December 2009

Editors:
Raymond D. Aller, MD
Hal Weiner

Pathology lab’s loyalty to Macintosh computers unwavering

When Dave Hanks and his wife, Debra Ann Hanks, MD, started a pathology lab in central California 11 years ago, they didn’t debate about whether to use Macintosh computers or Windows-based PCs. They’d grown to like Macs from previous business and personal experience and wanted to stick with what they knew. And more than a decade later, they are just as committed.

The Hanks’ decision is an unusual one for pathologists. Despite many people’s steadfast support of Macs, they are still a rarity in pathology labs. But while Macs and PCs can run similar software, Dave Hanks and other Mac users say their computers are more reliable and intuitive. The flip side is that it can be difficult to find technical support for Macs because they account for a small percentage of the marketplace.

Yet Hanks has no complaints. He and his wife set up Premier Pathology Laboratories, in Porterville, in 1998 with two Mac laptops and six used desktop Macintosh computers. Over the years, the facility, which focuses on anatomic pathology and cytopathology, has grown to include 16 Macintosh computers and three Mac servers for the business’ 13 employees, who are spread between its Porterville and Delano sites.

But Hanks, who refers to himself as Premier’s “IT guy,” concedes that he can’t escape the PC environment altogether. One of the lab’s Macintosh computers also runs Microsoft Windows because a reference lab that contracts with Premier posts its reports online in a format that requires a Microsoft Internet Explorer browser. And one of Premier’s microscopes is hooked up to a camera that uses a PC for its controls because “that’s how the vendor built it,” Hanks says. But that computer has broken repeatedly and has been replaced three times, he adds, reinforcing his belief that Macs are the better choice.

Dependability is the primary reason why the Hanks are staunch supporters of Macs. In Premier’s first nine years, Hanks estimates the network was down only 45 minutes. (More recently, a transformer blew near the Porterville facility, causing the network to go down for a day and a half.)

Hanks also loves the software available for Macs. Both of Premier’s offices use iChat to instant message and video conference. The lab’s pathologists use video chats to discuss difficult cases and share images of slides. The lab also uses iChat to link staff at different sites for virtual business meetings.

PhoneValet is another of Hanks’ preferred applications. The software blocks unwelcome callers, as defined by the user, and announces who is calling, so busy workers can immediately direct calls to the most appropriate staff member. “After hours,” says Hanks, “the system dispatches emergent alarms via SMS [short message service] text message and pager alerts to notify on-call pathologists to check their iPhone’s e-mail or call PhoneValet to hear a stat request. The iPhone integration eliminates the need for pagers and an answering service.”

PhoneValet has also discouraged incoming personal calls since people don’t like hearing their wives’ or boyfriends’ names announced to the whole office, Hanks continues. Phone traffic has fallen by more than 30 percent, he estimates, leaving more time for people to do their jobs.

While comparable software is available for PCs, Hanks says he finds “that a Mac is more intuitive in how it works. New employees haven’t had problems getting started on Macs—there’s no special training. We just tell people to use it and ask questions.”

Premier’s dedication to Macs extends to its information system selection as well. The lab has, from the beginning, used AP Easy for its anatomic pathology needs. The system, developed using FileMaker Pro, was designed as a cross-platform application. But Premier is one of only a few labs that continue to use the Mac version.

After 15 years, Small Business Computers of New England, which markets AP Easy, has only three or four Mac customers out of 325 labs, reports Gene Calvano, president of the Manchester, NH-based company. “They’re basically die-hard Macintosh people and they don’t want to give it up,” he adds.

Calvano tries to steer customers to the PC version of AP Easy. It’s not that it’s a better product—it’s just that it can be difficult to find technical support for Macs, he says. “The labs looking for local IT support on the Macintosh platform find it’s few and far between,” he explains. “We try to tell people they’re probably going to be better off with Windows.”

But Hanks thinks this is changing. “It’s now much easier to find local tech support,” he says, noting that he works with an expert in Bakersfield. Hanks expects the situation will continue to improve as more people become familiar with Macs through personal use and start bringing them into the office, like he did.

Raymond Aller, MD, agrees. Dr. Aller, who is director of automated disease surveillance for the Los Angeles County Department of Public Health and “Newsbytes” contributing editor, has been a Mac user since he bought one for his family in the late ’80s, though he’s often had to switch to PCs because that’s what his employers have used.

Pathology is the perfect specialty for Macs, he says, because Macs are well suited for integrating photos and visuals into different applications. “In laboratory medicine, the area that’s most clearly image oriented is anatomic pathology,” he continues. “Plus Macs are just more fun.”

NLM offers draft map that links SNOMED CT and ICD-9 codes

The U.S. National Library of Medicine has released a draft rules-based map that links SNOMED Clinical Terms to the ICD-9-CM codes for hospital diagnoses and procedures.

The draft map consists of approximately 5,000 links that represent the SNOMED CT terms most commonly used by Kaiser Permanente and the University of Nebraska, which offered to share their data for the project. It is designed to support administrative reporting and reimbursement processes originating with data sets for which SNOMED CT is the core terminology for clinical descriptions. The map provides a validated concept-based link to ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), but in select cases, users may need to further process ICD-9-CM codes for specialized business applications.

Users can evaluate and test the map by downloading it from the NLM Web site at www.nlm.nih.gov. The NLM will provide mechanisms through which users can provide feedback until Feb. 1. The CAP’s SNOMED Terminology Solutions division developed the map on behalf of the NLM.

The NLM encourages people who plan to use the map for billing purposes to test it during the feedback period. “The results from this test will...influence the development of related maps, including SNOMED CT to ICD-10-CM and ICD-10-PCS [procedure coding system],” says Betsy Humphreys, deputy director of the NLM.

ICD-9-CM is the official system of the U.S. government for assigning codes to hospital diagnoses and procedures. SNOMED CT is a controlled medical vocabulary that provides a common language for electronic health applications.

Initiate buys Accenx Technologies

Initiate Systems, a marketer of data-management software and services, has acquired Accenx Tech-nologies, a provider of health information exchange solutions.

“Leveraging Initiate interoperable health solutions as services through Accenx Exchange, Initiate now offers master data management along with a connectivity platform delivering applications and relevant information at all points of service,” says Bill Conroy, president and CEO of Initiate.

The Accenx Exchange integration platform allows health care providers such as reference labs, physician practices, and imaging centers to easily share information, including laboratory orders and results.

Atlas markets new version of LabWorks system

Atlas Medical Software is now marketing LabWorks version 10.0.0, the latest release of its order-entry and results-reporting system for outreach environments.

LabWorks 10.0.0 provides automatic specimen-volume management, advanced label generation, and an upgraded user interface to improve navigation and enhance visual display. The new version also supports Atlas’ optional integrated module for electronic prescribing.

McKesson releases HIE connectivity product

McKesson has introduced Horizon Connect, a solution that integrates the company’s Horizon product suite with its RelayHealth subsidiary’s connectivity platform. The new offering provides an interoperability foundation on which caregivers can exchange critical patient information across encounters and care settings.

Horizon Connect updates electronic medical records at key patient events and allows clinicians to seamlessly manage discrete actionable data from third-party systems as part of their workflow.

AAPC Web site provides ICD-10 training curriculum

The American Academy of Professional Coders is offering on its Web site an ICD-10 implementation training plan for health care providers.

Through the site, www.aapc.com, providers can access information about the AAPC’s ICD-10 on-site training sessions, webinars, and distance learning modules.

The AAPC is also offering a free application to help convert ICD-9-CM codes to ICD-10-CM codes. The academy developed the tool based on general equivalency mapping files published by the Centers for Medicare and Medicaid Services.

Data Innovations announces global access to Web portal

Data Innovations, a marketer of middleware systems, is offering worldwide access to its customer Web portal via region-specific links.

The portal allows Data Innovations’ customers to open and track support requests and download various resources and products, such as new versions of software, interface drivers, training material, and user documentation.

Mediware Information Systems reports software installation

Blood Bank of Alaska has licensed Mediware Information Systems’ LifeTrak blood-donor–management software. The blood bank, based in Anchorage, supports more than 25 hospitals and medical centers throughout Alaska.