirata.
Anna MacDonald (AM): che tipo di pressioni ha esacerbato o portato ai patologi la pandemia di COVID-19?
Mark Lloyd (ML): Le sfide principali riguardano
1) il lavoro dei patologi che stavano facendo pre-COVID,
2) i cambiamenti richiesti alla professione durante la crisi e
3) come miriamo a tornare a un livello di "nuova normalità"
".Per la pandemia, i patologi anatomici hanno valutato i tessuti per la malattia. La crisi ha interrotto bruscamente gli interventi chirurgici elettivi e la maggior parte delle organizzazioni ha subito cali nei casi a una frazione dei precedenti volumi di tessuto. I patologi di tali organizzazioni sono stati licenziati o hanno chiesto di lavorare da casa dove i corrieri hanno consegnato i loro casi o trasferiti al laboratorio di patologia clinica, se del caso, per soddisfare la crescente domanda di test sierologici (principalmente test COVID-19). Poiché gli interventi chirurgici elettivi stanno iniziando a ripristinare i livelli pre-pandemici in molte località, questo "arretrato" di casi sarà molto impegnativo per i patologi anatomici con capacità limitata. Richiederà le ore tarde, aumenti del personale e altre misure. La patologia digitale è qui per aiutare i patologi che lavorano in remoto. Può anche aumentare la loro produttività e facilitare la condivisione dei casi per affrontare l'arretrato di casi.
AM: Quali cambiamenti possono aspettarsi i patologi nei prossimi mesi in termini di ambienti di lavoro e flussi di lavoro?
ML: Molti patologi possono continuare a lavorare a distanza con la patologia digitale che può aiutarli a evitare le sfide legate all'essere fisicamente negli ospedali. La digitalizzazione offre loro anche gli strumenti per firmare i casi la sera e nei fine settimana per aiutarli a recuperare gli arretrati di casi. Una solida piattaforma digitale consente ai loro flussi di lavoro di rimanere intatti, anche se il loro ambiente sta cambiando. In situazioni che in precedenza richiedevano che molti patologi si trovassero in una singola stanza guardando attraverso un microscopio a più teste, la digitalizzazione facilita il distanziamento sociale senza cambiare il numero di patologi che interagiscono per segnalare casi difficili.
AM: L'FDA ha pubblicato una guida il 24 aprile 2020, per l'uso di dispositivi patologici digitali remoti. Questo rilassamento delle normative potrebbe continuare una volta terminata la pandemia?
ML: Molte patologie ritengono che i leader stiano indicando il successo che i patologi hanno avuto con la patologia digitale durante questo periodo di applicazione rilassata. Sostengono che Pandora è fuori dalla sua scatola e che i patologi semplicemente non accetteranno che queste regole ritornino. Gli esperti di regolamentazione sostengono che il rilassamento con successo delle normative è la prova che la patologia digitale era inizialmente troppo regolamentata. Mentre dovremo aspettare per vedere come reagiranno il CMS e l'FDA, ciò che è abbondantemente chiaro è che molti dati del mondo reale accumulati per l'uso della patologia digitale durante questo periodo supportano il continuo rilassamento delle normative per la patologia digitale una volta che la pandemia è finita.
AM: una maggiore adozione della patologia digitale è stata contemplata per qualche tempo. Quali obiezioni hanno finora impedito un uso più ampio di esso? In che modo la pandemia COVID-19 ha cambiato prospettiva?
ML: Il cambiamento richiede tempo; in particolare in medicina. Gli utenti nei mondi medico e scientifico sono spesso basati su prove. Una volta che gli utenti vedono come qualcosa può aiutarli, sono disposti a provarlo. La crisi COVID-19 è stata un potente catalizzatore per mostrare ai patologi che non hanno bisogno di essere rannicchiati attorno a un ambito a più teste. Possono invece lavorare in remoto, senza la necessità di attendere la consegna del campione. Nelle nuove circostanze, i patologi che erano in modalità di attesa per quanto riguarda la nuova tecnologia perché ciò a cui erano stati abituati era "abbastanza buono", ora si rendono conto che la patologia digitale ha molti vantaggi che sono preziosi per loro durante questa crisi e oltre.
AM: Come pensi che sarà la patologia post COVID-19?
ML: La patologia rimbalzerà con il resto dei nostri sistemi sanitari a livello globale, ma ha e continuerà a provare dolore. Il digitale una volta era considerato una curiosità. Più recentemente, è stata considerata una tecnologia che stava arrivando e la domanda non era più "questione di se, ma quando". Attualmente, è diventato chiaro che la patologia digitale ha un grande valore in una società agile, reattiva e moderna che viene spesso sfidata in modi molto fondamentali e di forte impatto. COVID-19 ha puntato i riflettori su ciò che in precedenza era noto solo a un gruppo più ristretto di primi utenti. La digitalizzazione è il nostro futuro e tanto più velocemente possiamo arrivarci, tanto più rapidamente possiamo raccogliere i frutti.
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