Telemedicine allows U.S. pathologists and other specialists to boost revenue by consulting with international partners.
Pathology laboratories in the United States are among the first adopters of a trend toward international telemedicine.
Pathologists working at a handful of well-known healthcare organizations here in the United States are forming partnerships with other hospitals and health systems worldwide, particularly in China.
Pathology Is Just One Medical Specialty Doing Global Telemedicine
Of course, there are other examples of international telemedicine that involve hospitals and other medical specialties. For example, during the past decade, the University of Pittsburgh Medical Center (UPMC) has operated the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), a transplant hospital in Palermo, Italy. However, what is different about newer international telemedicine relationships is that they benefit from faster, cheaper and more reliable information technology that was unavailable just a few years ago.
The growing interest in global telemedicine services also creates an opportunity for U.S. pathologists and other specialists to boost revenue by consulting with international partners. This is particularly true for those hospitals and health systems in the United States that use telemedicine technology domestically.
Telemedicine allows physicians to consult on treatment for patients in remote areas and build volume among patients who value the quality of U.S. healthcare, noted Modern Healthcare recently.
“New technology has created an explosion in demand for international telemedicine, especially in fields such as radiology and pathology that lend themselves to virtual care,” according to an article in Modern Healthcare titled “The long reach of medicine.”
For global telemedicine, the goal is bring specialist medical expertise into the treatment setting for a patient located thousands of miles away. Pictured above is a telemedicine arrangement used in the United States by Mayo Clinic. In this instance, a specialist physician at Mayo Clinic is doing an assessment and guiding treatment of a patient experiencing an acute stroke who is located in a rural hospital that is hundreds of miles away from the Mayo Clinic (Photo copyright Mayo Clinic.)
Shanghai East International Medical Center in China, for example, runs a telemedicine program with UC Davis, Modern Healthcare reported. A robot in the Shanghai facility sends a video feed to a cardiologist at UC Davis. This allows the specialist to examine patients and consult with colleagues in China about patients’ conditions. The robot rounds with other specialists in patients’ rooms in Shanghai while the cardiologist participates via video.
UCLA Pathologists Have Telemedicine Arrangement with Chinese Hospital
Pathologists also participate in such ventures. One pioneering example involves the Department of Pathlogy at the David Geffen School of Medicine at the University of California Los Angeles. UCLA pathologists have completed about 1,500 cases this year via telepathology in a partnership with 2nd Affiliated Hospital of Zhejiang University (SAHZU) School of Medicine, in Hangzhou, China.
In an interview in The Dark Report in August, Scott W. Binder, M.D., Senior Vice Chair of Pathology and Laboratory Medicine at UCLA, explained that pathologists at SAHZU refer cases to Binder and his colleagues for subspecialist second opinions, mostly on tumor cases. (See “Digital Pathology Enables UCLA-China Lab Connection, TDR July 16, 2012; and “Pathologists in China, U.S., Linked by Digital Pathology,” TDR Aug. 27, 2012.)
“This is also consistent with how the Food & Drug Administration (FDA) wants the digital pathology system to be used for clinical purposes,” Binder explained. “At least once every month, a tumor board is conducted with the SAHZU pathologists. With the growth in case volume, there are some months when we have two tumor board meetings.”
Actively Seeking Additional Telepathology Relationships
To develop additional partnerships and create new business models, the UCLA pathology department is talking with other Chinese companies seeking to fill a need created by a shortage of pathologists in the world’s most populous nation. “This demand and high interest is driven by the tremendous need for esoteric testing in China. There is also a substantial and untapped demand for reliable, second-tier testing and immunohistochemistry and flow cytometry,” Binder commented.
Binder also noted that Chinese patients—particularly those in the middle and upper classes with adequate purchasing power—are aware of the need for accurate diagnoses. At the same time, these patients know that pathology practices in China have not always achieved the level of quality that pathologists in the United States achieve. These same patients also are aware that brand names reflect value.
“Once these patients—who have the economic means to pay for quality healthcare—saw these failings, they started to demand that they get a correct diagnosis,” Binder said. “That puts pathologists front and center because of their role in performing and interpreting laboratory tests.”
Chinese Patients Recognize High Quality Health Institutions
“As a people, the Chinese want quality. For that reason, they are extremely brand-oriented,” he continued. “In particular, it is why medical schools, hospitals, and private health companies in China want to work with recognized leaders in medicine, such as UCLA, Stanford and Mayo. They want to affiliate with the best cancer institutes and diagnostic centers. That translates into a strong interest in raising the level of quality in pathology and lab accuracy and in precision of diagnosis.”
The benefits of UCLA’s work in China will result in increased revenue. “As UCLA develops its pathology network in China over time, there could be a sizeable amount of income in the future,” Binder said.
Adding revenue is a significant factor. “It’s [the growth of global telemedicine] 100% financially motivated,” David Jahns told Modern Healthcare. “This is a great way for the U.S. to export what we have an advantage in.” Jahns is managing partner at Galen Partners, a venture-capital firm in Stamford, Connecticut, that invests in healthcare companies.
The ongoing advances in digital pathology systems are another reason why anatomic pathology in the United States and other developed nations may be in the forefront of the global telemedicine trend. If it is easier to move specimens than it is to move patients, it is even easier and faster to provide access to digital pathology images. This technology affords U.S. pathologists the ability to provide sophisticated telepathology services anywhere in the world.
—By Joseph Burns
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