New technology is transforming blood smear review, reducing clinician workload while creating opportunities for collaboration, consultation and teaching across IDNs.
By Jim Poggi
Hematology automation for cell counts (WBC, RBC and platelets) dates back over 75 years. But for detailed morphology (cell types and structures) of WBC and RBC subtypes, the microscope and the experienced microscopist have been the gold standard until the present time. Early attempts to automate review of hematology blood slide smears to classify morphology of RBC and WBC have their history dating back over 50 years but did not achieve widespread adoption.
This month I plan to focus on newer technology that makes automated, reliable RBC and WBC slide analysis a reality in any size lab and can connect multiple sites to allow sharing of slides for consultation and teaching purposes. Whether you sell to individual, privately held hematology/oncology practices or to the largest IDNs that own 50 or more physician practices, this solution can vastly reduce the time clinicians spend reviewing routine blood smear slides. It may even improve slide review by pre-classifying easy-to-review slides and requiring clinician review only for the most difficult cases.
Why is this important? Many hematology/oncology practices still rely on manual hematology slide review of each blood smear. While this assures that every slide gets the highest level of review expertise possible, it also ties up valuable specialist time at the microscope and limits their time with patients. It has several other disadvantages, including that it does not provide the option to teach new clinicians how to review hematology blood smear slides and does not provide a way to share tough cases among multiple clinicians to assure the highest level of expertise across the IDN or other clinician network.
However, technology marches on and now there are solutions that can automate the entire hematology slide review process from making perfect slides every time, review of the routine ones, flagging the grossly abnormal slides for clinician review and even allowing review of slides across a network for teaching and consultative purposes.
Speed, consistency and reduction of high value clinical specialist labor are benefits baked into this kind of solution for any single practice. But the benefits can extend network wide in any IDN and bring a new level of accuracy and consistency across the entire network.
Finally, slide information can be fed into machine learning algorithms to improve expertise useful for difficult cases. The interesting thing to me is that the benefits span the entire slide process. They extend all the way from reduction in physician time reviewing slides to customization of which slides require review to group/peer review of slides for consultation and teaching purposes. They may also provide benefits by making the cell morphology information available to machine learning algorithms to make the network more well-informed about uncommon or difficult to review slides.
This goes far beyond our typical definition of automation and is a comprehensive solution for the hematology slide review process. In addition, the instrumentation and software are scalable, meaning it can serve the needs of practices of virtually any size and become the central location for blood smear slide data within the IDN. The benefits are powerful and really meet the definition of “game changer” in my mind. Rather than thinking in terms we typically associate with “automation” or “standardization,” I like to think of this solution as providing all of those benefits, but also providing a tool for multiple-site intellectual collaboration (MSIC).
A top-down selling opportunity
If you have bought into the excitement associated with this level of automation and the new level solution it provides, it is reasonable to ask “So, what is the sales process?” In my opinion, unless you have a strong coach who is a well-respected leader in your IDN, I do not think selling from the bottom up is the right approach. If we were to sell bottom up, the benefits of collaboration across the network and use as a teaching tool would not be realized.
I think this is truly a top-down selling opportunity that presents your team with exciting ways to collaborate, leveraging both your collective expertise and individual relationships across an IDN to promote and sell a strong, multi-location solution. Each distribution account manager, corporate account manager and manufacturer rep need to develop a different kind of plan than the one we usually think of. Selling this sort of solution involves the highest level of team selling I can envision. Why? Because the IDN, its most prominent clinicians and the sales team all need to work together in harmony to go from concept to first adopters to adoption and standardization across the network.
Your corporate accounts manager, the IDN chief medical officer, the IDN’s financial team and most of the clinicians in hematology/oncology practices owned or associated with the IDN need to see the solution and the future it provides in the same way. Since most IDNs include a teaching hospital, there is the opportunity to include members of the teaching staff to share their ideas of how they can train future practicing clinicians to use this powerful tool.
The only way to get the IDN to see and believe in the benefits is for the sales team to have the same view of the benefits. Who leads the team? How do you communicate the value elements? What are the specific roles and responsibilities of team members? What is the customer value proposition? What is the value to different decision makers? What is the value for the IDN?
A potential sales process
In one potential team selling example, the sales process would start with a meeting of decision makers across the IDN and feature a technical and financial presentation. The quarterly business review is likely the perfect venue for this topic. The sales team lead would be accompanied by the manufacturer and two or three account managers with solid relationships with hematologist/oncologist practices across the IDN.
Assuming a successful presentation and agreement on the technical and financial benefits, the sales lead would ask the CMO and IDN leadership to agree to a multi-site evaluation of the product and software. They would also ask:
- “What do you believe a successful evaluation needs to prove?”
- “Is this solution included in the current budget?”
- “If the demonstration shows the value we are confident it will, would you be prepared to adopt this solution across the IDN?”
Assuming agreement, the team would place the right instruments and software at three or four locations and conduct a demonstration to show the value at every level: each site would experience better use of clinician time and expertise with software solutions creating the best slide reviews with the least clinician effort. Collaboration across the network would be coordinated to show the overall value of the solution in terms of sharing expertise and teaching across the network.
The power of team selling
These sorts of IDN-wide solutions are exceptional examples of population-based medicine advancements. They also show the power of team selling at its best. As the healthcare system is asked to do more with less it is also asked to improve healthcare at the same time.
I believe this type of solution fits that need well. My suggestion? Spend time with your manager and sales team and take a strategic look at the IDNs you service, looking to determine whether you have a solid candidate. The right candidate will be forward thinking, open to new ideas, have high level relationships willing to spend time with your team and a budget that could accommodate this sort of system-wide solution.
Once you have identified the right IDN, then it’s time to go to work and prove your mastery of team selling.
Key Takeaways
- New hematology automation can streamline blood smear review by handling routine slides, flagging difficult cases and reducing the time clinicians spend at the microscope.
- The technology can improve consistency and extend expertise across an IDN by enabling clinicians to share difficult cases, consult with peers and use slides for teaching.
- Because the benefits extend beyond individual practices, these solutions represent a top-down selling opportunity that requires coordinated collaboration among sales teams, manufacturers and IDN leadership.
- Successful adoption depends on identifying the right IDN, demonstrating both clinical and financial value through a multisite evaluation and building a plan for network-wide standardization.