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Nice read by Dr. Stacey Mills over at Pathology Network (Pⁿ Blog). A recognized expert in surgical pathology and director of such at the University of Virginia, he writes, "It seems somewhat surprising, at least to me, that a technique based on standard light microscopy, with microscopes being essentially unregulated, Class I devices, should be given the "highest risk" class III rating." Vendors will have to speak to this at upcoming USCAP meeting.  I hope the word "surprise" is not in their vocabulary given statements made on this topic back at the FDA panel meeting in 2009 and inviting the FDA back to Pathology Visions for guidance on the subject.

The lead article in the January 2012 issue of CAP Today addresses the pending FDA regulation of whole slide imagers (WSI's). The FDA has concluded dthat these devices are "Class III" medical devices, and as such are subject to considerable federal regulation (compared to Class I and II devices).  Depending on your perspective, this is either a good thing for patient safety or the death knell for rapid development, certification and deployment of these devices in the United States, with many companies looking elsewhere for testing and validation).

 

By way of quick review, Class I devices are lowest risk and require no pre-market notification.  Your light microscope is, believe it or not, classified as a Class I device.  Class II devices are considered "moderate risk" and are usually based on modifications of prior approved devices or techniques.  Class III devices are considered "highest risk" and such devices require premarket FDA approval, quality controls, etc. Automated cytology screeners, for example, are Class III devices. The FDA has said that WSI's belong in this category as well.

 

It seems somewhat surprising, at least to me, that a technique based on standard light microscopy, with microscopes being essentially unregulated, Class I devices, should be given the "highest risk" Class III rating.  Although the rationale for that decision may be difficult to fathom, it has, in fact, been made and is highly unlikely to be reversed.

The fact that the FDA has even been reviewing WSI's and has decided to regulate them as "highest risk" Class III devices, may come as a surprise to most end-user pathologists since the topic of regulation is understandably not a major one at trade shows where vendors try to sell these devices.  It certainly isn't a topic the vendors themselves are likely to bring up, at least until now.

 

Although the FDA has been less than specific in discussing their thinking, they have indicated that they have concerns about image quality when compared to standard light microscopy, and the effect of navigating on a computer screen v. moving a slide on a microscope.  It is even unclear whether WSI's might be approved for a certain TYPE of specimen or group of diagnoses and not for other types or groups.  Might it be approved for small core biopsies and not for big tissue blocks?  Might it not be approved for hematologic malignancies, where the diagnosis often requires viewing large areas at relatively high magnification, something that is more difficult with a WSI?  At this point, no one knows.  Clinical trials comparing the accuracy of WSI's v. traditional microscopy will be difficult to construct and time consuming to perform, but will likely provide the data to answer these questions.

 

Given the FDA's pace of action in regard to other issues, it's now expected that it may take up to five years for the first devices to be approved in the United States, with Aperio likely to be among the first.  Some companies will most likely concentrate their efforts in Europe where the approval process (and subsequent sales) are likely to be much more rapid.

 

There are many unanswered questions at this early juncture, but it does seem clear that buying and using a WSI for clinical (not research) diagnosis would not be a prudent move at this point in time.  If you are currently using a WSI for primary clinical diagnosis, you had better have "state of the art" (whatever that is!) validation policies in effect, and even then your CLIA or CAP inspection is likely to be problematic.   Even when these instruments gain approval, their use for diagnosis at a distance will fall under the highly diverse state laws regarding telemedicine.  A topic I covered in one of my early blogs, "Down the Telepathology Rabbit Hole."

Published: 2/27/2012

Read more…

 

 

Stacey E. Mills, MD, a graduate of University of Virginia (UVA) and the UVA Medical Center, has authored nearly 230 articles, 20+ books, atlases and monographs—including the renowned Sternberg's Diagnostic Surgical Pathology. He has been a practicing Professor and Staff Pathologist at UVA for 30+ years and is Director of Surgical Pathology and Cytopathology. His clinical specialty is general surgical pathology with emphasis on neoplasms and neoplasm-like lesions. Dr. Mills is also Editor-in-Chief of The American Journal of Surgical Pathology.

 

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Web applications and cloud hosting bring new affordable options to Digital Pathology

Tissue Imaging is ready to go digital. In the last decade technology advances in hardware, computing, networking as well as declining storage prices have made storing and handling Whole Slide Images technically viable. The advantages of digital imaging are apparent and market size for pathology is significant, so a flock of companies from pioneers like Aperio and BioImagene, to established players like Leica, Zeiss, Olympus, Phillips and GE got busy working on innovative digital solutions for pathologists.

Today they have solutions that work well, but with the technical problem solved, the economic problem remains for typical pathology lab.  The Digital Pathology package usually includes a slide scanner, an image server and  software for handling and viewing digital slides, and will cost upwards of $150K for a typical installation. This price tag may be attainable for a large hospital chain with capital budgets and IT staff, but 80% of US pathology labs are small business employing staff of 10 people or less.  They are service providers that charge “by the drink” and have no capital budgets or IT support.  They cannot justify large IT investments or technical support staff.

For those who spent their careers in IT, this looks all too familiar: remember those old enterprise IT systems? If you wanted to have company email, share calendar and access your files remotely on the same server, you would have to spend hundreds of thousands of dollars on servers, software and IT support.  That is until cloud and web applications came along.  Now any small business can get big business IT for affordable monthly rate as long as it is connected to the internet, and every large tech company from Cisco to Microsoft is working hard to package their technology offerings for small businesses.

Serving the small business market economically is the inevitable next step and a challenge for Digital Pathology vendors. Number of industry innovators like Mikroscan, DigiPath, Objective Imaging, ViewsIQ and others are pushing technology envelope trying to bring the cost of equipment within the affordability range for a typical lab. They manage to bring hardware price under $30K. Yet, there is another challenge to overcome: small businesses have “0-0-0” expectation from technology. That means zero installation effort, zero learning curve and zero support. They need technology that “just works” and expect vendors to deliver it. The logical solution: cloud hosting and web applications. If done right, cloud software and web applications can bring the same benefits to pathology labs as they did to other businesses in other areas.

Houston-based software company, Smart Imaging Technologies aspires to bring cloud computing and web applications for whole slide imaging to Digital Pathology with software called Simagis Live. The company experience offers insights for those who are considering whole slide imaging in the cloud:

Upload. Once you move imaging server from the local network, uploading digital slides becomes a critical issue.  Traditional remote upload methods like FTP or WebDav do not work well for large image files; they drop data packets and take forever to complete the job. Smart Imaging had to develop special Turbo Upload Utility that can take Whole Slide Image or folder with image tiles and move it to remote server at blazing speed of 1.5 GB/ minute on high-speed internet connection, all with just 3 mouse clicks, right from the web browser. 

Access and Sharing. Small businesses do not conform to unified corporate IT policies. They use variety of computers, operating systems and browsers. So, the web image browser should “just work” across all computers, operating systems and browsers too, period. And don’t forget tablets! “Just works” means nothing to download, install or update before you can view digital slide online, be it on Windows, Mac, iPad, or Android tablet. Sharing and collaboration process in general should be both easy and secure. Users can invite collaborators and share digital slides in a few clicks, but also they should be able to separate shared and private images and revoke access at any time.

Integration. This issue is absolutely critical to success. In order to meet “0-0-0” expectation, the software should work seamlessly with the imaging hardware, making connections and handling images behind the scenes.  Simagis Live software, for example, includes nifty integration feature called “MicroPlug”.  It adds additional menu option “Save and Share” to imaging device software. When user clicks it, the digital slide is saved to disk and uploaded to user workspace on cloud server at the same time, automatically behind the scenes. The Company does not mind if an imaging device manufacturer puts custom branding on top of the software, in fact it encourages OEM and custom branding solutions as they deliver the most cohesive experience to the end user.  

Business Model and Pricing. Software technology vendors have to structure their offeringsso that they are paid the same way that their clients are paid and make money when their clients make money. They have to give customers no-obligation trials and free-tier service to try the new technology. Cloud software and web applications can provide that flexibility. In the case of Simagis Live, anybody can sign up for free service and get 2GB of space on public application server. If they like the experience, they can get additional space, rent private cloud server or install software on-site.  Clients can pay for only what they, by month or by image, with no upfront capital investments, long-term commitments, installation or IT costs.

In the coming years tissue imaging will follow the path of other imaging modalities like X-ray, CT and MRI and turn digital.  Web applications hold a lot of promise for Digital Pathology and Tissue Diagnostics.  Cloud software can make digital solutions affordable and universally accessible and we should see a lot of interesting developments in this area in the near future. 

 

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SALT LAKE CITY, Feb. 29, 2012 /PRNewswire/ -- ARUP Laboratories, a leading national clinical and anatomic pathology reference laboratory and a leader in innovative laboratory research and development, announced the establishment of a Business Innovations Division.

(Logo: http://photos.prnewswire.com/prnh/20110915/SF69370LOGO)

The new division is designed to align ARUP's business innovations in a manner that will enhance our ability to diversify into new market segments. This division will drive ARUP's continued growth by identifying and developing new and diversified business ventures, including the development of new market initiatives; identification and implementation of new business units; and exploration and establishment of potential joint venture strategic alliances.

"ARUP Laboratories has positioned itself as a major innovator in the field of laboratory medicine. Our mission is to improve healthcare and advance the science of laboratory medicine through the development of new laboratory testing and technology. With the introduction of our new division, we are simply expanding our expertise into the business operation side of laboratory medicine," said Edward Ashwood, MD, president and CEO of ARUP.

The division will be led by Khosrow Shotorbani, currently the senior vice president and director of Sales.

"Khosrow is a proven leader at ARUP with a strong track record of driving growth and innovation. Under his direction, I see tremendous potential for ARUP to help healthcare professionals provide improved patient care at reduced costs," said Ashwood.

"ARUP is uniquely positioned within the market to provide our clients with the value proposition necessary to reach their full potential. No other company in the healthcare industry has positioned itself as the knowledge and thought leader that assists physicians in ordering the right test at the right time," said Shotorbani.

About ARUP Laboratories Founded in 1984, ARUP Laboratories is a leading national reference laboratory and a nonprofit enterprise of the University of Utah and its Department of Pathology. ARUP offers more than 3,000 tests and test combinations, ranging from routine screening tests to esoteric molecular and genetic assays. ARUP serves clients across the United States, including many of the nation's top university teaching hospitals and children's hospitals, as well as multihospital groups, major commercial laboratories, group purchasing organizations, military and other government facilities, and major clinics. In addition, ARUP is a worldwide leader in innovative laboratory research and development, led by the efforts of the ARUP Institute for Clinical and Experimental Pathology.

Media Contacts Cyndee Holden, (801) 583-2787, ext. 3318 (wk)/(801) 386-6637 (cell) cynthia.holden@aruplab.com

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ARUP Laboratories Announces Creation of Business Innovations Division

The Digital Pathology Association (DPA), a non-profit organization that promotes education and awareness of digital pathology applications, is welcoming Lewis Hassell, M.D., a distinguished educational leader in the field of pathology, to the Board of Directors.

Indianapolis, IN (PRWEB) February 29, 2012

We are honored and excited to have Dr. Hassell joining our board of directors. His involvement in the clinical and research aspect of digital pathology will bring a diversity of knowledge and skills to the board, said Michael F. Ward, CEA, Executive Director of the DPA.

Dr. Hassell is a board certified Cytopathology and Anatomic and Clinical Pathologist. He currently acts as the director of Anatomic Pathology at the University of Oklahoma, as well as the associate professor of Pathology and professor of excellence in Anatomic Pathology. His program served eighteen hospitals and a variety of other labs. Having a platform outside of the university to present and publish his findings in his areas of expertise is one of the reasons Dr. Hassell was initially drawn to the DPA.

The networking, educational aspect, and thought stimulation is the biggest benefit. It is a great venue for bouncing ideas around and conversing with people who are having the same problems as you, said Dr. Hassell. There is a whole spectrum of users which is refreshing. Its more than just swapping business cards, its an intellectual exchange.

Prior to his work at the University of Oklahoma and his involvement with the DPA, Dr. Hassell was a resident in Clinical and Anatomic Pathology at the Massachusetts General Hospital, holding the position of Chief Resident in 1984. After that he participated in a visiting fellowship in nuclear medicine at the University of California, then went on to work in private practices in San Francisco and Maine. He earned his initial B.S. from Brigham Young University in 1978 and graduated summa cum laude.

About the Digital Pathology Association

The Digital Pathology Association, located in Indianapolis, IN, was founded in 2009. Its mission is to facilitate education and awareness of digital pathology applications in healthcare and life sciences. Members will be encouraged to share best practices and promote the use of technology among colleagues in order to demonstrate efficiencies, awareness, and its ultimate benefits to patient care.

Please stay involved with the Digital Pathology Association by joining the discussion on Linkedin, Facebook, and Twitter. To join the DPA or to learn more about the DPA and its members and membership opportunities, please visit our website.

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Digital Pathology Association Welcomes Distinguished New Board Member

Pathology evaluations done on-site cut operating time, reduced cost, study shows

Newswise — ANN ARBOR, Mich. — Nearly one in three women who have breast cancer surgery will need to return to the operating room for additional surgery after the tumor is evaluated by a pathologist.

A new service at the University of Michigan Comprehensive Cancer Center cuts that number drastically by having pathologists on-site in the operating suite to assess tumors and lymph nodes immediately after they are removed. Meanwhile, the surgeon and patient remain in the operating room until the results are back, and any additional operating can be done immediately.

This cut the number of second surgeries needed by 64 percent, to one of every 10 women.

U-M began offering the service about two years ago at its East Ann Arbor Ambulatory Surgery Center, where the majority of outpatient breast cancer surgeries now occur. A study evaluating 271 patients treated eight months before and 278 treated eight months after this program began appears in the American Journal of Surgery.

“The frequent need for second surgeries among patients undergoing breast cancer surgery represents a tremendous burden for patients. Beyond the inconvenience and additional time away from work, additional surgeries can result in worse cosmetic outcomes and increased complication rates. Our experience shows that offering on-site pathology consultation has a substantial impact on quality of care,” says lead study author Michael S. Sabel, M.D., associate professor of surgery at the U-M Medical School.

Patients must return to the operating room for two primary reasons: to remove additional tissue when the cancer cells are too close to the margin of tissue removed; and in some cases, to remove additional lymph nodes if the initial sentinel lymph node biopsy tests positive for cancer.

Before the on-site pathology, 25 percent of patients needed a second operation to remove more tissue, compared to 11 percent after the service began. Among patients with cancerous lymph nodes, 93 percent of them avoided a second surgery with on-site pathology.

In addition to reducing second surgeries, the study found that assessing the margins in the OR allowed more women to conserve their breasts. The study authors suggest that women who have positive margins requiring additional surgery are more likely to choose mastectomy because they fear their cancer will return or that they’ll need a third operation.

Establishing on-site pathology requires a different technique for preserving and evaluating the cells, called frozen section analysis. After this is completed, U-M pathologists then process the tumors for standard testing using traditional methods. The study showed consistent results across both types of analysis.

On-site pathology using frozen tissue sections is offered at a handful of academic medical centers across the country.

“In large part, routine intraoperative analysis of lumpectomy margins is rare because of logistical issues, especially as breast surgery is more commonly performed at outpatient surgical centers,” Sabel says.

Obstacles include transporting the tissue samples, building a pathology facility, and staffing it appropriately at an offsite surgical center.

“Despite these obstacles, we found that not only is this beneficial for our patients, but it reduced the costs of caring for patients with breast cancer,” Sabel adds.

The study authors also considered new guidelines that suggest fewer women need to have their lymph nodes removed if the sentinel lymph node biopsy is positive. The authors factored in that reduction and still found that intraoperative analysis was highly cost-effective.

“Establishing an intraoperative pathology consultation service is feasible, highly efficient and extremely beneficial to patients, surgeons and reducing the costs of cancer care,” Sabel says.

Breast cancer statistics: 229,060 Americans will be diagnosed with breast cancer this year and 39,920 will die from the disease, according to the American Cancer Society

Additional U-M authors: Julie M. Jorns, M.D.; Angela Wu, M.D.; Jeffrey Myers, M.D.; Lisa A. Newman, M.D., M.P.H.; and Tara Breslin, M.D., M.S.

Funding: None

Disclosure: None

Reference: American Journal of Surgery, doi:10.1016/j.amjsurg.2011.07.016

Resources:
U-M Cancer AnswerLine, 800-865-1125
U-M Comprehensive Cancer Center, http://www.mcancer.org
Clinical trials at U-M, http://www.UMClinicalStudies.org/cancer

About the University of Michigan Comprehensive Cancer Center:
The University of Michigan Comprehensive Cancer Center has more than 400 faculty members delivering compassionate care to today’s patients and researching ways to improve treatments for tomorrow’s patients. It’s our mission: the conquest of cancer through innovation and collaboration. The U-M Comprehensive Cancer Center is among the top-ranked national cancer programs for both research and patient care. It is one of 40 centers designated "comprehensive" by the National Cancer Institute and one of 21 institutions that make up the National Comprehensive Cancer Network, which sets national guidelines for consistent, high-quality and cost-effective cancer care.

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Fewer Women Need Repeat Breast Cancer Surgeries with New Service at University of Michigan

GAITHERSBURG, MD and WESTWOOD, MA--(Marketwire -02/28/12)- AccelPath, LLC, ("AccelPath" or the "Company"), a wholly-owned and operating subsidiary of Technest Holdings, Inc. (OTC.BB: TCNH.OB - News), completes base-level portion of workflow information technology.

AccelPath is developing a suite of HIPAA (Health Insurance Portability and Accountability Act) compliant software tools to enable creation, submission, and reporting of pathology cases and to provide secure online access to reports. AccelPath works with pathologists, laboratory staff and clinical office managers to design and develop the toolset. This toolset significantly improves efficiency of workflow and utilization of bandwidth while complying with strict guidelines dictated by HIPAA patient confidentiality requirements.

"We are pleased that AccelPath is building a comprehensive, HIPAA-compliant solution to a long-awaited need for digital transmission and management of pathology reports," said Shekhar Wadekar, the Company's Chief Executive Officer. "We believe that we will continue to improve the system and attract additional pathologists, medical institutions and new customers as they become more comfortable with our advanced product offerings."

About AccelPath

AccelPath provides technology solutions that play a key role in delivering information required for diagnosis of diseases and other pathologic conditions with and through its associated institutional pathologists. The medical institutions, with whom the Company partners, prepare comprehensive diagnostic reports of a patient's condition and consult with referring physicians to help determine the most appropriate treatment. Such diagnostic reports enable the early detection of disease, allowing referring physicians to make informed and timely treatment decisions that improve their patients' health in a cost-effective manner. The Company seeks out referring physicians and histology laboratories in need of high-quality pathology interpretations and manages HIPAA-compliant digital case delivery and reporting while developing comprehensive solutions for managing medical information.

AccelPath is currently focused on the $14 billion anatomic pathology market in the US. The Company's business model builds upon the expertise of experienced pathologists to provide seamless, reliable and comprehensive pathology and special test offerings to referring physicians using conventional and digital technologies. The Company establishes longstanding relationships with the referring physicians as a result of focused delivery of its partner's diagnostic services, personalized responses and frequent consultations, and its proprietary flexible information technology, or IT, solutions that are customizable to the referring physicians' or laboratories as well as the pathologists' needs. Such diagnostic reports often enable the early detection of disease, allowing referring physicians to make informed and timely treatment decisions that improve their patients' health in a cost-effective manner. AccelPath's IT and communications platform enables it to efficiently and securely deliver diagnostic reports to referring physicians. In addition, AccelPath's IT platform enables close tracking and monitoring of medical statistics.

Technest focuses on the design, research, development and integration of three-dimensional imaging devices and systems primarily in the healthcare industries. The Company also develops solutions and intelligent surveillance devices and systems, as well as three-dimensional facial recognition systems for security and law enforcement agencies. Historically, the Company's largest customers have been the National Institutes of Health and the Department of Defense. The Company's solutions leverage several core proprietary technology platforms, including 3D imaging technologies.

Additional Company information may be found on the Internet at:

http://www.accelpath.com.

Forward-Looking Statements

This press release contains certain "forward-looking statements" relating to the business of the Company, which can be identified by the use of forward-looking terminology such as "may," "will," "expect," "anticipate," "intend," "estimate," "believe," "project," "continue," "plan," "forecast," or other similar words, or the negative thereof, unless the context requires otherwise. These statements include, but are not limited to, statements about the Company's expected future performance and achievement of milestones. The results anticipated by any or all of these forward-looking statements may not occur. In addition, these statements reflect management's current views with respect to future events and are subject to numerous risks, uncertainties and other factors that could cause actual results to differ materially from those set forth in or implied by these forward-looking statements. Factors that could affect those results include, but are not limited to, the acceptance of our solutions in the marketplace, the efforts of our sales force, general economic conditions, and those described in the Company's reports on Forms 8-K, 10-Q and 10-K and proxy statements and information statements, which have been or will be filed by the Company with the Securities and Exchange Commission (the "SEC"), including without limitation under the caption "Risk Factors" in the Company's Annual Report on Form 10-K filed on October 13, 2011. Many of the factors that will determine the outcome of the subject matter of this press release are beyond the Company's ability to control or predict. The Company undertakes no obligation and expressly disclaim any obligation, to revise or publicly update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise.

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AccelPath Completes Base-Level Portion of Its Workflow IT Technology

BRANFORD, Conn., Feb. 28, 2012 /PRNewswire/ -- HistoRx, the leader in quantitative immunohistochemistry, has earned two additional patents covering AQUA technology and critical elements of digital microscopy standardization.  Combined with patents earned previously, these issuances by the US Patent & Trademark Office advance the Company's proprietary position in standardization of quantitative digital pathology to a dominant role in the industry. 

Challenges associated with the generation of reproducible digital microscopy images and image data at the appropriate stringency for quantitative analysis are addressed by these newly issued patents.  Digital pathology initially evolved to capture images of clinical samples interrogated through the microscope for telepathology, archival and research use.  Today, however, in the research and clinical settings, digital microscopy images support image analysis as well.  The image is the primary source of data used for the assessment of a variety of features of the clinical sample, from morphological characteristics to measurement of biomarker expression.  Robust quantitative data can only be achieved from analysis of reproducible images, generated from standardized digital microscopy instruments.  Digital pathology companies interested in making the leap from merely qualitative to truly quantitative analysis can ensure an effective transition to clinic-ready results through collaboration with HistoRx.

US Patent 8,121,794 "Systems and methods for automated analysis of cells and tissues," issued February 21, 2012, and is the third US patent protecting methods and now, microscopy systems, that localize and quantitate a biomarker in subcellular compartments in a tissue sample, the hallmark of AQUA technology.   US Patent 8,120,768, "Method and system for standardizing microscope instruments," also issued February 21, 2012, and is the third US patent protecting methods, software, and standardized microscopy systems that provide for the generation of reproducible digital microscopy images and image data at the appropriate stringency for quantitative analysis.

"Our patent position has evolved beyond AQUA technology to methods necessary for advancing digital microscopy images from images that are visually appealing to images that are suitable for quantitative analysis with the accuracy required for clinical results," commented Wendy Davis, VP of Intellectual Property and Portfolio Management at HistoRx.  "What can be measured can be managed.  It was through the use of AQUA technology that the need to standardize microscopy systems and the images they generate was revealed. Therefore the 8,120,768 patent is broadly applicable to digital microscopy bringing its utility from generating images to generating quantitative clinical diagnostic results."

AQUA technology is an automated, quantitative IHC testing method that enables measurement of protein biomarkers in tissue as an aid to a pathologist's diagnosis.  Such precise determination of first, the location within the tumor cell and second, the amount in each location is not possible with conventional testing methods, such as standard immunohistochemistry (IHC).  AQUA analysis is used in cancer research by more than twenty leading academic centers worldwide, is part of the clinical development plans for more than ten drug candidates from major pharma companies, and has been cited in more than 120 peer-reviewed publications.  AQUA technology is currently available on the ScanScope FL™ from Aperio and the Vectra™ 2 system from Caliper Life Sciences, a PerkinElmer company.

About HistoRx, Inc.

HistoRx, Inc. is the leader in quantitative immunohistochemistry and a leading developer of tissue-based diagnostic solutions to advance individualized patient care.  The company's products and services are based on proprietary analysis of tissue biomarkers using AQUA® technology.  HistoRx is commercializing a pipeline of proprietary diagnostic products targeting improved treatment decision-making and patient outcomes in cancer care.  For more information, please visit http://www.historx.com.

Originally posted here:
HistoRx Achieves Dominant Intellectual Property Position in Standardization of Results from Digital Pathology ...

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Corista to provide platform for Massachusetts General Hospital's Pathology Network

The Massachusetts General Hospital Pathology Service has chosen Corista's Digital Image Management Platform (DP3) to support its goal of providing clinical review of pathology cases with a digital platform. This new capability will allow MGH clinical experts to extend their reach to remote patients and their physicians for second opinions in real time.

"Recent technological advances have enabled immediate and widespread access to highly specific pathology expertise, speeding up both diagnosis and the start of treatment," said David Wilbur, MD, Director , Clinical Imaging -Pathology Services at MGH and Professor of Pathology at Harvard Medical School. "The key is having an image-centric platform that provides access together with the tools needed to respond and interact with multiple systems in the community."

 

Corista’s CEO, Elizabth Wingard said , "We’re pleased to be working with MGH and Partners Healthcare to extend the reach of the hospital’s expertise in pathology to physicians and patients in communities near and far. The Corista platform provides an intuitive case management dashboard that manages workflow and patient cases with digital images, and which can be integrated with existing hospital information systems," Wingard said. "In accessing specialists online and getting an immediate response, remote patients and hospitals can improve patient care with expertise that would have been delayed by days using couriers and FedEx. Eliminating the delay improves the patient’s care by enabling providers to initiate the appropriate treatment plan immediately."

 

Corista provides Pathologists with a single point of access to read and manipulate patient images with an extensive toolset for analysis, collaboration, diagnosis and report generation. With Corista's platform, MGH will be able to improve the process and quality of pathology medicine while extending real time clinical support for remote patients. 

About Corista

Since 2005, Corista has been developing its image-based processing software and proprietary browser-based software platform.  The patent-pending platform, DP3, provides a comprehensive solution for pathology practices that includes: a universal viewer that reads images from any whole slide imaging platform; secure local and remote image viewing and navigation, image management, on-demand colleague consultation, annotation, measurement  diagnoses; notifications to physicians of new cases or consults to be reviewed, and a centralized Physician Dashboard integrating in-house and remote patient cases into a single view for physicians. DP3 can integrate with existing hospital information systems, is hardware agnostic and supports a complete range of physician devices including high resolution monitors, tablets and touchscreens. 

 

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Source: Corista

 

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Perhaps in the end this "strategic alliance" aka acquisition of AMA's physician portal by AT&T could be a good thing but commercial ventures by the AMA in the past of this sort have not ended well.  Not sure this impacts pathology to a great degree, perhaps laboratory medicine in the general sense but AMA, in my opinion has not done terribly much on behalf of pathologists or the greater public health and why a majority of physicians are not members of the AMA. Time will tell if this "alliance" between two widely recognized brands will benefit patients and providers and offer a more robust and flexible health information exchange platform.  Meaningful use incentives while important for primary care providers, again, do not impact pathology or laboratories, both in terms of incentives or penalties.  This thanks to recent efforts by CAP to amend meaningful use penalties. This of course would not have come about if the original legislation excluded laboratories and pathologists from the reporting requirements recognizing that while we manage a huge amount of data often times the outcome assessment cannot be complete without missing corresponding clinical information collected by the clinical provider at the point of service of clinical services.  In any event, pathologists are now neither eligible for incentives and won't be penalized for not being able to do it.  Meanwhile, physician organizations can focus on working with communication companies to faciliate transfer of lab order and results so non-laboratory providers can be compensated for "meaningful use".

How about some "incentives" for reporting accurate timely data that is used to meet meaningful use?

AMA Press Release:

Strategic Alliance Helps Thousands of Physicians Modernize Practices

Chicago and Dallas – In a union of two iconic American brands, the American Medical Association (AMA) and AT&T* have formed a strategic alliance that will enable hundreds of thousands of physicians, physician organizations and medical societies nationwide to connect and collaborate with hospitals, payers and patients to help enhance patient care and reduce costs.

The organizations will integrate AMA's AMAGINE™ physician community portal for physicians with AT&T Healthcare Community Online, creating an advanced collaborative care and Healthcare Information Exchange (HIE) platform. By combining the platforms, both powered by Covisint, physicians will have more tools at their fingertips to modernize the management of their practices. 

AMA and AT&T will advance the adoption of health information technology (health IT) across the healthcare ecosystem by enabling customers that use the platforms – physicians, hospitals, payers and patients – to access health IT applications and exchange highly-secure clinical and administrative data. The alliance will create one seamless solution that will enable highly-secure, virtually anywhere, anytime access to advanced applications, aggregated clinical information and data analytics that enable the coordination and management of patient care and population health. 

The relationship will expand the functions and capabilities of the AMAGINE physician community portal that was created to help physicians easily integrate health IT into the management of their practices through a single source with affordable choices. AT&T Healthcare Community Online provides the foundation for a fully clinically integrated system across the entire care team and helps improve collaboration, reduce paperwork and potential errors, and ultimately improve the quality of patient care.

 

Together, the combined platform will:

• Increase caregiver collaboration by connecting AMAGINE customers with AT&T Healthcare Community Online customers
• Provide access to AT&T's patient care and clinical integration solutions that help bring evidence-based information to the point of care
• Enable access to important applications such as clinical decision support, e-prescribing, care management and electronic medical records
• Improve workflow efficiency and streamline processes associated with physician orders and referrals, lab orders and results, medications and discharge planning
• Help physicians to take further advantage of "meaningful use” incentives

"This alliance with AT&T makes the combined product offering that much stronger and more beneficial to physicians,” said Robert Musacchio, Senior Vice President of Business Operations for the American Medical Association. "With the AMA's extensive knowledge of physician and patient needs, and AT&T's proven track record delivering technology solutions to clients, we expect that physicians and their patients will be able to enjoy the benefits of advanced health IT sooner and with more dramatic results.” 

AT&T will own and operate the combined platform as AT&T Healthcare Community Online and lead efforts to evolve technology solutions and bridge clinical and information needs across patients, physicians, hospitals and ancillary organizations. AMA will remain actively engaged and will collaborate with AT&T on business strategies to expand availability and accessibility of health IT for physicians and practices.

"If caregivers across the country aren't connected, they can't collaborate effectively as a team. By joining forces with the nation's largest physician organization, we're providing a seamless solution to meet the "last mile' of connectivity across the entire healthcare ecosystem,” said Randall Porter, Assistant Vice President, AT&T ForHealth, AT&T Business Solutions.

Both organizations will be discussing the alliance at booth #3829 at HIMSS12 in Las Vegas from Feb. 20 - Feb. 24, 2012.

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For more information contact:

Robert J. Mills
American Medical Association
312-543-7268
robert.mills@ama-assn.org

Wendi Fuller
AT&T Corporate Communications 
214-373-0118
wendi.fuller@att.com

 

Source:
http://feeds.feedburner.com/DigitalPathologyBlog

The pancreas folks over at Johns Hopkins recently updated their already fantastic pancreas pathology app within the past week.  Search for "pancreas" in the app store and you would be hard pressed to find more than a couple of apps.

 

If you have any interests in pancreatic pathology, be it student or practioner, this is a must have app.  Stunning images in the atlas, teaching algorithm derived from the AFIP fascicle and a quiz for self-study.  The over 1400 images in the atlas are high resolution color images of awesome quality with captions covering over 100 entities.  A top notch app which can be found here:

 

 

 

Description provided by developers:

This app is a teaching tool for medical residents, fellows, and practicing pathologists.

The Atlas of Pancreas Pathology is comprised of three modules: an interactive teaching algorithm, a search-able image atlas, and an image-based quiz. Viewing multiple examples of the same entity or feature from this large, rich image atlas will strengthen your diagnostic skills.

Teaching Algorithm. The teaching algorithm is a tool to teach the diagnostic criteria for the most common neoplasms of the pancreas. The algorithm consists of a series of usually dichotomous decision points, starting with determining if the tumor is solid or cystic, which end in specific diagnoses. Gross and microscopic photographs, together with didactic illustrations created by medical illustrator Bona Kim, support the instructional design of the algorithm. The algorithm was adapted with permission from RH Hruban, MB Pitman, and DS Klimstra, Tumors of the Pancreas. Washington D.C.: American registry of Pathology; 2007. Atlas of Tumor Pathology; 4th series, fascicle 6.

Image Atlas. The image atlas contains over 1,400 high resolution color images with captions authored by a leading expert, and covers 115 diagnostic entities. These gross and microscopic photographs can be viewed together or separately, and two entities can be compared, side by side. The atlas can be viewed by diagnosis or by features (these features re-enforce the diagnostic features used in the algorithm), and the atlas can be searched using a key word search. You can create your own albums and add images you select from from the atlas to these albums.

Quiz: The Quiz contains 166 multiple choice questions for self-study.

 

 

 

 

 

 

Source:
http://feeds.feedburner.com/DigitalPathologyBlog

Successful Pathology speech recognition implementation at The Stamford Hospital to be featured at ?HOT TOPICS? Breakfast Roundtable.

Lake Success, NY, February 25, 2012 --(PR.com)-- Voicebrook, the leader in Pathology speech recognition and reporting solutions, today announces that it will be exhibiting at the American Pathology Foundation (APF) Spring 2012 Conference at the Marriott Marquis & Marina in San Diego. The exhibit hall is open from February 29th to March 2nd. Members of the Voicebrook team will be available in Booth 9 for demonstrations and discussion.

The APF carefully selects and develops educational topics within the Foundation’s programs to meet pathologists’ and practice managers’ most current needs and provide them with practical information for implementation within their practices. This year the Foundation has selected Voicebrook user, Dr. Bo Xu, from The Stamford Hospital Pathology Department in Stamford, CT, to lead the topic on voice recognition technology during its Friday “HOT TOPICS” Breakfast Roundtable session.

The Stamford Pathology Group has been successfully using Voicebrook’s VoiceOver® solution since 2009; they have realized $180,000 in annual savings and average report turnaround time improvement of 1.5 days, all while completing 20% more reports per day. When asked about the VoiceOver® solution, Dr. Robert Babkowski, Stamford’s Chair and Laboratory Medical Director, said, "VoiceOver® is as important to me as my microscope. It allows me to produce reports in a timely and efficient fashion and to effectively communicate with my clinicians."

"This is the second year that we are sponsoring the American Pathology Foundation Spring Conference, and if last year was any indication, this promises to be a great event," said E. Bruce Sopko, VP Sales of Voicebrook. “We are especially pleased that the Foundation invited Dr. Bo Xu from the Stamford Pathology Group to host their ‘HOT TOPICS’ session on voice recognition. Stamford’s use of our software has been a tremendous success story and Dr. Xu is a very accomplished and knowledgeable user.”

Voicebrook’s VoiceOver® speech recognition and digital dictation software is used in more than 200 laboratories across the United States and Canada and has been proven to be the most effective dictation solution for automating outdated reporting processes, saving customers time and money, and improving the overall quality of anatomic pathology reports.

For more information, please visit http://www.voicebrook.com.

About Voicebrook
Voicebrook is the leading provider of integrated speech recognition and digital dictation solutions for Pathology. Voicebrook’s VoiceOver® software integrates directly with most AP/LIS systems, and has been widely deployed in Pathology throughout the US and Canada. Voicebrook has developed specific best practices for implementation and on-going support, ensuring the most successful deployments of integrated speech recognition technology for Pathology.

About the American Pathology Foundation:
The American Pathology Foundation (APF) is a non-profit professional society devoted to the business of pathology. Founded in 1959, the Foundation provides quality educational programs, practice management resources and networking opportunities for its members.

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Link:
Voicebrook to Exhibit at American Pathology Foundation Spring 2012 Conference

Massachusetts General Hospital will be able to communicate with physicians and patients to review pathology cases in real time thanks to technology developed by Corista LLC.

Using Corista’s digital platform Massachusetts General Hospital’s Pathology Network will enable its clinical experts to share images with remote patients and their physicians in real time, the Concord-based company announced recently.

Members of the academic pathology department, which provide subspecialty clinical services, will be able to use Corista’s DP3 toolset to provide analysis and diagnosis on images and also generate reports. There are a total of 90 faculty, 800 employees and 50 residents under the direction of Dr. David Lewis, chief of pathology at Massachusetts General Pathology Service, who are responsible for 10 million clinical laboratory tests, 80,000 surgical specimens, 60,000 cytopathology specimens and 35,000 red-cell transfusions each year.

Corista CEO Elizabeth Wingard stated that remote patients and hospitals benefit from its DP3 platform because specialists are able to get immediate responses and therefore improve patient care. Without the real-time capability, information would have been delayed by days using other methods such as couriers and other delivery methods, she added.

Wingard, along with the company’s Managing Director Richard Wingard and CTO Charles Pace, co-founded Corista in 2005. Richard Wingard, who has 25 years in the business of medical imaging and healthcare technology, was the senior executive for Sprint’s healthcare initiatives. He designed and developed Sprint’s healthcare technology capability, HANDS, which set the standard for telemedicine and tele-radiology, according to Corista.

Go here to see the original:
Concord’s Corista helps MGH share images

CONCORD, Mass., Feb. 24, 2012 /PRNewswire/ -- The Massachusetts General Hospital Pathology Service has chosen Corista's Digital Image Management Platform (DP3™) to support its goal of providing clinical review of pathology cases with a digital platform. This new capability will allow MGH clinical experts to extend their reach to remote patients and their physicians for second opinions in real time.

"Recent technological advances have enabled immediate and widespread access to highly specific pathology expertise, speeding up both diagnosis and the start of treatment," said David Wilbur, MD, Director, Clinical Imaging -Pathology Services at MGH and Professor of Pathology at Harvard Medical School. "The key is having an image-centric platform that provides access together with the tools needed to respond and interact with multiple systems in the community."

Corista's CEO, Elizabeth Wingard said, "We're pleased to be working with MGH and Partners Healthcare to extend the reach of the hospital's expertise in pathology to physicians and patients in communities near and far. The Corista platform provides an intuitive case management dashboard that manages workflow and patient cases with digital images, and which can be integrated with existing hospital information systems," Wingard said. "In accessing specialists online and getting an immediate response, remote patients and hospitals can improve patient care with expertise that would have been delayed by days using couriers and FedEx. Eliminating the delay improves the patients' care by enabling providers to initiate the appropriate treatment plans immediately."

Corista provides Pathologists with a single point of access to read and manipulate patient images with an extensive toolset for analysis, collaboration, diagnosis and report generation. With Corista's platform, MGH will be able to improve the process and quality of pathology medicine while extending real time clinical support for remote patients.

About Corista:
Since 2005, Corista has been developing its image-based processing software and proprietary browser-based software platform. The patent-pending platform, DP3, provides a comprehensive solution for pathology practices that includes: a universal viewer that reads images from any whole slide imaging platform; secure local and remote image viewing and navigation, image management, on-demand colleague consultation, annotation, measurement diagnoses; notifications to physicians of new cases or consults to be reviewed, and a centralized Physician Dashboard integrating in-house and remote patient cases into a single view for physicians. DP3 can integrate with existing hospital information systems, is hardware agnostic and supports a complete range of physician devices including high resolution monitors, tablets and touchscreens.

Anne Marsden
anne@marsdenassociates.com
(678) 990-1259

See original here:
Corista to Provide Platform for Massachusetts General Hospital's Pathology Network