Dr Sjors Koppes is just finishing his postgraduate training in pathology and is on his way of specializing in Head and Neck pathology at Medisch Centrum Utrecht University. Asked what most people think of when they hear of his job, he chuckles.
“People think that it is Crime Scene Investigation and that we are dissecting dead bodies all day, but it is far from being our day to day work. We do research and diagnostics on tissue specimens that are resected. Autopsy to find a cause of death, is 2% of our job. It fascinates people because this aspect is morbid, people watch peculiar series about it. It is funny that people think this, it has such a mysterious aura which is not necessarily a bad thing, but it does not really represent our job. “
Like a lot of younger, digital native doctors, Dr Koppes instinctively appreciates the value of digital medicine. In his rare and complex speciality, it speeds up the process of working and will lead to better results because it will become possible to access the knowledge of the best specialists.
“Big hospitals have been digital for at least a year and they have multiple clinics, so exchange of imagery & data is seamless. For example, a hospital has a deal with Haemopathologists. When they diagnose a lymphoma, they chat around it digitally, and after 3 Haemopathologists have seen it and agree, they make the report and send it to the clinic. This speed is only possible when you are digital, whereas when you work with glass slides, you need to mail it and the process will take several weeks. “
“Eventually I believe it will be cheaper if we centralize more through digitalization and this will benefit everyone, and especially rarer and most specialized doctors. Let us say 20 pathologists have head and neck as their subspecialisation among other ones, but usually, only 10 of them will be solely doing head and neck pathology. We cannot do the exchanges of imagery easily yet. If I find a very rare salivary gland tumor, I know who the very best in the field is. I know her address, I can send the person the glass slides, but unfortunately the entire process takes days.”
“In 2016 we were the first hospital that rendered the diagnostics department of the hospital digital. Most other hospitals in the world were working with glass slides or still are. In Holland it is changing rapidly: we have roughly 100 hospitals and perhaps 20 pathology labs, and 5 will probably be going digital toward the end of this year. 2020 is the year where the most pathology labs are gradually going digital. In the end it is quicker, easier and it is better.” We were very fortunate to have already created a national pathology reports database back in the 80s. It has been very handy.” In fact, in The Netherlands pathology is the field which had digitized the earliest as this was deemed very important for research and epidemiology.
Being able to take a 3D, digital view is especially important in Dr Koppes’ chosen field of interest. And 3D working and thinking requires 3D-specialist tools. As he explains, “It is a speciality which has a lot of solid tumors. It is very 3 dimensional and requires 3-dimensional thinking. You really must know your anatomy, which part of the head and the neck you are looking at. Another interesting and challenging part are very rare tumors of the salivary glands. I like to do challenging tasks.”
‘I keep telling my peers every day that it is far more efficient to go through your case with a 3Dconnexion device than just working with a standard mouse and keyboard. The workflow creates more fluidity, yet most pathologists, despite these devices solving numerous efficiency issues do not know these products, or they still prefer the old way, which is very inefficient. For example, a new resident started this week, I immediately told her to spend time using 3Dconnexion’s device and adopt the “twohanded workflow” gesture motion so that she becomes quicker and more efficient. And believe me I tell my peers everyday! I do demos and they see how when I push a button it magically goes to the next slide.”