[Histonet] Changing dynamics in histotechnology
mpence <@t> grhs.net
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.
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus
Sent: Monday, September 17, 2012 4:12 PM
To: Morken, Timothy
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Changing dynamics in histotechnology
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
> 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
> 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
> 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
> Sent from my iPad
> On Sep 17, 2012, at 8:29 AM, "Judy O'Rourke" <jorourke <@t> allied360.com>
>> 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
>> Thank you!
>> 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 |
>> Follow us on Facebook, and follow me on Twitter at @editorCLPmag
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