Contributed Commentary By Eric Feinstein, CEO of Clarapath
October 15, 2021 | No one awaiting the results of a biopsy wants to hear that they may be in for a longer wait. But, there’s a good chance results may be delayed and there is an understandable reason for it: There are tens of millions of biopsies ordered each year, and there aren’t enough histotechnologists to process them.
The vacancy rate for histotechnologists, the trained medical professionals tasked with processing tissue samples for microscopic examination and eventual diagnosis, is approaching 10 percent. The labor shortage is largely due to an aging workforce and fewer histology programs to train new entrants.
It’s likely that it can also be attributed to the nature of the job. Histotechnology is tough, manual work, requiring skill and dexterity, astute attention to detail, and stamina.
Histotechnologists meticulously manage delicate tissue samples through a series of processing stages. Their work includes using a microtome to cut tissue embedded into paraffin wax into extremely thin slices, floating and removing the fragile slices from a carefully controlled water bath onto slides, and expertly mounting them before they are sent to a pathologist for analysis.
Providers and patients are anxiously awaiting lab results so there’s pressure on techs to move quickly, while avoiding a slip of hand that could damage samples, causing delays and leading to missed or inaccurate diagnoses that could have disastrous consequences.
The work is relentless. According to a recent study published in the National Library of Medicine, labs today, many of them short-staffed, process an average of more than 26,000 cases per year. The workload is expected to increase as awareness and interest in early disease detection leads providers to write more lab orders.
COVID-19 has also accelerated demand on labs. A report from the American Society of Clinical Oncology found that at the peak of the pandemic, screenings for breast, colon, prostate, and lung cancers were up to 85 percent lower than typical (85 percent, 75 percent, 74 percent and 56 percent, respectively). As patients begin resuming preventative screenings, and some sadly present more advanced disease, there’s more work for labs.
And, yet, as demand continues to increase, according to the U.S. Bureau of Labor Statistics, the number of job openings for clinical laboratory technologists and technicians is projected to grow faster than the average for all occupations.
How are labs to keep up? Technology can help.
How Automation Addresses the Labor Shortage in Labs
Because the work of a histotechnologist is manual and each technician’s technique and skill level is unique from others, the tissue samples they process are inconsistent. Inconsistency introduces the potential for error, for instance manual cuts can be missing tissue, contributing to a need for repeat biopsies. Furthermore, overtaxed histotechnologists working long shifts with limited sleep day after day, week after week, can lead to errors—processing errors, quality control errors, safety lapses, and more. These mistakes add additional workload and wait times to an already overtaxed, short-staffed industry where a patient is on the other side of a slide.
Automating manual steps in tissue processing that have not yet been modernized, specifically microtomy which involves the slicing and processing of tissue samples, can create standardization and bring consistency to the practice. With consistent, uniform samples, pathologists can accurately diagnose without the need for repeat biopsies, helping to reduce workloads and get patients quicker test results and more immediate access to care.
Consistency also leads to better digital pathology, enabling lower cost telepathology to firmly take hold. These advances can open the possibilities for 3D reconstruction of tumors at a microscopic level, along with matching genomic data with pathology data, contributing to remarkable advances in medicine.
Technology can help to modernize pathology, which is long overdue for transformation, addressing inefficiencies and labor shortages that threaten patient care. It’s a win for all, resulting in better quality slides, faster turnaround times, lower costs, and more accurate, timely delivery of care—among the primary tenets within healthcare reform: access, quality, and cost reductions.
Eric Feinstein is the CEO of Clarapath, a medical robotics company aimed at catalyzing change in the way laboratory medicine is practiced. As CEO, Eric has channeled his passions in healthcare, engineering and enterprise building into Clarapath’s innovative tools and workflow solutions that improve outcomes, reduce costs, improve access and increase efficiency in clinical and non-clinical pathology. He can be reached at efeinstein@clarapath.com.