August 2008

Editor:
Raymond D. Aller, MD
Hal Weiner

Health information technology projects: from the military to the mainstream

If all goes well, in as little as three years, cell phones may become miniature medical laboratories of sorts, transmitting images of pathology specimens. Researchers at the University of California, Berkeley, are in the early stages of developing a system that would allow a cell phone user to insert a glass slide containing a specimen into the phone. The phone would then scan the image on the slide and transmit it to the appropriate location.

The cell phone project is just one of hundreds of health care-related research endeavors managed and funded through the Telemedicine and Advanced Technology Research Center, or TATRC, part of the U.S. Army Medical Research and Material Command, Fort Detrick, Md.

While the projects are intended to aid soldiers and medical personnel on the frontlines, the technology developed through such initiatives often makes its way into the mainstream. “The key thing we’re looking for in any of these projects is good science,” says colonel Ron Poropatich, MD, deputy director of the TATRC, and medical informatics consultant to the U.S. Army surgeon general. “We start off with the premise that it has to be good science,” he emphasizes.

In addition to helping the military, cell phones that transmit slide images would support TATRC’s efforts to improve international health, Dr. Poropatich says. The technology would allow researchers, such as those involved in developing an HIV vaccine who are conducting field work remotely, to send in specimens quickly and easily. “My hope is we can do it on any cell phone,” adds Dr. Poropatich, noting that researchers have completed a prototype and expect to have a marketable product in three to five years.

In a separate project, TATRC worked with a commercial vendor, Trestle Holdings, in conjunction with professional medical societies, such as the American Telemedicine Association, to promote the army’s use of telepathology.

Walter Reed Army Medical Center and supporting U.S. Army-affiliated hospitals in the Washington, DC, area began using telepathology in 2000, eventually extending it to army hospitals throughout the Northeast, Dr. Poropatich says. TATRC deployed about 22 telepathology systems before transferring operation of the systems to the Armed Forces Institute of Pathology.

In 2004, the army began using telepathology systems in war operations in Iraq. “You upload your information by putting your glass slide on the microscope stage, and then AFIP accesses, via the Internet, this microscope in Baghdad,” Dr. Poropatich explains. Medical staff at AFIP can remotely manipulate the slide in Baghdad and change the lenses from high dry to low dry. After viewing the specimen through the Internet, “they [AFIP] then render an opinion from Washington, and they write that up into a formal report, which is then available to the providers in Baghdad,” he says.

In much the same way, Dr. Poro­patich continues, the telepathology technology is useful to rural pathologists at U.S.-based army hospitals who need a second opinion. “And so this provides a capability to get a second opinion from AFIP to verify diagnoses,” he says.

The telepathology technology involves the use of robotics, another key research area for TATRC. The center is conducting projects that involve using robots to remove casualties from the battlefield and to serve as scrub nurses in the operating room, as well as to help surgeons guide instruments during medical procedures. It’s just a matter of time, says Dr. Poropatich, until robots take specimens from the operating room so a pathologist can do a frozen section remotely. The pathologist will be able to, from a distance, identify what needs to be frozen, sectioned, and put on the glass slide. “The goal is for the remote pathologist to conference into the operative or pathology suite and complete the sampling via robots and real-time connectivity. Robotics become very pervasive,” he adds.

Additional TATRC projects involve developing technologies to improve the safety of the nation’s blood supply. One such undertaking was creation of the Mirasol pathogen reduction technology system by CaridianBCT Biotechnolgies, LLC, a subsidiary of CaridianBCT, Lakewood, Colo. The technology uses riboflavin and ultraviolet light to inactivate a range of viruses, bacteria, and parasites in platelets, says Wilbur Malloy, a program manager for TATRC.

In a separate endeavor, Cerus Corp., Concord, Calif., developed the Intercept blood system, which uses psoralens and UV light to inactivate a broad spectrum of pathogens and leukocytes in platelets and plasma components. “Continuing research is focused on red cell pathogen inactivation/reduction,” Malloy says.

Both technologies have been approved for use in Europe and are beginning to undergo U.S. clinical trials. It should take two to four years to get FDA approval, Malloy adds.

All told, TATRC manages about 700 research projects, totaling more than $350 million annually, in such areas as health information technology, neuroscience, and chronic disease management. Ninety percent of the funding comes from Congressional special interest, says Dr. Poropatich, adding that Congress, not TATRC, selects the projects that will receive funding. “Rather,” Dr. Poropatich says, “we [TATRC] help shape the research to make sure it is good science and, to whatever extent, try to make it militarily relevant.”

Practice Fusion unveils free Web-based applications

Practice Fusion, a provider of free, Internet-based physician practice solutions, has introduced applications for practice management, scheduling, patient management, and secure e-mail.

“Pathologists can make use of the hosted nature of Practice Fusion and access their clinical information from any of multiple locations,” Robert Rowley, chief medical officer for Practice Fusion, told CAP TODAY. “Pathology-oriented templates can be individually tailored to suit the unique needs of each practitioner. With upcoming document management, a pathologist will be able to categorize and track reports and images of any type and access these from any Internet-connected computer.”

The applications, supported by advertising from pharmaceutical and other companies, are designed for small and medium-sized practices. Users can be up and running in minutes.

The solutions can be accessed from Practice Fusion’s Web site.

Novovision debuts hosted anatomic pathology platform

Novovision has introduced Hosted NovoPath, a software-as-a-service solution for the company’s anatomic pathology lab workflow management, specimen tracking, and reporting platform. The hosted version provides the same features, including an electronic medical record interface, and ease of use as the standard Novo­Path platform but via a high-speed Internet connection.

Mediware launches dedicated business unit

Mediware Information Systems has formed a dedicated blood center technologies, or BCT, business unit. The group is expected to drive growth as Mediware expands its focus in the blood donor market with new products and services.

Mediware’s BCT offerings include a new version of its FDA 510(k)-cleared LifeTrak software and the donor-management tools and recruitment services from its acquisition of Integrated Marketing Solutions last October. The business unit will focus on solutions for donor recruitment and relationship management, blood drive coordination, computer-assisted donor screening, testing, clinical processing, product distribution, and hospital relationship management.

“Mediware BCT differentiates itself from competitors by providing à la carte offerings that are completely Web based, quick to install, and easy to use,” says Kelly Mann, president and CEO of Mediware. “We’ve seen tremendous interest in the new BCT model, and I expect this to be a key area of growth for Mediware in the future.”

Global Med Technologies announces U.S. release of cellular therapy software

Global Med Technologies has announced its U.S. debut of EdgeCell, a cellular therapy software for tissue banks, stem cell laboratories, and cord blood banks. The product has been available in Europe through Global Med’s European subsidiary, Inlog, SA.

EdgeCell tracks the procurement process, including the medical history questionnaire; required testing, such as specimen reception and infectious disease testing; and product preparation, from packaging, labeling, and storage, to crossmatching and distribution. It can configure and maintain distinct business rules and parameters for each type of product, whether it be tissue, stem cells, or cord blood.

“We know the need for software solutions such as EdgeCell is rapidly increasing as more hospitals enter the emerging tissue transplantation market,” says Thomas Marcinek, president and chief operating officer for Global Med Technologies. “With a global target market of more than 10,000 hospitals and surgical centers,” he continues, “we see EdgeCell as a growth platform that will greatly enhance our domestic and international expansion.”

Global Med Technologies, the parent company of Wyndgate Technologies, acquired EdgeCell through its purchase of Inlog earlier this summer.

Orchard marketing new version of Harvest LIS

Orchard Software is now offering version 8.0 of its Harvest laboratory information system.

Version 8.0 offers enhanced flexibility for customized reports, such as the ability to automatically incorporate a graph of the patient’s historical results on the report; additional priority designations, including timed, preoperative, and preadmission, all of which can be displayed in user-defined colors on worklists in the software and sorted to user specifications; support for patient aliases, such as maiden name or nickname; the ability to schedule standing or future orders; and quality control improvements, including the option to adjust quality control statistics.

Vachette Pathology expands services via agreement with The Coding Network

Vachette Pathology has formed a working agreement with The Coding Network under which Vachette can use TCN’s coding expertise to perform a government-style audit of a pathology practice’s coding process for patient services.

The Coding Network provides procedural and diagnostic coding support for hospitals and other health care entities. Vachette Pathology is a provider of practice management services.

Vendor contracts

ACL Laboratories, a joint venture between Aurora Health Care, Milwaukee, and Advocate Health Care, Chicago, has signed a $4.6 million contract with Sunquest Information Systems. Under the deal, ACL Laboratories will install the Sunquest CoPathPlus anatomic pathology system and integrate it enterprise wide with its Sunquest laboratory information system and other Sunquest solutions.

Aspyra has signed agreements to upgrade the following Aspyra LIS users to its CyberLab LIS version 7.2:

North Memorial Health Care, Rob­bins­dale, Minn., has signed a contract to implement the Sunrise Laboratory LIS from Eclipsys Corp. The hospital will also use the laboratory information system for its reference lab business in Minnesota and western Wisconsin.

MTuitive recently licensed its xPert for Pathology software, an interactive product for reporting malignant tumors, to the following research and teaching hospitals: University of California at Davis Medical Center; University Hospitals Health System, Cleveland (Case Western University); and University of Illinois Medical Center at Chicago.

Marion General Hospital, Marion, Ohio, has signed a seven-year agreement for remote hosting services for GE Healthcare’s Centricity Enterprise solution. Under the arrangement, Marion will implement the company’s clinical information system while maintaining a flexible technology model with remote services. The hospital will also install bar-code medication administration, multi-disciplinary documentation, and pharmacy and orders capabilities.

Noble Hospital, Westfield, Mass., has contracted for MedQuist’s enterprise technology solutions to provide hospital-wide dictation, transcription, and speech-recognition capabilities.

The Nebraska Health Information Initiative has selected Axolotl Corp. to build and operate a platform for a statewide health information exchange.