How the Affordable Care Act Impacts Your Practice

With the introduction of bundled payments, telepathology consults can greatly reduce the risk of unreimbursed tests. SPOT Imaging’s Philip Merlo explains.

By Phillip Merlo, VP-Digital Pathology Systems SPOT Imaging

Bundled payments are a hot topic in the healthcare industry these days, because with the Affordable Care Act’s bundled payments comes an increased risk to providers and caregivers of unreimbursed secondary procedures.

Fine needle aspirations (FNA) pose a particular challenge due to the difficulty of targeting small tumors in three-dimensional space. This issue was quantified in a recent University of Michigan study showing inadequacy rates of over 31% in thyroid FNA’s. The same study showed that the addition of immediate sample evaluation reduces the inadequacy rate to under 6%. This immediate consult represents a fivefold decrease in the need for secondary procedures to recover diagnostically significant tissue.

A second area of impact is surgical oncology and the intraoperative pathology support related to it. Multiple studies have shown intraoperative consults increase the efficacy of the surgical team multifold. The source of the improvements in efficacy was on the ability of the surgeons to adjust the intent of their procedure based on definitive diagnosis and staging of the cancer provided by the pathologist. Studies showed the following results:

• A reduction of secondary re-excision surgeries from 26% to 9%.
• An increase in diagnostic accuracy
• A reduction in unreimbursed secondary surgeries,
• A reduction in extended hospital stays, and nosocomial infections
• An increase in patient satisfaction level and referral rates
• An increase in the Oncology Center’s ranking

These studies demonstrate that properly performed consults can mitigate unreimbursed secondary procedure risk and provide substantial savings to caregivers and providers. They also improve medical care and patient outcomes.

The Question is, How do you provide those consults cost-effectively?

Answer: Telepathology.

Telepathology allows multiple experts from multiple institutions in multiple locations to look at the same slide in real time without having to leave their offices. This reduction in travel for highly paid hospital specialists results in a cost-effective means to provide consults under the relatively low reimbursement guidelines of the ACA.

There are two main telepathology methodologies:

• Broadcast telepathology
• Interactive telepathology

Broadcast telepathology enables pathology images to be streamed from the imaging site over the internet in real time to remote locations anywhere. While these systems do provide an improvement over strictly verbal communication they are still hampered by a lack of interactivity with the image stream by the remote observers. The remote observer’s only feedback is via telephone or Voice over IP (VoIP) comments about the image.

Interactive telepathology shares the real-time image stream, audio stream, cursor control and all the application controls with both the imaging host and the remote attendee. With its annotation, file sharing, and remote computer control capabilities, geographically isolated specialists can work together as if they were in the same room. Further, discussion images are archived to the case file with a click of a button allowing subsequent retrieval and review.

SPOT Imaging provides telepathology systems to some of the nation’s leading hospitals, medical centers and research facilities, including the University of Michigan, Duke University, Cedars-Sinai Medical Center and Kaiser Permanente. Our SPOT Imaging PathSuite software supports your team’s telepathology needs with SPOTMeeting, an easy-to-use, fully interactive telepathology environment designed around your workflow.

Click here for more information and see how you can get started in broadcast and interactive telepathology quickly and affordably with SPOT Imaging telepathology systems, improve outcomes and reduce the risk of unreimbursed tests.

Phillip Merlo is VP-Digital Pathology Systems for SPOT Imaging.