Horizon Pathology, PC

Horizon Pathology, PC*, is a 14-physician pathology practice that provides anatomic and clinical services to hospitals, surgery centers, and medical clinics in a progressive Western state. Horizon contracts with 4 hospitals from 2 large healthcare organizations (Prudential Health System and Aurora Health System) to provide the medical directorship of their laboratories. Horizon’s pathologists also represent eight board-certified subspecialties of pathology: dermatopathology, hematopathology, cytopathology, neuropathology, clinical chemistry, microbiology, breast pathology, and forensic pathology.

Early in 2009 Horizon Pathology was struggling with the dilemma that often plagues multi-location service organizations, i.e., how do these organizations deploy their limited subspecialty personnel in a manner that (a) best allocates scarce resources, (b) provides appropriate service levels to their clientele, and (c) maximizes revenue to the organization.

One of Horizon’s pathologist partners, Nicholas Randall, MD, thought that he had an answer: deploy a ‘whole-slide imaging’ (WSI) system at 2 of the smaller locations which could not financially support a subspecialty pathologist. However, upon examining carefully this potential solution Horizon’s partners realized that the cost associated with even one WSI would not provide them with a financially acceptable option. Dr. Randall summarized his partners’ conclusions about the WSI product in this fashion, “If we’d had the opportunity to purchase the WSI product at 15% to 20% of its market price, it would have worked – not worked perfectly well – but well enough.”

Later in 2009, some of Horizon’s pathologists were introduced to an alternative solution from one of their microscope manufacturers that would allow the sharing of a newly-prepared slide over the Internet with a subspecialty pathologist at a different location. Rudy Michaels, MD, the Horizon partner who investigated this particular alternative indicated that it would have satisfied most of the practice’s needs: “The greatest advantage to this option was that it was priced reasonably for what we were looking for. I was convinced that this solution would have worked reasonably well – although the length of the lag time (also known as “latency”) was undoubtedly distracting, and I would have preferred that the image resolution (standard resolution) was higher.”

In the end Horizon’s partners decided not go with this manufacturer’s product for a reason familiar to many pathology groups. “This manufacturer’s solution would not have simply and easily accommodated microscopes from other manufacturers. In other words, we would have had to replace and purchase at least 4 additional microscopes. This particular ‘inflexibility’ made this alternative just too expensive,” explained Dr. Michaels.

Early in 2010, Dr. Randall discovered a promising alternative to the products that Horizon Pathology had reviewed in the preceding year. This option came from a small technology company whose products were client-less & browser-based. And, the RMT HD TelePathology System that came from Remote Meeting Technologies, LLC (RMT) had a distinct advantage unseen and undemonstrated in earlier products that Horizon had investigated: it offered dynamic, streaming, real-time video in HD (high definition) resolution at 1920 x 1080 pixels.

“The clarity & precision of the live visual images from the RMT HD TelePathology System were tangibly better than anything that we’d seen in the past,” stated Dr. Randall. “That benefit alone might have provided my partners with a great enough incentive to make a decision in RMT’s favor, but we got a bonus benefit,” reported Dr. Randall, “RMT’s telepathology technology allowed us to attach it to microscopes from any manufacturer whose microscopes were attachable via a “C- mount” device. That advantage made the choice of RMT’s telepathology technology simple for us,” said Dr. Randall.

Horizon Pathology, PC, implemented its first two RMT HD TelePathology Systems at hospitals in the Aurora Health System in January, 2011. And, it has scheduled the implementation of two additional systems in the Prudential Health System.

“We were fortunate,” declared Dr. Randall, “We got the live telepathology features, functions & capabilities that we needed. For any pathologist or pathology tech who knows how to use a computer-attached mouse, the application is quite easy to master. And, we paid a price that my partners considered to be reasonable. As far as telepathology tools are concerned, we have no difficulty in recommending this tool.”

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*Horizon Pathology, Nicholas Randall, MD, Rudy Michaels, MD, Prudential Health System, and Aurora Health System are all fictitious names. However, the persons & the organizations which they represent have been characterized in this case study with accuracy.