[Histonet] H&E slide cost

Thu Jul 1 10:49:23 CDT 2010

Thank you for the direction to CAP, but I am registered on the CAP site and I have not been able to find a cost per slide calculation for H&E. I would welcome the assistance of CAP to help standardize the process and provide specific direction and guidance.

On the CAP site there is a paper by Dr. Hendricks, Cleveland Clinic. He does discuss cost per slide associated w/ digital pathology and capturing the FTE time required to scan, but even that discussion does not consider the "total" cost for a slide. The difficulty is that there is no standardization of process or procedure and the digital age means an increase in labor costs for the technical end of the process. We are rapidly moving to digital pathology and our lack of standardization will create many problems similar to those that are experienced when labs perform IHC. How do we progress Histotechnology from Open Standards to Interoperability, a must if we truly want to compare results?

What continues to concern me most, many Histology labs not only do not have an accurate cost per slide for H&E, they do not have a cost for special staining (Histochemical techniques) or IHC and they cannot break down each step of their process to consider the cost. Too many Histology labs rely on their vendors to provide costing information. In the past, there have always been enough dollars available in the reimbursements to more than cover the "technical component", but as we move forward and to more precise and complex procedures, while requiring better trained and educated technologists, the dollars will quickly become inadequate. We cannot continue to function as we do today.

In the future state of Histology and Histotechnology, it will be essential that each Histology lab be able to efficiently manage the technical process, remove waste and maintain a healthy profit margin, while providing excellent quality and patient care. There must be an increase in automation of instruments and even though we do not perform our tests in a test tube, more tests performed in Histology will be at the IVD level. We must become better at Histotechnology to continue to perform more complex tests and we will also need a better partnering of the Histotechnologist and Pathologist to keep up with the rapid advancement of technology.

Unfortunately, we will have many Histology labs struggle with this change and many will go out of business or be consolidated into larger labs that can afford the technology, through efficient process improvement, and control of quality and costs. The bright side is this is an exciting time for Histology and Histotechnology and I am certainly excited about the future.  

William DeSalvo, B.S., HTL(ASCP)

Subject: RE: [Histonet] H&E slide cost
Date: Wed, 30 Jun 2010 14:26:31 -0700
From: JHowery2 <@t> yrmc.org
To: wdesalvo.cac <@t> hotmail.com

Register on the CAP site. They have many documents on calculation of different costs in the laboratory.

From: histonet-bounces <@t> lists.utsouthwestern.edu on behalf of WILLIAM DESALVO
Sent: Wed 6/30/2010 11:09 AM
To: cmiller <@t> physlab.com; rcartun <@t> harthosp.org; histonet
Subject: RE: [Histonet] H&E slide cost

I agree w/ Cheryl, there are many variables to consider and there is no "standard" cost for an H&E because we, Histotechnology, do not have a standardized process for H&E. The calculation requires precise data and will often be higher than you anticipate. I find that most labs, and the vendors, do not account for the total cost. My cost calculation is as follows:

(Materials/Reagents + Instrumentation + Labor + Company Allocation) / Unit (i.e. Case/Specimen/Cassette/Slide/Stain) = Cost

You will need assistance from your Finance department to acquire many of the costs associated with your instruments, labor and especially the allocation back to your department for shared services.

I also feel that Cheryl's cost per slide is definitely in the ballpark. I have worked at labs, small to very large, and the cost per slide ranges in the $8.00 - $10.00 / slide, when all department expenses are accounted and the proper allocation of technical time is applied.

William DeSalvo, B.S., HTL(ASCP)

> From: cmiller <@t> physlab.com
> To: Rcartun <@t> harthosp.org; histonet <@t> lists.utsouthwestern.edu
> Date: Wed, 30 Jun 2010 11:51:13 -0500
> Subject: RE: [Histonet] H&E slide cost
> CC:
>
> There are so many variables, it all depends on your operating costs i.e. Labor, reagents, maintenance contracts and capitol equipment if applicable. I just completed my cost analysis today and it costs my department approximately $8.15 to produce 1 H&E slide, $2.55 each Special and $38.71 for each IHC Antibody.
>
> Cheryl A. Miller HT(ASAP)cm
> Histology/Cytology Prep Supervisor
> Physicians Laboratory Services
> Omaha, NE. 402 731 4145 ext. 554
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Richard Cartun
> Sent: Wednesday, June 30, 2010 8:43 AM
> To: Histonet
> Subject: [Histonet] H&E slide cost
>
> I apologize for asking this question since I'm sure it's been discussed before, but I need an answer ASAP. How much does it cost to produce an H&E-stained slide from formalin-fixed tissue? We want to give this figure to our new residents and fellows who start tomorrow in order to show them how much it costs the laboratory to produce the tissue that they submit. Thanks!
>
> Richard
>
> Richard W. Cartun, MS, PhD
> Director, Histology & Immunopathology
> Director, Biospecimen Collection Programs
> Assistant Director, Anatomic Pathology
> Hartford Hospital
> 80 Seymour Street
> Hartford, CT 06102
> (860) 545-1596 Office
> (860) 545-2204 Fax
>
>
>
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