Digital Pathology Blog

PathX LIS Mobile Edition

Frequent readers know I am a fan of cloud computing, hosted services and/or software or SAAS, IAAS, PAAS, web-based computing, etc...

Of course, cloud computing or any of the other acronyms or names is not new. The idea of utilizing remote servers or applications is as old as the most primitive networks. That is the premise for networks.

More recently, remote services, technology, applications that are maintained and served have become increasingly common for everything from enterprise e-mail solutions through Microsoft, for example, to image analysis applications.

As a consumer, I can get the latest version without the hassles of updates, upgrades or routine support that may normally be necessary with local applications or installations.

As a healthcare provider, particularly for organizations without a deep IT bench, the ability to outsource functionality to another provider can often mean lower costs without sacrificing reliability, support, security or access.

Digital pathology allows for "anytime, anywhere" review of pathology images (slides, cases) that can be viewed by the right person at the right time.  These images themselves can be locally served or hosted to be viewed but in order to report the diagnosis/findings in order to create a final surgical pathology report and a legal document requires access to the appropriate laboratory infromation system in order to do so.

This can be accomplished with remote services such as Citrix connectivity, remote desktop protocols, terminal server configurations or a host of others to allow for secure remote access.

Or we can leverage the power of the cloud and hosted functionality that provides a platform for remote signout over the web.  

Many laboratory information system vendors offer web-based signout to facilitate shared access regardless of where a particular individual may be, as mentioned previously on this blog, including a post about signing out cases from 35,000 feet, above the cloud(s).

Recently I had a chance to take a look at a hosted LIS available as a mobile application on my 4G iPad 3 from PathX.

A little skeptical of actually signing out cases from my iPhone or iPad, I assumed a very rudimentary experience that would look nothing like a conventional worklist-driven solution to present cases for review and signature.  Instead what I saw was just that - worklist of cases pending signature and release in the palm of my hand.  

Once you launch the application, you are presented with your worklist of completed cases which you can select, preview and verify.

Within the application is some other functionality including a Twitter feed from the vendor as well as Dark Daily updates, ability for clients to order supplies and some setting controls that are user defined.

Considering the value proposition of digital pathology, that one is no longer tethered to their microscope, their histology laboratory, and now their LIS, the added functionality of mobile review and signout facilitates a critical component of "anytime, anywhere" review AND signout.

This technology raises a major question in my mind, namely, what/where constitutes the point of service, a critical component of CLIA regulations in terms of "where the pathologist was sitting when he/she made the diagnosis".  Legitimately, this could still have been in a professional office setting with a CLIA license when the diagnosis was rendered, dictated and transcribed.  The act of verifying/certifying that report as accurate may or may not be another matter.  More on this in a subsequent post. 

In the meantime, if you are in the market for an LIS solution and considering a hosted solution, consider PathX, with the added functionality of mobile sign-out.

Teleradiology Solutions Celebrates its 10th Anniversary

Headquartered in Bangalore, Teleradiology Solutions (www.telradsol.com/) provides quality diagnosis to the world and much more.

Bangalore, India (PRWEB) February 24, 2012

Teleradiology Solutions, the #1 national teleradiology company in the United States, is happy to be celebrating the tenth anniversary of providing Teleradiology services to hospitals around the world. In a decade when a number of teleradiology vendors got sold or closed down, it is a matter of pride for TRS to still be standing and growing. It's special birthday gift was being awarded the title of "Best in KLAS" for Teleradiology Services in the USA 2011, by KLAS, a Utah-based research firm that specialises in monitoring healthcare vendors.

The company (www.telradsol.com) which started in a home office with 2 employees now has become a global group with radiologists based in Israel, USA, Europe and India. It covers over 150 hospitals in 20 countries globally. It recently started covering hospitals in Africa in Tanzania, Nigeria and Djibouti.

In 2005, the TRS became the first healthcare organisation outside Singapore to be accredited by the Ministry of Health of Singapore. In the same year it became one among the first teleradiology companies to be accredited by The Joint Commission, a U.S.-based organisation that accredits healthcare facilities. The Bangalore based company is growing and was showcased to US President Barack Obama during his visit to India in November 2010 as an example of innovation in action.

TRS not only provides teleradiology but is also involved in several other activities from training radiologists (www.radguru.net), to enabling teleradiology by other Radiologists/doctors by developing and marketing RadSpa, a new generation teleradiology workflow (http://teleradtech.com/), to helping poor patients in Asia get access to high quality diagnostics (www.teleradfoundation.org). The multispeciality clinic set up by it-RxDx (www.rxdx.in) uses Cisco's HealthPresence and provides telemedicine to poor patients living in villages in Raichur, located in North Karnataka in India. TRS has also become the managed service provider for Cisco's telemedicine in India in 2012.

Teleradiology Solutions is a company with a difference. It has evolved from being a pure nighthawk US teleradiology group to being at the forefront of several innovative technology and healthcare initiatives. For the coming decade, TRS aims at adhering to its new title -"Best in Klas" , innovating continuously, reaching needy patients around the world and widening its scope globally to include all facets of technology and health - teleradiology, telecardiology, tele-medical e-teaching, telemedicine and more.

Original PRWeb release

Read more

Specialists On Call Renews Joint Commission Accreditation

Courtesy of Business Wire:

Specialists On Call, Inc. (SOC), the nation's leading provider of clinical telemedicine, announced today that it has completed its 2012 Joint Commission review and maintained their accreditation. SOC provides hospitals nationwide with immediate 24/7 access to board certified specialty physicians via telemedicine and delivers over 1,500 emergency consultations each month.

"This is a very big deal for Specialists On Call," commented Dr. Joe Peterson, CEO of SOC. "We've always distinguished ourselves by the clinical quality we offer hospitals and renewing our Joint Commission accreditation validates that commitment to excellence. Completing this Joint Commission Survey with no findings is rare and furthers our leadership position within the industry."

Specialists On Call was the first free-standing and commercial telemedicine service to earn Joint Commission accreditation and this latest evaluation was SOC's third formal review. To date, SOC has helped more than 40,000 patients and their family members with time sensitive clinical consultations via telemedicine.

SOC's growth plan for 2012 includes multiple new telemedicine service lines that address the nation's growing specialty physician shortage. Last year Specialists On Call launched an emergency telepsychiatry service for hospitals that are hard pressed to provide 24/7/365 psychiatric on-call coverage in their emergency room. Thus far, the telepsychiatry service has produced six times the consult volume that SOC's long-established teleneurology service generated during its first year.

About Specialists On Call

Specialists On Call, Inc. (SOC), is a Joint Commission-accredited organization that is changing emergency medicine. As the leading provider of emergency telemedicine consultations, SOC gives hospitals vital 24/7/365 access to more than 50 board certified, fellowship trained academic specialists, each with a minimum of 10 years experience. With operations on both coasts, SOC provides more than 1,500 emergency consultations per month for hospitals nationwide and hospital systems such as Vanguard Health Systems, HCA, Inc. and Tenet Healthcare Corporation.

For more information please visit www.specialistsoncall.com

Source: Specialists On Call, Inc.

 

Blog App to be Launched

Coming to an iPhone near you soon.  The Digital Pathology Blog App.  Look for iPad and Android OS versions to follow.  Stay connected and up to date from your mobile device to the blog with Twitter (@tissuepathology) and Pathology 2.0 Facebook (http://www.facebook.com/pathology2.0) tabs.

 

 

 

 

REFCOR Chooses mScope for National Expert Pathology Panel

Aurora will supply the French Expert Network for the Diagnosis of Rare Otolaryngology (ENT) Cancers (REFCOR) for their medical multi-disciplinary team meetings (MDTMs) and their case reviews by the national pathology expert panel

MONTREAL (CANADA), December 22, 2011 - Aurora Interactive Ltd., the world leader in digital pathology communications, announced today that the company has signed a contract for the supply of its mScope clinical communications platform following a request for proposal from the REFCOR group for the establishment of a national telepathology network to implement: information sharing; case management; and the viewing and analysis of diagnostic pathology images. The system allows for remote diagnostics and collaboration among expert pathologists and clinicians.

"REFCOR’s goal is to improve the management of treatment for patients with rare head and neck cancers including those of the paranasal sinuses, salivary glands, ears and rare cancers of the upper aerodigestive tract. The mScope network will provide us with a communication tool for the submission of cases to the national MDTM or the national pathology expert panel,” said Dr. François Janot of the Gustave Roussy Cancer Institute.

Pierre Le Fevre, President and CEO of Aurora Interactive, said: "We are very proud to have won this contract and to have earned the trust of the REFCOR group's leaders and their partners in this project. We are also very pleased to partner with a project that is at the forefront of the use of digital pathology to advance the science relating to rare head and neck cancers.”

About Aurora Interactive

Aurora Interactive has developed the leading Web-based software platform (mScope) for simplification, productivity and ease of pathology communications.  mScope’s Universal Web Viewer has collaborative tools to view medical slides and images anytime, anywhere, regardless of file format.  The software has four applications to aid digital pathology web based communications needs: mScope Education, mScope Clinical, mScope Research and mScope Universal Viewer. Aurora’s mission is to improve patient outcomes and help members of the medical community achieve their full potential by eliminating the learning, diagnostic and collaborative restrictions imposed by time and space. www.aurorainteractive.com  
 

The French Rare Head and Neck Cancer Expert Network (REFCOR)

Created in 2008 under the patronage of the Société Française ORL (French Society of Otolaryngology), REFCOR’s objective is the improved management of medical treatment for patients with rare head and neck cancers. The first four objectives of REFCOR are: The publication of reference national recommendations on the four main types of rare head and neck cancers; The creation of a national database referencing cases and incorporating epidemiological, clinical and anatomic and cytopathology data; The establishment of reference centres including the ability to coordinate medical multi-disciplinary team meetings to review "rare head and neck cancers" at the regional level while providing an efficient network for national collaboration; and the organizing of tumor banks / serum banks / tissue banks, the standardization of methods for the collection and systematic storage of samples taken from targeted patients. REFCOR currently organizes national MDTMs for the most difficult cases and a system of case review by pathologists specializing in  these cancers.

 

China sees expanding need for anatomic pathology services

Abundant opportunity to in-source pathology services from overseas illustrated by this story.  Also speaks to why I think outsourcing not a threat -- pathologist capacity and the main reason in-sourcing from countries such as China may represent a significant opportunity for U.S. pathologists.

See entire story from The Dark Daily: Anatomic Pathology in China Is a Booming Growth Industry

Shortage of pathologists only adds to the challenges of providing high quality anatomic pathology testing services
DATELINE: Hangzhou, China—More than 1,200 Chinese pathologists and medical laboratory scientists assembled this weekend in a city marked by 1,500 years of history. The occasion was the first-ever combined meeting of the Chinese Society of Pathology and the Pathology Branch of the Chinese Medical Association.
Across the globe, pathologists and clinical laboratory professionals regularly hear about the rapid economic growth in China. This country is modernizing at an astounding rate and the evidence is easy to see in its major cities. That is certainly true here in Hanghzou, which has a population of 8.7 million people and is the anchor city for Zhejiang Province, with a population of approximately 54.4 million. It has many new buildings in its downtown and construction cranes are visible in every direction.

See entire story from The Dark Daily: Anatomic Pathology in China Is a Booming Growth Industry

Learn the Latest About Telemedicine, Neuropathology, and Image Analysis of Biomarkers

Courtesy of the Digital Pathology Association.

I think this years' program will be among the best line up of speakers, topics (including update from the FDA on their thoughts), exhibitors, posters and networking opportunities this meeting has had.  The talks and meeting come at an important time for digital pathology including new vendors in the space, regulatory issues and new business models, all of which will be discussed. 

2011 PATHOLOGY VISIONS CONFERENCE

OCT. 30 – NOV. 2, San Diego, CA

A distinguished field of 41 speakers will highlight the hot topics in the world of digital pathology at the 2011 Pathology Visions Conference. Telemedicine, neuropathology, and the image analysis of biomarkers are just some of the subjects experts will discuss at the 7th annual Digital Pathology Association Conference.

Click Here to Register

Telemedicine and Neuropathology

In the clinical arena, Clayton Wiley, M.D., Ph.D., will discuss inter-institutional and interstate tele-neuropathology. Dr. Wiley will share his knowledge on telemedicine and its emersion as an efficient means of distributing professional medical expertise to geographically dispersed sites. He’ll also share his expertise on neuropathology and why it’s well-suited to utilize telepathology.

Image Analysis of Biomarkers

Tony Magliocco, M.D., will highlight the development of quantitative microscopy methods as prognostic and predictive cancer biomarkers. The digital pathology research expert will discuss three emerging analytical methods that hold promise for routine diagnostic pathology, including fractal analysis, analysis of DAB stained ki67 tissues with a focus on breast cancer, and the use of multiplex fluorescent imaging to study "functional tissue dynamics."

Guest Discount

The Pathology Visions Conference is also offering a special discounted rate for conference guests. For a reduced registration fee, your spouse or special guest can attend all meals, take part in the Sunday evening welcome reception and enjoy all that San Diego has to offer.

Poster Competition Extended Deadline Aug. 31

See contest details ►
Share your knowledge with others in a dynamic, interactive collegial environment and be rewarded! Submit your abstract for the poster competition at the Pathology Visions Conference. The deadline has been extended to Aug. 31.

"Access to sub-specialist pathologists using telepathology and image analysis of biomarkers are two of the strongest value propositions for why institutions adopt digital pathology," said Dirk Soenksen, President of the Digital Pathology Association and Chair of the Pathology Visions Program Committee. "Attendees at this year's conference will learn best practices for these and other applications of digital pathology, as well as how digital pathology can improve patient care and enable personalized medicine."

History Lesson

Did you know early pathologists started laying the groundwork for the digital pathology industry nearly a century and a half ago? Dr. Clive Taylor, M.D.,D. Phil., will give the audience a history lesson about the journey from microscopy to whole slide images. Dr. Taylor’s insight into how the past has shaped our industry will give attendees a firmer grasp on the important role they will play in the future of digital pathology.

Click Here to Register

These three speakers offer just a sneak peek at a line-up filled with distinguished presenters. The Pathology Visions Conference will host 38 additional research, education and clinical experts. Click here for a complete list of the speakers and details of their presentations.

Conference attendees will also have the opportunity to earn up to 13 CME credits, take part in an FDA panel discussion, and participate in cutting-edge industry workshops. DPA white paper and scientific poster sessions, roundtable discussions, networking events, and dozens of exhibitor displays will round out the three day conference.

 

	About the DPA The mission of the Digital Pathology Association is to facilitate education and awareness of digital pathology applications in health care. Members will be encouraged to share best practices and promote the use of the technology among colleagues in order to demonstrate efficiencies, awareness, and its ultimate benefits to patient care.

 

 

Killer App Discovered for Digital Pathology

10 August 2011 -- Fenway, MA. After many years of anticipation, a killer application has finally been discovered for digital pathology, by researchers at the Fenway University in Boston, Massachussetts. "One would think that simply being able to work from anywhere, share anything, with a full audit trail of what was viewed, and the ability for the computer to assist in scoring would be enough to drive digital pathology adoption," said Dr. Mark Lowell, Professor at Fenway University. "However, the industry has been waiting for a killer application to drive adoption, and we believe we have finally found it."

"We studied pathologist patterns while at the microscope and while traveling to peer reviews, conferences, and tumor boards, and we were struck by an amazing pattern. Pathologists that regularly flew through Newark Airport, were far more likely to go digital in their work than those that did not fly through this airport. Basically, we modified an advanced pattern recognition software that was previously only used in over-training results in gene expression datasets, and applied this to pathologist commuting patterns. The trend was consistent everywhere in the United States, the more a pathologist has to travel through Newark Airport, the more likely he or she will stay home and read slides digitally." 

"These results fit well with other evidence we examined in our algorithm," said Dr. Karlton Phisk, a co-author in the study. "First, a ranking of airports has Newark rated first for the most delays. Second, we noticed that pharmaceutical pathologists seem to be adopting digital slides faster than clinical anatomic pathologists, and we can attribute this directly to them having to fly more frequently through Newark for corporate pharma meetings. Third, the Cambridge area of Boston is adopting digital pathology faster than other parts of the United States. Clearly Boston pathologists hate having to travel through the New York area more than other pathologists would, given the historic rivalry between these two cities."

"Saving even one trip through Newark is well worth the purchase of multiple scanners," said Dr. Karl Yastemsky, a third author on the study. "Actually, avoiding New York City for any reason is worth spending a few additional seconds to view the images digitally versus with glass." 

The results are not without controversy, on both sides of the Atlantic. In the United States, Professor R. Ruffen of Yanqui University in New York City strongly disagreed with the study's conclusions. "First, scientists in Cambridge will buy anything, and second, Newark is a beautiful airport.  You can see all of New York City multiple times while circling the airport on most flights. If we applied the logic used in this study, we would expect to see British pathologists also adopting whole slide imaging faster than their peers, because Heathrow Airport is one of the worst to fly through." 

The study's original authors disagreed with Dr. Ruffen's logic challenge comparing Heathrow to Newark. "Everyone knows that British pathologists will take every chance they can get to travel, in hopes of escaping bad food and bad weather, so the effect of Heathrow is a net neutral effect," said Mr. Jon Riddeck, a up and coming star and graduate student at Fenway University, and the fourth author on the study. "Although to be fair, the British breakfasts are quite good, but probably not enough to keep pathologists from traveling abroad" he added.

At a recent pathology meeting, several English pathologists first apologized for their Heathrow Airport as well as their weather and their food, but then asked why they were included in this controversy, that seemed entirely American in nature and had nothing to do with them.

Submitted anonymously to avoid reprisals from anyone and everyone

How Internet-Based Lab Tests Access Helps Clinical Laboratories Serve Un-Insured and Under-Insured Patients

FREE Special Edition White Paper

Download Your FREE Special Report Today!
Simply Complete the Form Below

 

Internet-based companies that provide consumers with access to lab tests provide a significant and highly valued service for patients, particularly for those patients who are uninsured and underinsured.

The companies also provide services for patients who have high deductible health insurance plans and for any patients looking to keep the cost of lab tests low. Typically, patients who are fully insured do not need to the services of Internet-based companies that provide consumers with access to lab tests because their lab tests are paid in full by third-party insurance  company or these patients are required to pay only a small co-pay or coinsurance at the time of service.

The Dark Report is happy to offer our readers a chance to download our recently published FREE White Paper “How Internet-Based Lab Tests Access Helps Clinical Laboratories Serve Un-Insured and Under-Insured Patients” at absolutely no charge. This free download will provide readers with a detailed explanation on how these services work and the benefits these companies provide to the uninsured, the underinsured, and those with high-deductible health insurance. This report also will outline the value of transparency in healthcare pricing and how price transparency helps physicians in Ohio provide better patient care for the uninsured and underinsured.

—

Among other topics, this FREE White Paper specifically addresses:

1. Current State of Uninsured Patients in US
2. The Pros and Cons for Health Insurers
3. Transparency in Laboratory Test Pricing
4. Why Lab Test Firms Can Improve Patient Care

For more about internet-based laboratory test access for un-insured, please CLICK HERE

Table of Contents

Introduction — Page 3

Chapter 1. Current State of Uninsured/Under-Insured Patients in the US. — Page 5

Chapter 2. Transparency in Medical/Medicare Laboratory Test Pricing — Page 7

Chapter 3. Pros and Cons for Health Insurers — Page 11

Chapter 4. Case Study: Creating Transparency in Today’s Laboratory Test Pricing — Page 14

Chapter 5. Why Internet Lab Test Firms are Important for Improving Patient Care — Page 17

Chapter 6. Conclusion — Page 19

Appendices

A-1 About Joseph Burns — Page 22
A-2 About PrePaidLab.com — Page 23
A-3 About DARK DAILY— Page 24
A-4 About The Dark Intelligence Group, Inc., and The Dark Report— Page 25
A-5 About Executive War College on Laboratory and Pathology Management— Page 26
A-6 About Robert Michel — Page 28  

Terms of Use — Page 32

Can vendors use the word "telepathology"?

 

Can vendors use the word "telepathology" in marketing materials?  Few do out of concern due to lack of FDA clearance for the scanning device.  Companies based overseas are particularly reluctant and dare say the term.  Even some of the newer vendors to the space are careful to point out that their devices are for "research purposes only" and disclaimers to the effect that the devices have not been cleared by the FDA for primary interpretation are nearly universal among vendors.  

So, manufacturers do not make a claim that their device can be used for primary H&E reads.

Enter AccelPath which I mentioned a couple of weeks ago in a post.  Since that post, courtesy of Laboratory Economics (subscription required) they recently reported that:

"AccelPath LLC (Westwood, MA) has partnered with the in-office lab consulting firm Triangle Biomedical Sciences (TBS-Durham, NC) and begun marketing digital pathology services to urology, gastroenterology and dermatology groups. Under the partnership, TBS will help specialty groups build in-office labs and AccelPath will install digital slide scanners. Digitized slide images will be sent electronically to AccelPath, which has contracted with the Pathology Department at the Lahey Clinic (Burlington, MA) for professional interpretations."

 On AccelPath's website they mention specifically "primary interpretations" as one of the many uses with these added value propositions:

• Eliminate the cost, delays and logistics of shipping slides and blocks
• Eliminate the need to recruit, hire and retain pathologists
• Enjoy full access to AccelPath's prestigious team of U.S. based pathologists
• Receive fastest slide-to-report service
• Obtain 24/7 access to digital archives of all reports, requisitions and images
• Maintain control by keeping all slides on site at all times
• Implement our program easily with support from trained professionals

All of this is both encouraging and a real threat with continued commoditization of pathology services.

Laboratory Economics notes that the transaction has created the first publicly-traded company focused on two key trends in anatomic pathology (i.e., digital pathology and in-office histology labs).

This means clinicians in-source histology for the technical component and out-source the professional component in lieu of an in-office pathologist or local pathology group.

Apparently, they are comfortable with primary reads although I am not clear what scanner(s) are being used and how they have addressed the issue.  Presumably they have validated the technology internally and are confident in their ability to offer fast, accurate diagnoses. 

The encouraging part is that this marriage between in-office labs and digital pathology with a validated system allows for other groups to replicate the model whether it is a local GI group who is going to bring histology "in house" to referring work to other pathologists from primary laboratories for primary reads.  Unmanned pathology shops with 24/7 MD support. 

This may provide a completely legitimate way for pathologists to try to "get back" work that has been "lost" to in-office labs with medical director oversight of the laboratory and a TC/PC arrangement where the parties involved get paid for what they are doing rather than having employed pathologists who may not see the full PC for work that he/she has done.

Is this a threat or opportunity for pathology?

About AccelPath

AccelPath was formed in October 2008 by Shekhar Wadekar, PhD, chief executive, and H. Lance Evans, MD, head of medical affairs. Wadekar has a PhD in engineering from the University of Delaware and an MBA from New York University. Evans is a board-certified pathologist and practiced hematopathology at Impath (now part of LabCorp/Genzyme Genetics).

AccelPath was recently acquired by Technest Holdings Inc. (Bethesda, MD). Technest is a penny-stock company that trades on the OTC Bulletin Board at a current price of about 8 cents per share (as of March 15). Technest issued 86 million shares valued at roughly $6.5 million to purchase AccelPath. As a result of this reverse-buyout transaction, AccelPath members now own approximately 72.5% of Technest and Wadekar has become chief executive.