Anatomic Pathology Roundtable Recap: Balancing Pressures with the Promise of New Technology

The August 2023 issue of CAP Today includes an interesting roundtable discussion about the current state of anatomic pathology. The discussion centered around the pressures that these pathology labs face, and what new technology is now available to help them deal with downward trends like shrinking reimbursement rates, a pathologist shortage, and on-the-job burnout. 

As usual, CAP Today publisher Bob McGonnagle deserves loads of credit for bringing together an excellent panel that included pathologists and representatives of laboratory information system companies that support their work.

LigoLab CEO Suren Avunjian is a regular roundtable guest and he participated in the discussion. In case you missed it, the entire discussion is linked below. 

CAP Today’s August Roundtable Discussion: In Anatomic Pathology Labs, a Balancing Act

Editorial Note: Because of the limited space, Suren’s responses were abbreviated in the CAP Today article. Below are his full responses to the questions asked of him during the discussion. 

Suren Avunjian, your customers’ headaches are your headaches. Tell us what you make of the situation and what you suggest might give us relief at this time.

Suren Avunjian, co-founder and chief executive officer, LigoLab Information Systems: Reimbursement issues are adding to the perfect storm. We're currently facing what can be described as a 'perfect storm'. Declining reimbursements, the shortage of staff and pathologists, and the continually escalating costs represent significant issues for the laboratory sector. Amidst this complex scenario, laboratories are struggling to maintain operational efficiency while also ensuring that they continue to deliver high-quality patient care.

However, every challenge also presents an opportunity, and in this case, these substantial hurdles are opening doors for technology companies to step in and make a real difference. Advanced and comprehensive technology platforms and the right kind of automation can offer solutions that directly address these issues, enabling laboratories to navigate the choppy waters of today's healthcare environment more effectively.

Meanwhile, innovative RCM technology solutions can provide critical support in dealing with declining reimbursements. By leveraging advanced rule sets, strategies, and analytics, labs can gain better control and insight into their technical and financial operations, identify areas of waste, and make informed decisions that enhance collections and profitability. Furthermore, advanced technologies such as Artificial Intelligence and Machine Learning can also play a crucial role in enhancing the capabilities of pathologists, thus helping to mitigate the impact of pathologist shortages.

LigoLab integrated with BioImagene (acquired by Ventana and now Roche in 2010) as a digital pathology partner over a decade ago, marking our entry into this space. Since then, we've established integrations with a host of whole slide imagers and have developed an agnostic laboratory information system (LIS) platform. This approach enables rapid integration with an array of digital pathology solutions and provides a marketplace layer for AI technology, tailor-made for different machine learning models and specific to each stain and specimen.

As more practices embrace digital pathology over the next few years, these technologies will prove increasingly valuable. We're seeing this trend among our pathology customers, many of whom have already initiated a digital pathology strategy or plan to do so within the next 12 months.

One of our key initiatives is developing a cloud-based EHR integration network to alleviate some of the industry's challenges. With this engine, when customers join LigoLab, they gain automatic access to all EHRs integrated into the cloud network. This happens without the need for individual labs to rebuild them. Point-to-point interfaces have created considerable struggle and costs within our industry. Our cloud-based integration engine aims to eliminate these pain points, allowing customers to plug into our system cost and time effectively.

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Suren, what are you seeing in terms of the demand to bring this in-house, recognizing the complexity of the technology, the IT, and the expertise of operators?

Suren Avunjian (LigoLab): We see the appetite in the general pathology labs we serve. A few have deployed in-house gene sequencing technologies but most are still in research and planning phases. 

The decision to bring gene sequencing in-house can be influenced by various factors, and indeed we are observing an increasing interest and contracts from specialized laboratories that focus on genomic testing. The driving force behind this trend often revolves around personalization and deployment of new clinical products that require greater control over the sequencing process, faster turnaround times, and the ability to customize analysis based on specific research or clinical needs.

Cost is certainly a significant factor when considering this transition. The upfront investment for sequencing equipment can be substantial, not to mention the ongoing costs of consumables, maintenance, and the necessary informatics infrastructure. Additionally, gene sequencing requires specialized personnel to operate the equipment and interpret the data, which adds to the overall operational cost. However, as sequencing technologies advance and become more efficient, these costs gradually decline, making in-house sequencing more feasible for many laboratories.

The informatics needs for gene sequencing are considerable and extend well beyond the sequencing process. Data management, analysis, interpretation, and storage require robust and sophisticated laboratory software systems. The vast amount of data generated by sequencing procedures can be overwhelming, so having the right bioinformatics resources in place is critical. Furthermore, this data is highly sensitive, requiring stringent security measures to protect patient privacy and comply with regulatory requirements.

Ultimately, whether an organization decides to bring gene sequencing in-house depends on its specific circumstances, including its budget, the volume and type of sequencing it plans to do, its timeline requirements, its informatics capacity, and the expertise of its staff. 

LigoLab: Pathology Lab Software to Take Your Practice to the Next Level

LigoLab Informatics Platform is a comprehensive and highly configurable enterprise-grade LIS software solution that helps pathology groups and clinical and reference labs modernize and grow efficiently. LigoLab empowers laboratories to differentiate and better serve patients as they scale their operations, improve compliance, and increase profitability.  Contact us today to learn more.