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March 2008 Editor: 
How one medical center is using a software module to decentralize image analysis
Pathologists have their own microscopes-so why not add a digital camera so they can digitize slides and interpret them at their own workstations using stand-alone imaging analysis software? That's the solution that Baystate Medical Center, Springfield, Mass., came up with to solve the challenge of how to implement image analysis for breast panels when pathologists work at medical centers up to 45 miles away, says Liron Pantanowitz, MD, director of pathology informatics at Baystate. "We could not get each pathologist to use a central imaging station," he says. Consequently, Baystate adopted BioImagene's imaging software module, Pathiam, to decentralize image analysis for HER2, estrogen receptor, and progesterone receptor. In an initial pilot study, the surgical pathology lab found that the computerized imaging analysis correlated well with pathologists' manual analyses. "Now we're going to roll it out and do a prospective validation of it as a stand-alone module that each pathologist can use at his or her microscope," says Dr. Pantanowitz. Because the images are hosted on a dedicated server, pathologists can retrieve them from any location. To standardize the individual setups, each pathologist has a Spot Insight digital camera (Diagnostic Instruments) on his or her microscope. "In using the system, we had to make sure that all our cameras are equally calibrated," Dr. Pantanowitz says. "Fortunately, the use of different cameras in our validation study did not prove to be a problem." "The pathologist uses his or her camera to take images of selected fields of view that contain representative tumor cells," he says. The system can also analyze whole slide images and perform annotations and measurements. Baystate plans to use computer-assisted analysis extensively once the laboratory completes the validation studies. After installation, pathologists will do manual and computer-assisted analyses in parallel for some time. "The system," says Dr. Pantanowitz, "allows us to archive all field-of-view images taken, areas of diagnostic interest, and the associated case information so we can also look for trends." Sunquest Information Systems and mTuitive have announced that mTuitive's xPert for Pathology software can now be integrated with Sunquest's CoPathPlus anatomic pathology system. MTuitive's add-on module seamlessly integrates CoPathPlus with a structured data capture, synoptic reporting, and expert rules system based on the College of American Pathologists' cancer protocols and checklists. The new module, which works with CoPathPlus version 2.5 or higher, includes over 70 pre-built electronic templates to reduce errors, help standardize operational practices, and assist with regulatory compliance. "The mTuitive structured data reporting product, particularly as integrated with Sunquest CoPathPlus, represents an exponential advance in pathology reporting," J. Mark Tuthill, MD, a beta site tester for the new module, told CAP TODAY. "This is due to an efficient, intuitive user interface, the ability to incorporate logic and error checking via forcing functions, and the ability to create calculations to derive data points such as cancer grading and staging. "We find that this application allows our pathologists to directly enter these data elements without the need for dictation, transcription, and editing," continues Dr. Tuthill, a pathologist with Henry Ford Health System, Detroit. "This markedly improves the capture rate, accuracy, and efficiency of structured data entry and reporting for cancer staging as well as other non-neoplastic entities." The partnership benefits hospitals in two ways, adds John Murphy, CEO of mTuitive. "First, pathology departments maintain compliance with current and future Commission on Cancer requirements and save money through reduction in transcription expense," he says. "Second, accurate diagnostic data is structured electronically. The structured data can then be shared between applications to help clinicians begin automation of disease staging and treatment protocol planning and can be easily mined for research purposes." Sunquest's CoPathPlus version 4.0 anatomic pathology system, which is slated for release this month, will also support mTuitive's xPert for Pathology software. CoPathPlus 4.0 will also feature a Ventana stain orders interface, Sakura/Leica interface, reflex testing, reference lab integration, and an interface through the Sunquest LIS, as well as aid compliance with the National Identifier Provider Standard. Sunquest Information Systems, Circle No. 186 Pathology Associates Medical Laboratories has created an independent operating division, named Outreach Advantage, to commercialize a variety of technologies for the outreach laboratory. The Outreach Advantage suite of products and services includes:
PAML has also secured an exclusive sales distribution agreement with Maplewood Software. Under the agreement, PAML will market and sell Maplewood's ScheduleLabs application to automate scheduling, credentialing, and competency verification activities in laboratory departments. PAML announced too that it has entered into a letter of intent to market its Outreach Advantage products through ARUP Laboratories, a national pathology reference laboratory and enterprise of the University of Utah. ARUP will offer OAMobile, OACRM, and ScheduleLabs through its ARUP Direct program, which is designed to support the growth of outreach testing within ARUP's customer base. PAML is a division of Bourget Health Services, a subsidiary of Providence Health Care, Spokane, Wash. It operates a full reference laboratory and maintains laboratory operations throughout the western United States.
PAML, Circle No. 188
EasyPath Software has released its free Pathology Assistant software program in Windows and Macintosh formats. The software program features laboratory procedures, canned text, journal references, and links to pathology resources and images. It includes a predictive value calculator, with educational material about the predictive value theory, and calculators for interpreting glucose tolerance test, anion gap, and blood gas, and an analyte converter for SI units. Also available is the calculation for the risk of prostatic spread, the results of which can be copied into any pathology information system; an immunocytochemistry module, with a list of antibodies and clinical problems; and information related to breast cancer, Gleason grade, hepatitis, and other health care topics. The software can be downloaded at no charge from http://idisk.mac.com/seligl-Public.
EasyPath Software, Circle No. 191
The FDA has granted 510(k) clearance to Wyndgate Technologies for its ElDorado Donor blood-management product. ElDorado Donor is a comprehensive blood-management software application for blood bank and donor centers of all sizes. The software is designed to manage, automate, and control activities associated with donors, donor collections, testing, manufacturing, inventory, and distribution. ElDorado Donor includes safety checks for blood components, blood products, and other related supply items, as well as drop-down lists and "find" forms, and Wyndgate's At-a-Glance bars, which provide visual indications of relevant information. ElDorado Donor supports ISBT 128 and the ABC Codabar blood product labeling standard. Wyndgate Technologies is a division of Global Med Technologies.
Wyndgate Technologies, Circle No. 192
Aspyra has released its CyberLab version 7.2.3 laboratory information system for general distribution. The new release enhances patient safety by including additional patient information on inquiry, call, and resulting screens, allowing users to further verify pertinent information before releasing critical clinical information.
Aspyra, Circle No. 193
Compuware Corp. has acquired Hilgraeve, a vendor of integration and messaging software for health care organizations. Terms of the acquisition were not disclosed. Compuware's Covisint division, which sells Web portals and other platforms, has had to integrate client applications with Web portals on site. "With Hilgraeve, we can do that remotely in a 30-minute process," says Brett Furst, vice president of health care at Covisint. Hilgraeve's HyperSend PDX software integration tool can help transfer data between physician practice management systems and other applications. Compuware Corp., Circle No. 194
SNOMED Terminology Solutions, or STS, a division of the College of American Pathologists, has recently undertaken several projects and completed others, including the following. STS has designed custom education programs for Roswell Park Cancer Institute, Buffalo, NY, and Alert Medical Systems, Porto, Portugal. STS has been selected by the Hong Kong Hospital Authority to map SNOMED CT to ICD-9-CM diagnoses and procedures. The STS mapping team will map 6,500 procedure terms and 7,000 diagnosis terms to SNOMED CT. STS is validating SNOMED encoding of the Minimum Data Set for long-term care and the Outcome and Assessment Information Set data set for home health care for the U.S. Department of Health and Human Services.
SNOMED Terminology Solutions, Circle No. 195 Cerner has announced that Poughkeepsie, NY-based Health Quest health care system will implement a suite of Cerner Millennium clinical solutions in Health Quest's three New York hospitals: Northern Dutchess Hospital, Rhinebeck; Putnam Hospital Center, Carmel; and Vassar Brothers Medical Center, Poughkeepsie. Health Quest will install Cerner's Millennium PathNet laboratory information system, PharmNet pharmacy system, PowerChart electronic medical record, and MillenniumPOC medication administration solution. Cerner also reported that MedStar Health, a large health system in the Baltimore/Washington region, will implement multiple Cerner Millenium solutions at its seven hospitals. MedStar is moving to the Cerner Millennium PathNet, PharmNet, PowerChart, and MillenniumPOC solutions at Franklin Square Hospital Center, Good Samaritan Hospital, Harbor Hospital, and Union Memorial Hospital, all in Baltimore, and Georgetown University Hospital, National Rehabilitation Hospital, and Washington Hospital Center, in the District of Columbia. Cerner Corp., Circle No. 196 Vachette Pathology has signed contracts for its practice management services with Pathology Consultants, PC, Grand Blanc, Mich., and Phoenix Pathology, Dayton, Ohio. Vachette Pathology, Circle No. 197 Dr. Aller is director of automated disease surveillance and team lead for disaster preparedness Focus B, Los Angeles County Department of Public Health. He can be reached at raller@ph.lacounty.gov. Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at hal@weinerconsulting.com. |
