Digital Pathology Blog

ASCP 2010 Annual Meeting Digital Pathology Course Offerings

The upcoming ASCP Annual Meeting will feature several sesssions discussing Pathology 2.0, digital pathology, including telepathology and image analysis and personalized healthcare. 

Looks like an excellent faculty for these sessions.  The meeting will take place in San Francisco between October 27-31, 2010. 

A257 Harnessing Web 2.0 to Improve Consultation and Communication

Thursday, October 28 9:30 am - 11:30 am

Get an overview of the power of Web 2.0 to link laboratory practitioners across the globe. Discussions will include a big-picture view of how the internet is changing communication among professionals, how digital pathology can facilitate consultations, and much more. Interactive lectures will offer you an opportunity to connect with select web sites and participate in a Q&A session. You will leave with the ability to:

Establish communication networks with colleagues around the world.
Understand how digital image capture/sharing will transform practice in the next decade.
Access web sites that offer specialized content in pathology and laboratory medicine.

Moderator:
William E. Schreiber, MD, FASCP, University of British Columbia

Faculty:
Dean Giustini, MLS, MEd, University of British Columbia
Michael Feldman, MD, FASCP, University of Pennsylvania

Credits: 2.0 CME

SP88 Hauling Pathology and Pathologist into the 21st Century – Telepathology and Image Analysis

Thursday, October 28 9:30 am - 11:30 am

Review telepathology for patient care, including new systems, software, government regulations, and a real-world two-year experience with a successful telepathology deployment. You will also benefit from a multifaceted view of image analysis, including a brief overview, current commonly used applications, potential research applications, and possible future developments in image analysis. You will leave with the ability to:

Recognize the challenges for so-called low- and high-end telepathology systems.
Appreciate the utility of image analysis for patient care and how these solutions can generate revenue for pathology departments.
Appreciate how images analysis can be applied to daily practice and research.

Moderator:
N. Volkan Adsay, MD, FASCP, Emory University

Faculty:
Alexis B. Carter, MD, FASCP, Emory University
Alton B. "Brad" Farris, III, MD, FASCP, Emory University

Credits: 2.0 CME

SP89 Expanding the Pathologists’ Toolbox in the Era of Personalized Healthcare – Next-Generation Pathology Technology

Thursday, October 28 3:00 pm - 5:00 pm

Hear about new information regarding several technologies – including virtual slide imaging/image analysis, circulating tumor cells, and quantum dot multiplexing – with the potential to form the basis of future high-value medical diagnostics performed and interpreted by pathologists. The faculty will discuss the need for research-grade discovery technologies to be adapted rapidly into diagnostic products that are not only analytically accurate, but also fit into routine clinical practice. You will leave with the ability to:

Recognize the relevance of the Personalized Healthcare (PHC) model for pathologists.
Understand the basic principles underlying key technologies that may play an important role in the future of pathology.

Moderator:
Jared Schwartz, MD, FASCP, Aperio Technologies, Inc.
Gary Pestano, PhD, Ventana Medical Systems
Mara Aspinall, MBA, On-Q-ity

Credits: 3.0 CME

ATA 2010 Meeting Announcement

To zero in on the latest telemedicine, telehealth, ehealth, mobile applications, and advanced remote medical technology, sign up now for the 15th American Telemedicine Association Annual International Meeting and Exposition to take place at the Henry B. Gonzalez Convention Center in San Antonio, Texas, on May 16-18 2010.

In recent months, the industry has seen huge changes in both national and state telehealth policies, National Health Reform, billions spent on broadband and health IT, new FCC broadband activities, and states mandating telemedicine coverage. The next year will be equally critical for the industry.

To address the many changes and issues involved, Aneesh Chopra, Federal Chief Technology Officer of the U.S. and John P. Howe, III, MD, President and CEO, Project Hope will be the featured speakers at the opening plenary session on Tuesday May 18th.

If you use telecommunications solutions for healthcare, the ATA Annual Meeting is the single most important event of the year to keep you up-to-date on the latest developments in your field. ATA 2010 will provide insightful keynote speakers, peer-reviewed presentations, executive roundtables, professional networking events, daily breakout sessions, and pre-meeting certificate courses.

Educational concurrent sessions will feature 72 peer-reviewed sessions and discussions on clinical services, telemental health, pediatric telehealth, remote monitoring, consumer and mobile health, emergency and disaster response, operations, business and finance, regulatory issues, and reimbursement issues.


For a preliminary program and further details, go to www.americantelemed.org.

World's Smallest, Lightest Telemedicine Microscope

via MedGadget

Researchers at The California NanoSystems Institute at UCLA (CNSI) have developed a tiny telemedicine microscope for imaging blood samples or other fluids, testing water quality or other public health need in resource-limited settings.

From the press release:

Slightly wider than a US quarter and weighing just 46 grams, the lensless microscope is a self-contained imaging device. Using LUCAS (Lensless Ultra-wide-field Cell Monitoring Array) technology, it generates holographic images of microparticles or cells by employing a light-emitting diode to (LED) illuminate the objects and a digital sensor array to capture their images.

Samples are loaded using a small chip that can be filled with saliva or a blood smear for health monitoring. With blood smears, the lensless microscope is capable of accurately identifying cells and particles, including red blood cells, white blood cells and platelets. The technology has the potential to help monitor diseases like malaria, HIV and tuberculosis.

The microscope is fairly robust with few moving parts and a large aperture. Images can be uploaded via a direct USB connection to a smart phone or other device, and sent to a hospital.

More information: UCLA engineer invents world's smallest, lightest telemedicine microscope

New Digital Pathology Blog - Digital Pathology Insights from Definiens

Peter Duncan and colleagues over at Definiens have started a new insightful blog appropriately called Digital Pathology Insights.  (Link in sidebar provided).

There are a number of interesting posts already since this weekend including linked content about Definiens products such as in the video below. 

As I have written about before, the use of image analysis algorithms is one of the major added value drivers for digital pathology and digital pathology adoption.  

Definiens as part of their marketing strategy has also been active with other Web 2.0 modalities including You Tube and Twitter to showcase and educate users about their software programs. 

Welcome Digital Pathology Insights to the blogosphere!

Blood Test Meant To Analyze Genetic Activity Could Replace Biopsies After Heart Transplantation

The New York Times (4/23, B5, Pollack) reports that "a blood test that analyzes genetic activity could let heart transplant patients avoid many of the invasive and uncomfortable biopsies now used to monitor whether their immune systems are rejecting their new organs," according to a study scheduled to be presented at the International Society for Heart and Lung Transplantation meeting and published online by the New England Journal of Medicine. The research "involved 602 patients at 13 American transplant centers who had received a transplant from six months to five years earlier." Half of the participants "were given periodic biopsies and the others the blood test," called AlloMap, "at the same frequency." 

The Wall Street Journal (4/23, Winslow) reports that just under 15% of patients who were given the test died or experienced complications during the follow-up period, compared to just over 15% of patients who were given biopsies.

The Los Angeles Times (4/22, Maugh) "Booster Shots" blog reported that "the primary limitations of the study were that it did not include patients in the first months immediately after their surgery and that it probably did not include patients who were at high risk of rejection, the authors said."

The Time (4/22, O'Callaghan) "Wellness" blog reported that AlloMap "was approved by the US Food and Drug Administration in September 2008 and assesses rejection risk by examining gene expression in patients' white blood cells." 

Reuters (4/23, Steenhuysen) quotes one of the researchers as saying, "This represents a major step forward in the way we manage a patient after heart transplants because we can now safely reduce the numbers of heart biopsies." 

MedPage Today (4/22, Phend) reported, "Rather than suggesting that the assay should become the standard, the real implication is the evidence the study offers questioning whether any routine screening is needed over the longer term after transplantation, [John A. Jarcho, MD, of Brigham and Women's Hospital] said" in an accompanying editorial. HeartWire (4/22, Stiles) and MedWire (4/22, Price) also covered the story.

CALL FOR ABSTRACTS: Medicine 2.0’10: 3rd World Congress on Social Media and Web 2.0 in Health, Medicine, and Biomedical Research on November 29-30, 2010 in Maastricht, The Netherlands.

CALL FOR ABSTRACTS:
http://bit.ly/dCOIeT

DEADLINE: May 31st, 2010

As announced earlier this year, the Medicine 2.0® conference – in 2008 and 2009 hosted in Toronto – goes global and will in 2010 be organized in Europe. The University of Twente (UT), the Radboud University Nijmegen Medical Centre (UMNC) and the National Institute for Public Health and the
Environment (RIVM) will host Medicine 2.0 Congress (Medicine 2.0’10: 3rd World Congress on Social Media and Web 2.0 in Health, Medicine, and Biomedical Research) on November 29-30, 2010 in Maastricht, The Netherlands.

Medicine 2.0® 2010 will be supported by the core Medicine 2.0® team in cooperation with scientists from UT, UMNC and RIVM; the website will remain at http://www.medicine20congress.com, and the submission and dissemination process will remain centralized. Medicine 2.0'10 will serve as an umbrella for REshape (Fall edition, UMNC) and the ‘Supporting health by technology’ (IIIrd edition) symposium
series (University of Twente, RIVM).

Abstract submissions for the Medicine 2.0'10 congress in Masstricht are open.


Medicine 2.0'10 will contain a mix of traditional academic/research, practice and business presentations, keynote presentations, and panel discussions to discuss emerging issues. We strive for an interdisciplinary mix of presenters from different countries and disciplines (e.g. health
care, social sciences, computer sciences, engineering, business) and with a different angle (research, practice, and business).

Participants are invited to either submit a 500 word abstract to propose a 15 minute single-presenter talk, or can submit a a 500 word panel proposal to present or discuss a topic in a 45-60 min session with 3-4 colleagues from other organizations/institutions (panel proposals with all authors from
the same institution or organization are not permitted).


All submissions will be considered for one of the Medicine 2.0 Awards, if eligible. To nominate your work for one of the awards, read the award criteria and prepare the abstract as outlined below. Note that in order to be considered for the IMIA Medicine 2.0 Award, a checkbox must be checked on the submission form (consideration for all other awards is automatic).



Track what is being submitted in real time through RSS feed at http://feeds2.feedburner.com/med2submit.

Follow on Twitter (http://twitter.com/medicine20)


Only requirement issubmission of a short abstract, no full papers. However, the meeting is working towards (optional) publication of full papers in PubMed-indexed publications, either in form of a full paper submitted to a special issue of the Journal of Medical Internet Research, or publication of the presentation transcript including the audio/video podcast in a new, electronic forthcoming serial called "Medicine 2.0", indexed in PubMed.

If you are interested in either of these options, please check the respective checkboxes in the abstract submission form (subject to additional publication charges).


For general questions please contact the conference secretariat at congres@key-cs.nl

CAP and ASCO Release New ER/PR Testing Guideline

The College of American Pathologists (CAP) and the American Society of Clinical Oncology (ASCO) issued a joint guideline today aimed at improving the accuracy of immunohistochemistry (IHC) testing for the expression status of estrogen (ER) and progesterone receptors (PR) in treating breast cancer patients.
Because as many as two-thirds of breast cancers are ER and/or PR-positive, the new guideline has the potential to prolong and save the lives of the vast majority of breast cancer patients worldwide.

To improve the accuracy of ER and PR testing, the CAP and ASCO recommend the following:

• Testing ER and PR status on all newly diagnosed invasive breast cancers (primary site and/or metastatic site), and whenever appropriate, repeat testing in patients with a known breast cancer diagnosis who now present with a local or distant recurrence.
• Establishing uniform testing measures that focus on proven, reliable and reproducible assays and procedures.
• Having testing laboratories validate their assays against existing and clinically validated tests. Results should agree at least 90 percent of the time with those of the clinically validated assays for positive receptor status and at least 95 percent for negative receptor status.
• Transporting breast tissue specimens from the operating room to the pathology laboratory as soon as they are available for gross assessment. The time from tumor removal to initiation of fixation should be kept to one hour or less.
• Performing ER and PR testing in a CAP-accredited laboratory or in a laboratory that meets the accreditation requirements spelled out in the guideline. The CAP will require that every accredited lab performing testing participate in a mandatory proficiency testing program.
• Considering an ER and PR test, performed by IHC, positive if at least one percent of the tumor in the sample tests positive, which helps predict whether a patient is likely to benefit with endocrine treatment. The panel recognized that it is reasonable for oncologists to discuss the pros and cons of endocrine therapy with patients whose tumors contain low levels of ER by IHC (one percent to ten percent weakly positive cells) and to make an informed decision based on available information.

The CAP also developed a list of frequently asked questions to help members and laboratories understand what the new guideline will mean in their practice setting. In addition, a joint press release was posted today on the College's website and on ASCO's website, illustrating the collaboration between the two organizations on behalf of breast cancer patients.

Patients can find a resource guide on the College's patient website, www.MyBiopsy.org. In addition, the homepage of MyBiopsy.org features ER/PR breast cancer survivor Ruth Chermok and highlights the life-saving role of pathologists in diagnosing and assisting with the treatment of breast cancer patients.
This is the second time that the two organizations have collaborated on guidelines. In 2007, the CAP and ASCO issued clinical practice guideline recommendations to improve HER2 testing accuracy.

PathXL: Cloud Computing for Virtual Microscopy

i-Path has developed web-based software products together with an entirely hosted solution for virtual microscopy, removing the need to store any slides locally and for local installations of software, and providing reliable speedy access to images in a stable, managed environment. The product portfolio, PathXL™, represents cloud computing for virtual microscopy at its best, and offers a unique solution across a range of applications including education, training, competency testing, biomarker research, biobanking, and digital archiving of clinical samples.

Cloud computing is now a familiar cliché but has unique advantages when applied in digital pathology. It removes the need to purchase dedicated server hardware and employ dedicated staff to manage systems, reducing the cost by as much as 50% per annum. Storage and server capacity is all managed off-site in one of i-Path’s dedicated high performance server farms which guarantee up-time, regular backup and disaster recovery plans. Extensive storage facilities are available for clients to upload and manage their digital slide archives on-line. This is fully scalable allowing clients to grow their needs accordingly. i-Path’s cluster of high

performance image servers allows for high volumes of internet traffic without impacting on the speed of delivery. It is resilient where if one server goes down, traffic is routed to another server. By using satellite clusters, dispersed across continents, i-Path have reduced latency of image transmission over distance supporting the sharing of slides and easy collaboration across laboratories, hospitals and or universities. It is a highly secure facility, already being used by major Pharmaceutical organizations and Hospitals.

Clients can be given access to i-Path’s digital pathology software PathXL upon request – no need for on-site software installations and ongoing maintenance. Updates to software are made centrally and clients access all of the functionality via a standard web-browser. i-Path offer a range of digital pathology toolboxes aimed at supporting a range of applications. These include (i) an Educational Authoring Toolbox allowing clients to build and manage an e-learning web site including the ability to configure on-line tests on virtual slides for students, classrooms and residents (ii) External Quality Assurance Toolbox for managing virtual distribution of slides and polling diagnoses on-line (iii) Research Toolbox for management and

sharing of research slide sets and on-line scoring of biomarkers and (iv) TMA Toolbox for on-line archiving and scoring of TMA biomarkers.

PathXL, from i-Path, integrates novel web-based viewing technology and management software with a high performance hosting capacity to provide a cloudbased service to customers, across a range of disciplines.

Consult A Doctor, Inc. Names Retail Clinic Pioneer, Douglas Smith, M.D. as Chief Medical Officer

Douglas Smith, MD, the medical founder of Minute Clinic, joins Consult A Doctor, Inc. as Chief Medical Officer; calls Consult A Doctor “the next evolution in medical care delivery, increasing access and lowering costs.” Miami, FL (PRWEB) April 13, 2010 -- Consult A Doctor, Inc. announced today that Douglas Smith, board-certified family practice physician and pioneer of retail medical clinics, has joined as its Chief Medical Officer. Consult A Doctor is a nationwide telemedicine service provider of 24/7 access to physician consultations by phone and online. “We are thrilled to have Dr. Smith on our team. He brings years of experience and a deep understanding of the delivery of quality care in an accessible and affordable way with new disruptive business models,” said Wolf Shlagman, CEO. Mr. Shlagman added, “He will help to expand our telemedicine service offerings with specialist consultations, lab services and telemonitoring in addition to leveraging our online software platform for use by health plan providers and their own physician networks.” Consult A Doctor’s telemedicine services reduce health care costs for all payers by providing members with convenient efficient access to medically equivalent care in a lower-cost setting, reducing unnecessary doctor and ER visits by up to 80%. In 1999, Douglas Smith, M.D. and his partners formed the idea of a retail health care model: convenient clinic locations staffed by physician-supervised nurse practitioners who could focus treatment to common family medical conditions. They set out to offer the same top-quality care expected from a primary doctor's office, urgent care center or emergency room, but made quick and affordable. CVS acquired Minute Clinic for over $200 million in 2005. Today, Minute Clinic operates over 500 clinics in 25 states. “I joined Consult A Doctor because it was apparent that there was a great synergy between the utilization of evidence-based medical care, technology and patient knowledge allowing more of the care that can be delivered by telephone and online. Consult A Doctor’s platform allows more complete medical offerings than the others that I have looked at,” Dr. Smith said. “I believe that consumers have become educated regarding the availability of alternative methods of accessing lower cost, high quality care and Consult A Doctor is well positioned to address many current and future problems facing the American health system, bringing disruptive change in the way medical care gets accessed and delivered.” said Dr. Smith. About Consult A Doctor, Inc. Consult A Doctor partners with health insurance companies, self-insured groups, third-party administrators, brokers and others to offer convenient 24/7 access to doctor consultations by phone and online to their members and customers. Its proprietary nationwide network of U.S.-based physicians provides specific answers to medical questions and advice regarding non-emergency, routine medical conditions. All Consult A Doctor physicians are carefully screened, credentialed and have malpractice insurance coverage. They discuss symptoms, recommend treatment options, diagnose many minor conditions, and can prescribe medication when appropriate. Consult A Doctor’s telemedicine service reduces healthcare cost for all payers by providing members with convenient efficient access to medically equivalent care in a lower-cost setting, and considerably reduce unnecessary doctor, ER and urgent care visits. For more information about Consult A Doctor – call 888-688-DOCTOR (888-688-3628) or visit http://www.consultadoctor.com

Hospitals test iPad for patient education

You may have heard about the launch of Apple's iPad, and how the device seems to be drawing a lot of interest from healthcare circles. It's not only seen as something clinicians can use to chart patient encounters, but also as a tool for patient education.

The newly expanded Walt Disney Pavilion at Florida Hospital for Children in Orlando and St. Luke's Health System in Boise, Idaho, last week began testing a customized version of an app called Medical Video jLog from Eagle, Idaho-based Unity Medical, Health Data Management reports. Florida Hospital for Children will employ iPads as a way of explaining tests such as CT scans and MRIs to children with videos and interactive question-and-answer features. St. Luke's has loaded its iPads with with about 20 educational videos on topics such as heart and vascular procedures and physical therapy.

"This application will support our patient resource specialists in ensuring that children and their parents understand and feel comfortable with important medical procedures and mitigate any potential fears or concerns they may have," Marla Silliman, administrator of Florida Hospital for Children, says to the Orlando Business Journal.

For more information:
- see this Health Data Management news brief
- read this Orlando Business Journal article
Related Articles:
iPad 'commandments': 'Mobile, capable and handy' device could be a breakthrough
Engaging patients with simple technology