“ImmunoQuery seduced us due to its value when it comes to determining the diagnosis and through its added saving in time"

We interview Doctor Ramiro Álvarez Alegret, Head of the Pathological Anatomy Department, Hospital Universitario Miguel Servet, Zaragoza

“One of the great values of ImmunoQuery is the time saved in resolving the immunophenotype. In view of what the pathologist’s time is worth, this is efficiency”

Doctor Ramiro Álvarez Alegret
Head of the Pathological Anatomy Department
Hospital Universitario Miguel Servet

70% of hospital decisions are based on pathological reports; as many as 20% of the diagnoses are retarded, are not formulated or are incorrect; 35% of the claims for malpraxis are due to incorrect diagnoses. Doctor Ramiro Álvarez Alegret, Head of the Pathological Anatomy Department, Hospital Universitario Miguel Servet, Zaragoza, has to deal every day with that work load and the pressure of a swift, correct diagnosis. To assist him in this task, he has ImmunoQuery, a decision-making support system for immunohistochemistry based on evidence and on the experience of experts.

As Head of the Pathological Anatomy Department at   Miguel Servet University Hospital, Zaragoza, you’ve been using ImmunoQuery for two years. What is your clinical rating of this tool to date? 

So far, the rating is highly positive. ImmunoQuery is an excellent back-up tool for diagnosis and enables us to save a lot of time in our daily round.

Why did you decide to opt for implementation of this tool at your hospital? What was it about ImmunoQuery that most “seduced” you? 

We were seduced both by its value when it comes to determining the diagnosis and that additional saving in time you mentioned before, which is extremely beneficial, for instance, when it comes to establishing immunohistochemistry panels in differential diagnosis between tumors.

Based on the evidence and on the experience of experts, ImmunoQuery sets out to assist the making of a more precise diagnosis: To what extent has it helped you in this task, especially insofar as more complex cases are concerned? Can you give us some specific example from within your own hospital?

It’s hard to select a single example, I have to say that with our present knowledge the panel of fully differential or discriminatory markers has lead us to receive more than one agreeable surprise. What’s more, the panels proposed have enabled us to get to know new antibodies that we have added to our portfolio of services. ImmunoQuery is an excellent diagnosis support tool, and it allows us to save a lot of time in our everyday work

Another of its strong points is its optimization of time and of economic resources: In what way has use of ImmunoQuery helped you to save time and money?

Over and above economic saving, which does indeed exist, I would single out as one of the great values of ImmunoQuery the time saved in resolving the immunophenotype or the appropriate panel. This is true efficiency, if we take into account what the pathologist’s time is worth.

The training of residents and auxiliaries is a priority at any hospital. To what extent does a system in support of decision making like this one assist this work and contribute to the teaching methodology?

The program not only assesses the resident physician but also permits evaluation of the on-line activity carried on and skills developed. I wasn’t familiar with the program, but as soon as they showed it to me I considered having it available as essential.

Miguel Servet University Hospital, Zaragoza, will shortly be implementing use of ExpertPath too. What contribution do you expect this new tool will make to the Pathological Anatomy Department that you direct, both on an individual basis and forming a tandem with ImmunoQuery?

In the short term, I think we’ll go on consulting our reference books, but as you say, this tandem will allow us to optimize our time and know-how.

To round off, the digital transformation of the healthcare sector often comes up against the reticence of some   professionals, especially amongst the most veterans, not so in line yet with this technological era. For those still housing some doubt, does the usability of ImmunoQuery and ExpertPath require some prior advanced training, or are we talking of intuitive software’s tailored to all 'technological levels'?

Digitalization is the present, not the future, and its non- implementation in some departments (nobody questions that radiologists work in this way) is due only to budgetary shortcomings, not to lack of interest. I’ve been working for three years with Digital Pathology and it proves hard to return to the optical microscope. It’s possible that older pathologists may be less skilful than those trained in that culture.

Regarding ImmunoQuery and ExpertPath

ImmunoQuery provides an important meta-analysis of updated references of the leading publications in pathology. With ImmunoQuery pathologists use the information to obtain assistance in the diagnosis of a wide variety of diseases, such as cancer, infections and metabolic and connective tissue alterations. In addition, it provides quick Access to a list of antibodies that confirm the diagnosis or suggest diagnoses with similar tinctures, which helps to save reading errors which not only compromise the quality of the care processes but also place the patients at risk and increase the costs.

ExpertPath, produced by reputed pathologists, is a tool in support of decision making, based on the experience of experts, which helps pathology professionals to take into account multiple differential diagnoses, providing them with more direct access to the correct diagnosis. The lists of auxiliary ExpertPath tests help to give priority to certain studies, which involves fewer searches and firmer decisions. Through including information on prognoses as well as therapeutic information, ExpertPath provides doctors with critical information from which the patient draws benefit.

ImmunoQuery and ExpertPath form part of LIS and Oncologic solutions, which saves time, as the content is available in the user’s work flow. In this way, pathologists focus on key information:

  • Comprehensive reliable content
  • Reduction of manual processes
  • Standardization of care processes