Inside the Lab

Digital pathology refers to everything from a static image of a slide to a real-time broadcast image. So, what do laboratory professionals mean when we talk about using digital pathology? What infrastructure is necessary beyond the scanners themselves? And what is driving the adoption of digital pathology tools? 

On this episode of Inside the Lab, Dr. Dan Milner and guest host Dr. Joe Sirintrapun, MD, Director of Pathology Informatics at Memorial Sloan Kettering Cancer Center, are joined by Dr. Orly Ardon, PhD, MBA, Science Manager for Digital Pathology Diagnostics at Memorial Sloan Kettering Cancer Center’s Pathology Department, Dr. Matthew Hanna, MD, Director of Digital Pathology Informatics at Memorial Sloan Kettering Cancer Center, and Dr. Jochen Lennerz, MD, Associate Chief of Pathology and Medical Director of the Center for Integrated Diagnostics at Massachusetts General Hospital, to discuss digital pathology. 

Our panelists explore the barriers to widespread implementation of whole slide imaging, and discuss factors a laboratory should consider before investing in a particular digital pathology system. They explain how digital pathology can benefit laboratory professionals in microbiology, cytology, and hematopathology and describe how the pandemic accelerated the adoption of digital tools. Listen in for insights on incentivizing vendors to facilitate interoperability and learn how AI technology is driving the use of digital pathology. 

Topics Covered
·       What pathologists and laboratory professionals mean by the phrase "digital pathology"
·       Barriers to widespread adoption of whole slide imaging systems
·       Important factors a laboratory should consider before investing in a particular digital pathology system
·       How digital pathology can benefit laboratory professionals in areas like microbiology, cytology, and hematopathology
·       Why decentralized, rural laboratories should consider using digital pathology
·       How commercially available artificial intelligence drives the adoption of digital pathology
·       Lessons learned around the adoption of a digital pathology platform for clinical use 

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Connect with Dr. Ardon
Dr. Ardon on LinkedIn
Dr. Ardon on Google Scholar 

Connect with Dr. Hanna
Dr. Hanna at Memorial Sloan Kettering
Dr. Hanna on Twitter
Dr. Hanna on PubMed 

Connect with Dr. Lennerz
Dr. Lennerz at Massachusetts General
Dr. Lennerz on LinkedIn

Connect with Dr. Milner & Dr. Sirintrapun
Dr. Milner on Twitter
Dr. Sirintrapun on Twitter 

Resources
Inside the Lab in the ASCP Store 

In medical circles, we say, “When you hear hoofbeats, look for horses, not zebras,” as a reminder that when people present with a given set of symptoms, the diagnosis is generally something common. But sometimes it IS a zebra, and patients sometimes DO have a rare condition like the one we’re exploring in this episode—breast implant associated lymphoma or BIA-ALCL. 

On this episode of Inside the Lab, our hosts Dr. Dan Milner and Ms. Kelly Swails are joined by Dr. Kirill Lyapichev, MD, Molecular Genetic Pathology Fellow at MD Anderson Cancer Center in Houston, Texas, and soon-to-be Hematopathology Director at the University of Texas Medical Branch in Galveston, and Dr. Deniz Peker, MD, Associate Professor in the Department of Pathology and Laboratory Medicine at Emory University in Atlanta, Georgia, to discuss breast implant associated ALCL. 

Dr. Lyapichev shares the history of breast implants in general and BIA-ALCL specifically, walking us through two case studies of the entity with very different outcomes. Dr. Peker describes her approach to diagnosing breast implant associated ALCL, and our panelists explain the clinical signs associated with the rare condition. Listen in for insight on the treatment options available to patients and learn what pathologists need to know about the epidemiology of BIA-ALCL.  

Topics Covered  

· Two contrasting case studies of patients with breast implant associated ALCL
· What we know about the epidemiology of BIA-ALCL and its relationship with chronic inflammation
· Why BIA-ALCL is considered a very rare entity
· Diagnosing BIA-ALCL and hesitations around making a diagnosis based on cytology alone
· The role molecular clonality test plays in diagnosing BIA-ALCL and how common clonality is in published cases of the entity
· How to recognize the clinical signs of breast implant associated ALCL
· Insight on the history of breast implants in general and BIA-ALCL specifically
· The excellent prognosis for patients diagnosed with BIA-ALCL in its early stages (and why reconstructive surgery patients with the condition are caught earlier than cosmetic cases)  
· What treatment options are available for patients with breast implant associated ALCL
· The latest developments in BIA-ALCL and why pathologists need to be familiar with it 

Connect with ASCP
ASCP
ASCP on Facebook
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ASCP on Twitter 

Connect with Dr. Lyapichev
Dr. Lyapichev on Twitter
Dr. Lyapichev on LinkedIn 

Connect with Dr. Peker
Dr. Peker on Twitter
Dr. Peker at Emory Winship Cancer Institute 

Connect with Dr. Milner & Ms. Swails
Dr. Milner on Twitter
Ms. Swails on Twitter 

Resources
Thomas Cronin & Frank Gerow
Inside the Lab in the ASCP Store 

The ASCP Board of Certification (BOC) is the gold standard of certification for pathologists and laboratory professionals. And while the committees who put together these exams don’t want candidates to fail, they DO want to ensure that the right people are caring for patients. With that standard in mind, how is a BOC exam put together? 

On this episode of Inside the Lab, our hosts Dr. Lotte Mulder and Ms. Pat Tanabe are joined by Ms. Kathleen Finnegan, MS, MT(ASCP)SHCM, retired Clinical Associate Professor and Program Director at the Department of Clinical Laboratory Sciences at Stony Brook University of New York and Member of the ASCP BOC Phlebotomy and MLA Committees, Ms. Karen A. Brown, MS, MASCP, MLS(ASCP)CM, Adjunct Professor at the University of Utah’s Department of Pathology, Medical Laboratory Sciences Division and Member of the ASCP BOC Research & Development Committee, and Mr. Walter Oliveira, MASCP, MLS(ASCP)CMSI, Medical Laboratory Manager at the University of Virginia Health System, Chair of the ASCP BOC MLA Certification Committee and Member of the BOC Flow Cytometry Specialty Exam Committee, to discuss the making of a BOC exam. 

Our panelists describe the duties and functions of each exam committee, walk us through the anatomy of an exam question, and weigh in on how questions are developed and maintained. Listen in for insight on the benefits of computer adaptive testing and how the practice analysis helps the BOC keep their certification exams fair and current. 

Topics Covered
· The importance of earning an ASCP BOC certification and its benefits in terms of job prospects and professional success
· The group within ASCP’s BOC that oversees exam preparation and how that group is organized
· The anatomy of an exam question and why the BOC prefers comprehension, application and analysis questions over recall questions
· How computer adaptive testing (CAT) works and its advantages 
· How the practice analysis ensures that BOC exams are fair, valid and legally defensible and how the data collected from practice analysis surveys informs the examinations
· The exhaustive standard-setting process the BOC uses to determine an exam’s pass-fail line 

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ASCP
ASCP on Twitter 

Connect with Ms. Finnegan
Ms. Finnegan at Stony Brook
Ms. Finnegan on LinkedIn 

Connect with Ms. Brown
Ms. Brown at the University of Utah
Ms. Brown on LinkedIn

Connect with Mr. Oliveira
Mr. Oliveira on Twitter
Mr. Oliveira on LinkedIn 

Connect with Dr. Mulder & Ms. Tanabe
Dr. Mulder on Twitter
Ms. Tanabe on LinkedIn 

Resources
ASCP Board of Certification
National Accrediting Agency for Clinical Laboratory Sciences
Inside the Lab in the ASCP Store 

Multiple companies are in the process of launching universal cancer screening (UCS) technologies. And while the ability to identify tumors earlier will be revolutionary, especially for for patients with less common cancers, there are still a lot of questions around how to read the reports and apply the results. So, what do pathologists and laboratory professionals need to know about these multicancer screenings and how such tests might affect our daily practice in the immediate future? 

On this episode of Inside the Lab, our hosts Dr. Dan Milner and Dr. Lotte Mulder are joined by Dr. Alarice Cheng-Yi Lowe, MD, FASCP, Cytopathologist, Surgical Pathologist, and Director of the Circulating Tumor Cell Lab at Stanford University, Dr. Jeff Gagan, MD, PhD, Molecular Genetic Pathologist, Assistant Professor of Pathology, and Medical Director of the Clinical Next Generation Sequencing Lab at the University of Texas Southwestern Medical Center, and Dr. Maria Arcila, MD, Molecular Genetic Pathologist, Hematopathologist, and Director of the Diagnostic Molecular Pathology Laboratory at Memorial Sloan Kettering Cancer Center, to discuss universal cancer screening. 

Our panelists explain why UCS isn’t a part of our current toolbox and what data we need before it can be integrated into standard cancer care. They weigh in on why it’s so difficult to confirm a positive UCS result and walk us through the challenges associated with interpreting multicancer screening reports. Listen in for insight on why pathologists need to be aware of USC technology, its capabilities, and limitations and why it's likely to shift the role laboratory professionals play on the clinical team moving forward.

 Topics Covered  

· The rapidly evolving technology that allows us to evaluate a patient for many cancers in a single assay
· Why USC isn’t part of the current toolbox now and the data needed to integrate it into standard cancer care
· Challenges to confirm a positive UCS result and how such screenings might force patients into a stressful watch and wait process
· Challenges associated with interpreting multicancer early detection reports and why getting comfortable with understanding molecular data is critical
· Concerns around direct-to-consumer testing
· How the rise of UCS is likely to shift the role laboratory pros play on the clinical team 

Connect with ASCP
ASCP
ASCP on Facebook
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ASCP on Twitter

Connect with Dr. Lowe
Dr. Lowe at Stanford University 

Connect with Dr. Gagan
Dr. Gagan at UT Southwestern
Dr. Gagan on LinkedIn 

Connect with Dr. Arcila
Dr. Arcila at Memorial Sloan Kettering
Dr. Arcila on LinkedIn

Connect with Dr. Milner & Dr. Mulder
Dr. Milner on Twitter
Dr. Mulder on Twitter

Resources
Inside the Lab in the ASCP Store
Mayo Clinic Summit&

It is our duty as medical professionals to provide the safest blood possible for patients undergoing a transfusion. Hemovigilance is crucial in ensuring that the blood products we use are of the highest quality. So, how does the data collection and reporting process work? 

On this episode of Inside the Lab, our hosts Dr. Dan Milner and Ms. Kelly Swails are joined by Dr. Chester Andrzejewski, MD, Medical Director of System Blood Banking and Transfusion Medicine Services at Baystate Health in Springfield, Massachusetts, and Assistant Professor in the Department of Pathology at the University of Massachusetts Medical School, Ms. Lynne O’Hearn, MT(ASCP), Transfusion Safety Officer at Baystate Medical Center in Springfield, Massachusetts, and Mr. Karl G. Stein, BB(ASCP)CM, Lead Medical Technologist for OneBlood, Inc., and Manager of the Infusion Center at St. Joseph’s Hospital in Tampa, Florida, to discuss hemovigilance and how it fits into the larger culture of safety in medicine. 

Our panelists describe the complexity of data collection and how they streamline the reporting process. They weigh in on why transfusion services at every hospital should participate in hemovigilance regardless of size, discussing the benefit of being able to compare your data with that of other facilities. Listen in for insight on how hemovigilance data has inspired changes in policy and learn where you can find resources around initiating data collection systems in your lab. 

Topics Covered  

·  The concept of hemovigilance and how it fits into the larger culture of safety in medicine
·  Why data collection for hemovigilance is so complex and how standardizing forms and leveraging databases streamline the reporting process
·  The importance of developing relationships with nursing and IT to build reporting systems for transfusion medicine
·  How hemovigilance reporting is mandatory in Massachusetts and the benefit of being able to compare your facility’s data with the rest of your state
·  The value of integrating medical data systems on a national scale
·  Resources on hemovigilance to initiate data collection systems in your lab 

Connect with ASCP
ASCP
ASCP on Facebook
ASCP on Instagram
ASCP on Twitter 

Connect with Dr. Andrzejewski
Dr. Andrzejewski at Baystate Health

Connect with Ms. O’Hearn
Ms. O’Hearn on Facebook

Connect with Mr. Stein
OneBlood
Mr. Stein on LinkedIn 

Connect with Dr. Milner & Ms. Swails
Dr. Milner on Twitter
Ms. Swails on Twitter

 Resources
American Association of Blood Banks Hemovigilance Resources
AABB Quick Reference Guide for the NHSN Hemovigilance Module
Inside the Lab in the ASCP Store 

Conflict in the workplace is not necessarily a bad thing. When managed well, it can lead to learning and improve an organization overall. But when conflict is managed poorly or not at all, it makes for a combative environment where people feel disrespected and can’t do their best work. 

On this episode of Inside the Lab, our hosts Dr. Lotte Mulder and Ms. Kelly Swails are joined by Dr. Karim E. Sirgi, MD, MBA, FCAP, Founder and CEO of Sirgi Consulting and President of the American Pathology Foundation, Dr. Marissa White, MD, Assistant Professor of Pathology at Johns Hopkins University School of Medicine and Member of the ASCP Diversity and Inclusion Committee, and Mr. Paul Chiou, MPH, SCT(ASCP), Faculty at the Department of Clinical Laboratory and Medical Imaging Sciences at Rutgers University and a 2015 ASCP 40 Under Forty Honoree, to discuss conflict in the workplace. 

Our panelists share the most common areas of conflict among pathologists and laboratory professionals, and describe how to distinguish between productive and unproductive or even discriminatory conflict. They weigh in on how diversity can both cause conflict and enhance our learning overall, explaining what microaggressions look like and how they compromise a safe working environment. Listen in for Dr. Sirgi, Dr. White, and Mr. Chiou’s insight on the relationship between conflict and burnout and learn what we can do to foster a healthy competition of ideas while resolving unproductive conflict in the workplace.

 Topics Covered  

· How lack of leadership, communication, transparency and trust lead to conflict among pathologists and laboratory professionals
· Why conflict in the workplace or learning environment isn’t always a bad thing
· Distinguishing between productive conflict and conflict that is unproductive or
discriminatory
· How diversity both causes conflict and enhances our learning overall
· What microaggressions look like and how they compromise a safe working environment
· Our panelists’ personal experience with conflict in the laboratory workplace and how they resolved the situation
· How chronic unresolved conflict impacts our health and causes burnout
· Why knowing people as human beings is the best way to facilitate conflict resolution 

Connect with ASCP
ASCP
ASCP on Facebook
ASCP on Instagram
ASCP on Twitter 

Connect with Dr. Sirgi
Sirgi Consulting
Dr. Sirgi on Twitter 

Connect with Dr. White
Dr. White at Johns Hopkins 

Connect with Mr. Chiou
Mr. Chiou at Rutgers
Mr. Chiou on LinkedIn 

Connect with Dr. Mulder & Ms. Swails
Dr. Mulder on Twitter
Ms. Swails on Twitter 

Resources
ASCP Diversity and Inclusion Resources
Inside the Lab in the ASCP Store 

An autopsy is the final chapter in a patient’s life. And while it can be a research tool, its underlying purpose is to give the family closure. So, what does the death certification process look like? How does the work of autopsy pathologists serve patients, their families, and the community at large? 

On this episode of Inside the Lab, our hosts Dr. Dan Milner and Ms. Kelly Swails are joined by Dr. Wendy Lavezzi, MD, Deputy Chief Medical Examiner for the Districts 5 and 24 Medical Examiner’s Office in Leesburg, Florida, Dr. Robert Padera, Jr., MD, PhD, Pathologist at Brigham and Women’s Hospital and Associate Professor of Pathology at Harvard Medical School, Dr. Joneé M. Taylor, MD, MA, Deputy Medical Examiner for the District of Columbia’s Office of the Chief Medical Examiner, and Dr. Alex K. Williamson, MD, Chief of Autopsy Pathology at Northwell Regional and Associate Professor of Pathology and Laboratory Medicine at Zucker School of Medicine at Hofstra/Northwell, to discuss death certificates. 

Our panelists introduce us to the vocabulary of the death certification process, explaining who can legally certify a death and what mistakes non-pathology physicians make in filling out death certificates. They weigh in on what differentiates the work of a medical autopsy pathologist from that of a forensic autopsy pathologist and describe the particular challenges they all faced during the pandemic. Listen in for our panelist's insight on the shortage of autopsy and forensic pathologists and what we can do to address that need. 

Topics Covered  

· Who can legally certify a death and when it’s appropriate to certify a death without an autopsy
· What differentiates the work of a medical autopsy pathologist from that of a forensic autopsy pathologist, and when they might work together
· Common mistakes non-pathology physicians make in filling out death certificates
· What the terms “cause,” “mechanism,” and “manner of death” mean in the formal death certification process
· The challenges in the death certification process during the pandemic
· Disparity challenges around death certification in the pandemic and the distinction between dying with COVID and dying of COVID 

Connect with ASCP
ASCP
ASCP on Facebook
ASCP on Twitter 

Connect with Dr. Lavezzi
Dr. Lavezzi on LinkedIn 

Connect with Dr. Padera
Dr. Padera on LinkedIn 

Connect with Dr. Taylor
Office of the Chief Medical Examiner, District of Columbia 

Connect with Dr. Williamson
Dr. Williamson at Northwell Health
Books by Dr. Williamson 

Connect with Ms. Swails & Dr. Milner
Ms. Swails on Twitter
Dr. Milner on Twitter 

Resources
Inside the Lab in the ASCP Store 

Pathologists and lab professionals in global health are working to achieve health equity for all people worldwide. But what does that look like in practice? What challenges do global health advocates face, and what resources do they need to do their work? Which factors influence their ability to help build sustainable health delivery systems in places where people currently lack access to care? 

On this episode of Inside the Lab, our hosts Dr. Lotte Mulder and Dr. Dan Milner are joined by Dr. Beatriz Hornburg, MD, Anatomic Pathologist and Cofounder of the CEDAP Laboratory in South Brazil, Dr. Dianna Ng, MD, Assistant Attending Physician at Memorial Sloan Kettering, Ms. Linda Cherepow, HT(ASCP)HTL, Founder of Global Histology Consulting and Cofounder of Swift Path Solutions in Uganda, Dr. Jane Brock, MD, PhD, Chief of Breast Pathology at Brigham and Women’s Hospital, and Dr. Timothy Amukele, MD, VP Global Medical Director for ICON plc, to share their experiences with global training programs for pathologists and laboratory professionals. 

Our panelists discuss their concerns around realizing sustainable interventions, recruiting the right volunteers, and securing the resources they need to do effective work in global health.  

Topics Covered  

·  Challenges around understanding culture, finding the right local partners, and realizing sustainable interventions
·  Strategies for recruiting local and international volunteers and why it’s important to establish a standard of training for global health volunteers
·  What diseases our panelists see as major threats to global health that need our attention 
·  Virtual teaching in the COVID era and how travel restrictions have affected work in global health 

Connect with ASCP

ASCP
ASCP on Facebook
ASCP on Twitter 

Connect with Ms. Hornburg 

Ms. Hornburg on Twitter 

Connect with Dr. Ng 

Dr. Ng on Twitter 

Connect with Ms. Cherepow 

Ms. Cherepow on LinkedIn 

Connect with Dr. Brock 

Dr. Brock on Twitter 

Connect with Dr. Amukele 

Dr. Amukele on Twitter 

Connect with Dr. Milner & Dr. Mulder 

Dr. Milner on Twitter
Dr. Mulder on Twitter 

Resources 

Inside the Lab in the ASCP Store
World Health Organization
WHO’s Global Initiative for Childhood Cancer
WHO’s Global Strategy to Accelerate the Elimination of Cervical Cancer
WHO’s Global Breast Cancer Initiative 

For all of its faults, social media provides an extraordinary opportunity for pathologists and laboratory professionals to engage with each other as well as the general public. And if we are mindful about how we show up, platforms like Twitter give us a forum for networking, advocating for our profession, and sharing our work with the world. 

On this episode of Inside the Lab, our hosts Dr. Dan Milner and Dr. Lotte Mulder are joined by Ms. Dana Baker, MLS(ASCP)CM, Assistant Professor in the Department of Clinical Laboratory Sciences within the School of Health Professions at the University of Kansas Medical Center, Dr. Kamran Mirza, MD, MLS(ASCP)CM, Associate Professor of Pathology and Vice Chair of Education at Loyola University Health System in Maywood, Illinois, Dr. Sanjay Mukhopadhyay, MD, Director of Pulmonary Pathology at the Cleveland Clinic and Associate Editor of the American Journal of Clinical Pathology, and Dr. Sara Jiang, MD, Associate Professor of Pathology at Duke University and Director of the Duke Pathology Communications Group, to discuss how social media can benefit medical laboratory professionals. 

Our panelists offer advice around posting cases on social media, and discuss the challenges of creating and enforcing social media policies for pathologists and laboratory professionals. They weigh in on the potential pitfalls of social media and share their individual approaches to posting personal versus professional content. Listen in for insight on leveraging social media for educational purposes and learn how we can use social media to increase the visibility of medical laboratory professionals. 

Topics Covered  
· The impetus to use social media for professional reasons and why busy lab professionals should take time to learn and use social media
· Advice for posting cases on social media and why it’s crucial to be in compliance with your organization’s social media policies
· Challenges around creating and enforcing social media policies for pathologists and laboratory professionals
· How social media can open up professional opportunities and access to the global community of pathologists and laboratory professionals 

Connect with ASCP
ASCP
ASCP on Facebook
ASCP on Instagram
ASCP on Twitter
Connect with Ms. Baker
Ms. Baker on Twitter
Connect with Dr. Mirza
Dr. Mirza on Twitter
Connect with Dr. Mukhopadhyay
Dr. Mukhopadhyay on Twitter
Dr. Mukhopadhyay on YouTube
Connect with Dr. Jiang
Dr. Jiang on Twitter
Dr. Jiang on Facebook
Connect with Dr. Mulder & Dr. Milner
Dr. Mulder on Twitter
Dr. Milner on Twitter
Resources
 ‘The Network That Never Sleeps’ in Lab Medicine
ASCP 40 Under Forty
Inside the Lab in the ASCP Store 

Seventy percent of medical decisions depend on laboratory results. And yet, pathologists and medical laboratory professionals received very little press coverage prior to the pandemic. Now that our work has been recognized, what can we do to keep that ball rolling? How can we expand Medical Laboratory Professionals Week beyond the walls of the lab and inspire our communities to celebrate with us? 

On this episode of Inside the Lab, our hosts Dr. Lotte Mulder and Ms. Kelly Swails are joined by Ms. Theresa Tellier-Castellone, EdD, MPH, MLS(ASCP)CM, Program Director at Our Lady of Fatima Hospital and Rhode Island Hospital, Dr. Melanie Johncilla, MD, Consultant Pathologist at Port of Spain General Hospital in Trinidad and Tobago and Medical Director at Global Pathology Solutions, and Mr. Aaron K. Odegard, MS, MLS(ASCP)CMSMCM, Medical Laboratory Technologist at Baptist Health in Jacksonville, Florida, and Chair of the ASCP Council of Laboratory Professionals, to discuss their plans for Medical Laboratory Professionals Week and the importance of celebrating the lab. 

Our panelists share how they recognize Lab Week outside the lab, offering insight how to engage the rest of the hospital staff and even the general public to celebrate with us. They weigh in on the psychological benefit of celebrating the work we do and describe how we might take advantage of the lab’s visibility during COVID to elevate Lab Week this year. Listen in for Ms. Tellier-Castellone, Dr. Johncilla, and Mr. Odegard’s favorite Lab Week memories and get their top ideas for celebrating our role as medical laboratory professionals and pathologists. 

Topics Covered  

· Our panelists’ favorite Medical Laboratory Professionals Week games and activities
· The challenges celebrating Lab Week in a resource-restricted setting
· What to do to have Lab Week recognized outside the lab
· How we might take advantage of the lab’s visibility during COVID to elevate Lab Week this year and invite the rest of the hospital staff to celebrate with us
· The psychological benefit of celebrating the work we do as medical laboratory professionals

Connect with ASCP 

ASCP
ASCP on Facebook
ASCP on Instagram
ASCP on Twitter 

Connect with Ms. Theresa Tellier-Castellone

Ms. Tellier-Castellone on LinkedIn

Connect with Dr. Johncilla

Dr. Johncilla on LinkedIn
Global Pathology Solutions 

Connect with Mr. Odegard 

Mr. Odegard on Twitter
Mr. Odegard on LinkedIn 

Connect with Ms. Swails & Dr. Mulder 

Ms. Swails on Twitter
Dr. Mulder on Twitter 

Resources 

ASCP Resources for Celebrating Medical Laboratory Professionals Week
ASCLS Resources for Celebrating Medical Laboratory Professionals Week
Inside the Lab in the ASCP Store