[Histonet] Changing dynamics in histotechnology

Mon Sep 17 16:17:12 CDT 2012

Just to shed more light on one thing: can you direct me to where it
states that you can only bill for 4 IHC per patient. I am not
questioning what you are saying, just want more info on this subject.

Thanks, Mike

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus
Ellin
Sent: Monday, September 17, 2012 4:12 PM
To: Morken, Timothy
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Changing dynamics in histotechnology

Tim,

I think basic histology is going to be manual,, but i see the explosion
of technology sweeping our field.

As Bill states it all about standardization,, but try getting the same H
and E across the board,, thats not going to happen

IHC will always we a bread and butter, but now since the government has
limited the amoun t of IHC per patient, we are going to see a lot
changes here.  With only 4 IHC per patient 

Sent from my iPad

On Sep 17, 2012, at 2:00 PM, "Morken, Timothy"
<Timothy.Morken <@t> ucsfmedctr.org> wrote:

> Histology is going to have a huge manual component for a long time. 
> Even though embedding has been automated to a certain extent it has
not been accepted by many...yet. Automated sectioning is a long way off
- and who would have the money to buy sectioning robots that could do as
well as a human? Would it even be cost effective (and that IS the
question!)?
> 
> Much of this could be made much easier by proper application of 
> grossing/processing/embedding procedures. But we can't even get
pathologists to agree how long any particular tissue should be fixed -
no matter what the literature says. Good luck standardizing grossing and
tissue processing across a single large department, let alone the entire
industry (though I know Bill has done wonders with this in his company).
Simply due to that lack of standardization manual work will be with us
for a LONG time since every block requires individual care and decision
making by the person sectioning it.
> 
> IHC is bread and butter to the lab now. ISH is coming along but still 
> too rare to make much money off of it, if any at all. I don't think we
do much more of it percentage wise than 20 years ago.
> 
> The best IHC techs take interest in the cases, learn what the 
> antibodies are for and pay attention to the staining they get (if they

> have time before the TAT deadline!).  They do research on diseases and

> can converse with pathologist about the results.
> 
> Molecular methods (ie, DNA/RNA, besides ISH) is quite different than 
> histology. Completely different training required, though I have no 
> doubt histotechs could do it, why would they hire a histotech when 
> there are umpteen biochemists applying for every biology job 
> advertised (including histology!!)?
> 
> Digital pathology is still "promising," just as it was 10 years ago, 
> and will be "promising" 5 or 10 years from now unless a technology 
> comes along to scan slides FAST - ie 10 seconds, not 5 minutes. Maybe 
> someone will adapt the Lytro Light Field Camera to slide scanning. 
> Seems a perfect match (google it!).
> 
> Barcoding is on the way in. We are going to have a system by June 
> 2013. But it is in the growing stage and there are lots of tradeoffs. 
> The hardware has just become available in the last 5 years to make it 
> reliable. Now the vendors have to get going. Some have with great 
> systems  - Ventana, possibly Leica, Omnitrax. The LIS vendors have 
> fallen flat on their faces on this - totally missed the boat and ceded

> the specimen tracking space to histology and IHC vendors. Shows what 
> happens when your company is too big and you don't pay attention to 
> the possibilities. As recently as 3 years ago I had an LIS vendor 
> technical person ask me what on earth I would use bar coding for in 
> histology. I hope that guy has been fired by now for ignorance!
> 
> Of course one huge disadvantage to having histology and IHC vendors 
> providing barcoding/tracking systems is some want to limit your 
> choices to their instruments. That is a big bugaboo right now. But I 
> understand Clinical Chemistry is dealing with the same issue - 
> instrument vendors forcing certain parameters on the lab.
> 
> Training of histotechs is and always will be a problem. 95+% of 
> histotechs are trained OJT. I think there is only one program on the 
> west coast. So, for the most part forget formally trained techs (and 
> those that are formally trained should make the most of it!). It is 
> all dependent on individual initiative and the training skill of the 
> lab managers they work for. NSH is doing a pretty good job - and I 
> only say that because while the various meetings are great, only a 
> small percentage attend. The vast majority of histotechs don't ever 
> get outside training, either because they don't know about it, don't 
> have the money, or their labs don't promote it.  A lot of techs work 
> in labs whose managers consider advancement a bad thing - train a tech

> and they look for better pay elsewhere. How do you counter those 
> types?
> 
> Most pathologists trained these days are clueless about histology and 
> aren't concerned about  much else beyond ordering and getting their 
> slides. Histology is a black box to them.  They wouldn't have a clue 
> how to train a histotech if they had to.
> 
> All I can say on this is that everyone has to take care of themselves 
> and their own advancement first. Hopefully those same people will see
the value of training others in any way they can and promoting getting
more involved with the entire system.
> 
> 
> 
> Tim Morken
> 
> 
> 
> 
> 
> 
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu 
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus
Ellin
> Sent: Monday, September 17, 2012 12:22 PM
> To: Judy O'Rourke
> Cc: histonet <@t> lists.utsouthwestern.edu
> Subject: Re: [Histonet] Changing dynamics in histotechnology
> 
> With mixed emotions I read this article, not because of its context or

> information, but rather the outlook for our future.
> 
> I would like to pole on the histonet today, who is enter in:
> 
> 1.  Digital Pathology
> 2.  Molecular Testing (ISH, PCR, Next Gene Sequencing) 3.  Automation 
> Semi to complete 4.  Barcoding
> 
> A good question to ask is, are we, as Histology professionals, 
> positioned to make this change.  Case in point, how many people are
signed up and preparing for this transition at the NSH convention this
year?
> 
> Sent from my iPad
> 
> On Sep 17, 2012, at 8:29 AM, "Judy O'Rourke" <jorourke <@t> allied360.com> 
> wrote:
> 
>> Hello...
>> 
>> In Clinical Lab Products' just-released September issue, the article
>> "Changing Dynamics in Histotechnology" addresses the challenges and 
>> trends you face daily. William DeSalvo, B.S., HTL(ASCP), chair, NSH 
>> Quality Control Committee, is quoted.
>> 
>> Please share comments on CLP's Facebook page, where I've just posted
>> the
>> article: 
>>
http://www.facebook.com/pages/Clinical-Lab-Products/56624886500#!/page
>> s/Clin
>> ical-Lab-Products/56624886500
>> 
>> Thank you!
>> 
>> Judy
>> 
>> JUDY O'ROURKE |  Editor
>> Clinical Lab Products
>> 6100 Center Drive, Suite 1020, Los Angeles, CA 90045 office
>> 619.659.1065 | fax 619.659.1065 jorourke <@t> allied360.com | 
>> www.clpmag.com
>> 
>> Follow us on Facebook, and follow me on Twitter at @editorCLPmag
>> 
>> 
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