CC BY-NC-ND 4.0 · Appl Clin Inform 2022; 13(05): 1108-1115
DOI: 10.1055/a-1957-6219
Research Article

Remote Digital Microscopy Improves Hematology Laboratory Workflow by Reducing Peripheral Blood Smear Analysis Turnaround Time

Ben-Zion Katz
1   Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2   Division of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
3   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Dan Benisty
1   Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2   Division of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
,
Yael Sayegh
1   Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2   Division of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
,
Inna Lamm
1   Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
2   Division of Clinical Laboratories, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
,
Irit Avivi
1   Division of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
3   Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
› Author Affiliations
Funding None.

Abstract

Background The demand for morphological diagnosis by peripheral blood smear (PBS) analysis with clearly defined turnaround times (TAT), coupled with a shortage of morphologists and increasing cost containment, is driving digitalization to the forefront of laboratory workflow. Labor-intensive manual PBS review affects weekend workflow with limited staff availability. The impact of remote analysis of PBS on the performance of hematology laboratories has not yet been assessed.

Objectives Following implementation of fully remote digital microscopy within our laboratory, we measured its impact on morphology workflow efficiency, TAT, and hours saved per month.

Methods A retrospective study of the effects of remote PBS analysis on the morphology workflow in a tertiary medical center using the Scopio Labs X100 Full-Field PBS system was conducted. 10,704 PBS samples were analyzed pre-and post -implementation, over a 5-month period. Overall PBS workload, and average TAT of PBS samples over weekends and the first two weekdays were collected and evaluated.

Results Remote weekend viewing resulted in a 15.8% reduction in the overall morphology TAT of the laboratory (p <0.03) over a 5-month period, despite similar overall workload. PBS analysis TAT on Fridays was reduced by 41.4% (p <0. 006), and by 59.1% on the first weekday (p <0.02). The additional hours incurred over the weekend were offset against a reduced need for double weekday shifts resulting in approximately 12.76 work hours saved per month. Internet links to clinically relevant cases are provided.

Conclusion The Scopio Labs Full-Field X100 PBS system with remote analysis capacity significantly reduced PBS TAT and improved the morphology workflow of the hematology laboratory. PBSs with significant clinical findings are now available for remote viewing by on-call clinicians located outside the medical center perimeter. Remote PBS viewing, coupled with the overall monthly cost savings, merit consideration for the implementation of full digitalization for remote PBS review.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects, and was approved by TASMC Institutional Review Board. Animal subjects were not included in the project.


Supplementary Material



Publication History

Received: 12 July 2022

Accepted: 20 September 2022

Accepted Manuscript online:
08 October 2022

Article published online:
23 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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