Check out Nikon’s One-Stop Solution for Gross Specimens

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 If you are attending USCAP check this out and other Nikon products related to telepathology in Booth #348.

Mi

Introducing Nikon's one-stop solution for gross specimen imaging.

Nikon's Mi macro imaging station revolutionizes gross histology documentation by addressing the workflow necessary to cleanly and safely capture, annotate, compare, and measure images of biopsied gross specimens in the pathology, histology and forensic lab. The Mi offers a stable, versatile, contamination-free imaging station, providing the ideal first step in capturing an entire pathology case history.

LED lighting - Provides bright, sharp images with perfect detail, and ensures that specimens will not be damaged by heat.

Ease of Use - With its simple interface and straightforward operating actions, users need not have expertise in photography for successful imaging.

Top Quality Camera - Nikon DS-Fi1 camera with motorized lens provides high resolution imaging and offers the option to select either standard or publication quality images, as required.

Reduced Risk of Contamination - Workstation is water and splash-resistant, and user has option to carry out all functions via touch screen, keyboard, mouse, foot pedal or barcode reader.

Pathology-Focused Software - Simple menu options enable rapid image capture and annotation, live comparison, object measurement and counting, and database functions to maximize information from images.

For a look at Mi-related product literature and multi-media resources, click here.

Data Sheet, Brochure, White Paper, Image Gallery, Demo

For even more information, contact us at nikoninstruments@nikon.net.

If you would like a price quote, click here.

 

Aperio Webinar: Adopting Digital Pathology for Core Labs – February 22

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Tuesday, February 22, 2011

7:00am PST, 10:00am EST, 3:00pm GMT
 OR
4:00pm PST, 7:00pm EST
(8:00am Japan Standard Time / 9:00am Australia EST February 23) 
Presenters:
Charles R. Handorf, M.D., Ph.D.
Anand Kulkarni, M.D.
University of Tennessee Health Science Center

In this 60-minute, complimentary webinar, Drs. Handorf and Kulkarni will discuss adopting digital pathology for core labs.

Topics include:
Digital imaging: Service and support for core labs
Digital imaging integration for biobanks
Instrument procurement and operational costs
Future of digitized images
To register for the 7am PST session, click here.
https://aperio.webex.com/aperio/onstage/g.php?t=a&d=485058319

To register for the 4pm PST session, click here.
https://aperio.webex.com/aperio/onstage/g.php?t=a&d=485629421

You may also register by visiting the Aperio Events page.

You will receive a confirmation email upon registration with a web link that will lead you to the online event. Simply visit the link at the assigned time. The session is secure and easy to access. If you have any questions or would like additional information, please contact the Aperio Events Team at events@aperio.com or 760.539.1192.

FDA clears first app for image review on iPads, iPhones

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Pathology Next? Pathology could use this as a leverage point to use pathology digital imaging on iPADs and other related media.

February 4, 2011 -- The U.S. Food and Drug Administration (FDA) has issued clearance of MIM Software Mobile MIM application, the first mobile image viewing application to receive clearance for diagnostic use on Apple's iPhone and iPad devices.

The clearance covers viewing and making medical diagnoses using iPads and iPhones for CT, MR, and nuclear medicine images (including PET), but the software is not intended to replace full workstations, and it's indicated for use only when there is no access to a workstation, according to the FDA.

While smartphones and tablets such as Apple's iPhone and iPad have drawn interest for their potential in radiology applications, broader clinical use has been held back due to an early 2010 FDA decision to classify Mobile MIM as a class III device requiring premarket approval (PMA) instead of a class II device requiring 510(k) clearance.

The situation changed in the summer of 2010, however, when MIM Software was discussing its appeal of the 510(k) decision with the FDA, said Mark Cain, chief technology officer of the Cleveland-based company.

"We were able to identify many of the key issues that concerned them [and] it was jointly decided that another 510(k) would be the best way to proceed," Cain said.

With the clearance of Mobile MIM, the regulatory picture has now brightened, likely ushering in increased investment in these applications.

In its evaluation of Mobile MIM, the FDA said it reviewed performance test results on various portable devices, measuring luminance, image quality (resolution), and noise in accordance with international standards and guidelines. The FDA also reviewed results from demonstration studies with qualified radiologists under different lighting conditions.

"All participants agreed that the device was sufficient for diagnostic image interpretation under the recommended lighting conditions," the FDA said in a statement.

With Mobile MIM, images are compressed for secure network transfer and sent to the appropriate portable wireless device. Mobile MIM also enables physicians to measure distances and image intensity values, as well as display measurement lines, annotations, and regions of interest, the FDA said.

The FDA noted that there can be significant variations in the display performance of mobile devices, even between mobile devices of the same model. However, the Mobile MIM application includes sufficient labeling and safety features to mitigate the risk of poor image display due to improper screen luminance or lighting conditions, according to the FDA.

"The device includes an interactive contrast test in which a small part of the screen is a slightly different shade than the rest of the screen," the FDA said in a statement. "If the physician can identify and tap this portion of the screen, then the lighting conditions are not interfering with the physician's ability to discern subtle differences in contrast. In addition, a safety guide is included within the application."

MIM Software welcomes the clearance, particularly because the FDA had turned down the company's original 510(k) application

"After three years, it is a relief to see this chapter close," Cain said. "We're looking forward to the next step."

By Erik L. Ridley
AuntMinnie.com staff writer
February 4, 2011

Copyright (c) 2011 AuntMinnie.com 

Danaher-Beckman Coulter Deal: ‘More than Fair’

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Danaher also owns Leica and SlidePath

Danaher agreed to buy lab-equipment maker Beckman Coulter for $5.87 billion.

Danaher’s deal is valued at $83.50 a share in cash, which the companies said was 45% more than the price of Beckman Coulter shares before The Wall Street Journal and others reported in December that the company was on the auction block. At the time, Danaher was among the companies expected to take a run at Beckman Coulter.

Beckman Coluter’s stock price is pointing up about 10% in pre-market trading, to $82.62. Danaher shares also are trending up – unusual for acquiring companies when they announce deals.

Here is a look at Wall Street’s first read on the deal:

“While our analysis of strategic buyers suggested that a deal could be done hypothetically at a higher price per share, we felt there were very fewer bidders who could go materially higher than $80 per share without incorporating an equity component and/or risking changes to their credit rating. Thus, we feel that a sale price in the low $80s is more than fair.” –- Cowen & Co.

“Given prior speculation about the deal in the press…we think another party coming in over the top at this point is highly unlikely. Valuation looks fair based on prior transactions. The announced $83.50 price represents 11x EV/(EBITDA-lease capex) on a trailing basis. –- J.P. Morgan

“We view DHR’s proposed acquisition of BEC for $83.50/share [~8x 2010e EBITDA (ex options) and ~10% premium to the 2/4 close] as a positive for DHR. We believe the probability that this deal closes is very high. The bidding process was comprehensive and competitive, and thus we view a higher competing bid as unlikely.” –-Leerink Swann

Courtesy of Wall Street Journal

Dark Report: More Clinical Pathology Laboratories are Purchasing Digital Pathology Systems

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According to the Dark Daily, acquisition of digital pathology technologies still remains in earliest stages:

"Anatomic pathology laboratories continue to purchase and deploy digital pathology systems at a brisk rate. It is confirmation that ever more pathologists are ready to adopt and use digital pathology systems."

The story goes on to say:

"It should be pointed out that, at this time, total worldwide sales of digital pathology systems do not exceed much more than 1,000 to 1,500 systems, exclusive of digital slide scanners. This number represents only a small percentage of the developed world’s clinical pathology laboratories. But the number is a useful benchmark that pathologists can use to track the adoption of digital pathology."

Full story from Dark Daily

Getting Paid for Molecular Tests: How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by Payers

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FREE Special Edition White Paper

download your report now!

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


Getting Paid for Molecular Tests: How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by PayersThe proliferation of molecular diagnostics is bringing a tidal wave of complexity, cost and quality issues for payers, clinicians and laboratories. Although clinical laboratory testing costs represent only 3 percent of total health care costs, diagnostic testing influences 70 percent of all health care decisions.  Therefore, payers are accelerating efforts to appropriately manage the utilization and reimbursement of molecular diagnostics and genetic tests. Payer initiatives include developing utilization management programs, such as pre-authorizations r notifications, to identify genetic and molecular tests using stacked codes, ensure medical appropriateness, and encourage increased use of in-network laboratories.

Payers will likely require pre-authorization/ notification for clinical laboratories and pathology groups, just as they have done for radiology.  To stay ahead of evolving requirements, successful laboratories are deploying technology to collaborate real-time with clinicians, payers and other laboratories. In addition to making payer rules, benefits and coverage policies transparent to ordering clinicians, patients and laboratories at the point of care (or within the context of an order, successful technology deployments enable early adopters to further penetrate their market, increase clinician loyalty and better manage their utilization and relationships with payers.

The Dark Report is happy to offer our readers a chance to download our recently published FREE White Paper “Getting Paid for Molecular Tests: How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by Payers” at absolutely no charge.  This free download will provide readers with a detailed overview of current legal challenges that your lab may encounter in the near future.


download your report now!

—

Here is just some of what you will take away…

  1. Why Payer Pre-Authorization and/or Notification for Genetic Molecular Tests Will Become Widespread
  2. The Advantages of Automated Payer Communication
  3. A Systematic Approach to Evaluating Genetic and Molecular Test Claims
  4. For more about How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements, please CLICK HERE

 

download your report now!

Table of Contents

Introduction

Chapter 1. Current Status of Managed Care Requirements for Coding, Claim Submission and Reimbursement of Molecular Tests

Chapter 2. Why Payer Pre-Authorization and/or Notification for Genetic Molecular Tests Will Become Widespread 

Chapter 3. Existing Differences Among Payers in Pre-Authorization of Genetic and Molecular Tests  

Chapter 4. Advantages of Automated Payer Communication

Chapter 5. A Systematic Approach to Evaluating Genetic and Molecular Test Claims

Chapter 6. Case Study: Improving Clinical, Operational and Financial Performance in the Laboratory

Chapter 7. Conclusion 

A-1 About Matthew Zubiller
A-2 About McKesson
A-3 About DARK DAILY
A-4 About The Dark Intelligence Group, Inc., and The Dark Report
A-5 About Executive War College on Laboratory and Pathology Management
A-6 About Karen Appold

 

Terms of Use — Page 36

download your report now!

Blumenthal Resigns ONC Post

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2-3-2011 5-53-42 PM

David Blumenthal, MD MPP has resigned his position as National Coordinator for Health Information Technology for the Department of Health and Human Services. He will leave office sometime in the spring to return to Harvard University.

Prior to his March 2009 appointment, Blumenthal was a practicing physician and Director of the Institute for Health Policy at Massachusetts General Hospital / Partners HealthCare System in Boston. He was also a professor of medicine and health care policy at Harvard Medical School.

 

Slide scanning services from Micro Optical Solutions LLC

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Microscope Slide Scanning Services

1x3 & 2x3 slide scanning services for brightfield & fluorescence applications.

4x slide scan of mouse brain10x slide scan of mouse brain20x target of mouse brain
The Microscopes: Custom automated for high resolution imaging
  • Illumination: Transmitted light LED and metal halide reflected light fluorescence.
  • Optics: plan fluorite 10x 0.25NA, 20x 0.46NA, and 40x 0.75NA as standard.
  • Other optics available upon request.
  • High resolution cooled color digital camera, meets Nyquist Theorem requirements.
  • XYZ automated platform with high resolution motorized stage.
  • Autofocus capability - several autofocus applications available.
  • Custom integrated PC / imaging software platform for a variety of applications.

The Services: What We Provide

  • You decide - we acquire high resolution images per your determined methodology.
  • Single images are in standard single TIFF image format for ease of use on a variety of analysis platforms.
  • Custom software is included in the scanning service for our customers to navigate and view the full macro image at lower resolution and then expand to the single full resolution image for detailed viewing.
  • All scanned image sets and folders will be stored on a USB digital hard drive, included with the return of your samples. We will store copies of these images at Micro Optical until you confirm that your hard drive and data has been received. You can choose to return the hard drive to Micro Optical or keep it as a backup copy of your original data.

Richard Schneider

Applications Engineer

Office: (978) 255-2220
Cell: (978) 697-2216
Fax: (978) 255-2221

Postal

P.O. Box #383

Newburyport, MA 01950

Shipping

Suite F B310
100 Macy Street
Amesbury, MA 01913
 

Q&A: The State of Digital Pathology, with Paul Chang, MD

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Interesting perspective from Dr. Paul Chang on digital pathology and workflow processes published in Health Imaging and IT.  

With vendors inking partnerships and developing new tools to bring pathology out of the dark ages and experts pegging the integration of radiology and pathology as one of the top opportunities for imaging, digital pathology may be imaging’s next frontier. This month, Health Imaging & IT chatted with Paul Chang, MD, professor and vice chair of radiology informatics and medical director of pathology informatics at University of Chicago, who offers insights into pathology workflow.

How does digital pathology workflow compare to radiology workflow?

Chang: I’ve been struck by a few assumptions that have been made about pathology workflow. The first is the belief that the pathology imaging task is similar to radiology. People see the success of digital image management in radiology and believe we should apply the same paradigm to pathology. However, pathology workflow differs in fundamental ways which I believe change the direction of digital pathology. 

Can you describe these differences?

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Chang: As a radiologist, the most important part of my interpretation is whether or not there has been a change from the previous images. I need a high-quality representation of current and prior studies. This is not how pathologists use prior studies.
When evaluating prior studies, pathologists typically refer to a few key selected regions—the fields that represent the prior histology. The pathologist’s job is to tell if the current cells represent the same or different histology. Accordingly, the pathologist almost never is required to review every prior slide.

What are the image management implications of this pathology workflow process?

Chang:The consequences are significant. I don’t have to replicate digital radiology image management, which requires a large, complex and costly archive. It’s hard to justify an archive that is write once, read almost never. Wouldn’t it be better to just capture and store the key regions from the slides? Those selected images would be far easier to store and would be more cost-effective.

That addresses the image storage process, the PACS component. What about the RIS side of imaging informatics?

Chang: This is another fundamental difference between radiology and pathology workflow. In radiology, we acquire the digital image of the patient as one of the first steps in our workflow. From an informatics perspective, we transform the “analog” patient into digital data at the beginning and maintain that digital representation throughout the workflow process, which makes it easier to leverage digital technology to realize quality and efficiency.
In pathology the transformation from physical to digital is not done until near the end of the workflow.  The pathology workflow process requires the handling, tracking and processing of physical specimens throughout. In many labs, specimens are identified with patient demographics by the use of rubber bands binding the specimen container with a paper requisition form. A lot of things can go wrong. The real need here is not digital imaging but specimen tracking.
This very important part of pathology workflow doesn’t need PACS; it needs Fed Ex. Fed Ex manages the handling of physical packages by embracing digital workflow. They use barcoding to make sure packages don’t fall through the cracks. In anatomic pathology, barcoding and similar digital approaches could link the physical specimen to the patient and help manage specimen handling to avoid lost or misidentified specimens.

Can you provide an example?

Chang: At the University of Chicago, we are building a workflow solution that attempts to leverage digital technology appropriately. Barcoding will be used to unambiguously associate specimens with patient demographics and to track these specimens throughout the process. This specimen tracking system will provide the ability to launch contextually relevant decision support tools for users. For example, at the grossing station, scanning the specimen barcode will automatically show the pathologist the patient information and the relevant radiology images to help guide the specimen sampling. 
This is good news. We don’t have to wait for PACS archive technology to get significantly cheaper before we can embrace digital pathology. We can leverage existing enterprise PACS to store the much more modest representative images and then apply appropriate digital solutions such as specimen tracking to orchestrate more efficient and safer workflow. We can do this now.

 

Voicebrook Featured in CAP Today Article

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Voicebrook Inc., the leading provider of integrated speech recognition and digital dictation solutions for Pathology, recently announced its inclusion in a feature article “Voice of Choice for lab transcriptions,” in the January 2011 issue of CAP TODAY.

The article focuses on the role of speech recognition software for laboratory transcription, and declares that when it comes to choices in the marketplace, Voicebrook’s VoiceOver® software is the only speech recognition product that is designed for pathologists. The article quotes several prominent pathologists from across the country, who universally confirm that VoiceOver® is the best solution for pathologists who are looking to implement a speech recognition product in their laboratory. Benefits mentioned include financial savings, improved turnaround time, assistance in training residents, time savings, improved accuracy over traditional transcription, adaptability to different LIS systems, and ease of adoption for even the most hesitant and technology-phobic pathologists.

E. Ross Weinstein, CEO of Voicebrook said, “We are pleased that CAP TODAY decided to write a feature article about speech recognition in Pathology, and that they accurately identified our role as the leader in speech recognition solutions for Pathology. In the article, the question, ‘How good is the one option I’ve got?’ was raised, and we feel that the users of our software clearly identified the many benefits of VoiceOver that are unique for Pathology. These features include advanced templating, discrete data entry and CAP Cancer protocols, a knowledge base of Pathology templates, hands-free microphone and foot pedal integration, delegated and digital dictation workflows, custom integration with over 16 AP/LIS products, downtime procedures, integration with Digital Imaging platforms, and customized vocabulary and functionality to handle unique Pathology reporting workflows. Our goal is to continue to build upon that feature set in order to provide our clients with the most robust and usable speech recognition and digital dictation solutions for Pathology, while maintaining excellence in delivering the professional services necessary in this demanding environment.”

For more information, please visit http://www.voicebrook.com or read the article at the CAP website at http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt{actionForm.contentReference}=cap_today%2F0111%2F0111c
_voice.html&_state=maximized&_pageLabel=cntvwr.

About Voicebrook
Voicebrook is the leading provider of integrated speech recognition and digital dictation solutions for Pathology. Voicebrook’s VoiceOver® Enterprise 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.

How to Use Pathology 2.0 and Social Networking to Advance Your Career

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Social networking and Pathology 2.0 are giving young pathologists unique opportunities to advance their careers and their clinical expertise. If you're a pathology resident or fellow, smart use of these tools can help you identify the perfect job, with ample salary and benefits to match.

If you're preparing to enter the professional arena, you'll want to use Pathology 2.0 and social networking to build valuable collaborations within the pathology profession. In the clinical area, it's a great way to open doors and interact with nationally prominent sub-specialist pathologists and professional leaders. 

Keith J. Kaplan, MD, FCAP is an up-and-coming young pathologist who is recognized as an early master of social networking-and is credited with coining the term "Pathology 2.0." Now he's ready to share what he's learned with you.

If you're a pathology resident or fellow, this is your chance to understand the essentials of Pathology 2.0 and social networking. Find out how the effective use of these resources can boost your career-both clinically and financially when you register to attend "Finding Your Perfect Pathology Job: How to Use Pathology 2.0 and Social Networking to Advance Your Career" on Thursday, February 10, 2011.

"Web 2.0" refers to an Internet that is both personalized and interactive. It incorporates technologies that allow websites to recognize the individual and deliver information and content tailored specifically to each user's interests and needs. It's about instant communication and collaboration across large numbers of like-minded individuals, enabled by the Internet.

Take all those Web 2.0 capabilities, add digital pathology images and you have the basis of Pathology 2.0, which represents a disruptive change agent in today's practice of anatomic pathology. 

Pathology 2.0 is the convergence of digital imaging, digital pathology systems, and integrated healthcare informatics. This combination of digital pathology images with social networking collaborations gives you the ability to discuss or diagnose a case across an ever-expanding network.

During this webinar, you'll learn how Pathology 2.0 is already beginning to change the daily practice of surgical pathology. Find out how digitized whole slide images, combined with different web-based technologies, can change case referral patterns. It all starts with a physician treating a patient and extends to the pathologist who may want a sub-specialist to review the images.

It is easy to see why Pathology 2.0 is likely to transform the current anatomic pathology practice into a different, more vibrant, and more collaborative profession. It will be today's pathology residents-already familiar with computers, email, and video games-who will be more likely to use the Internet to support their surgical pathology practices. 

As a pathology resident or fellow today, you have incredible new tools to advance your clinical skills and increase your professional compensation. Pathology 2.0 and social networking are valuable resources that can help you identify and secure the perfect job this spring. Find out how when you register to attend this very special webinar. 

And don't forget the question-and-answer session at the end of this 75-minute conference. It's your opportunity to get answers to specific questions about how to put Pathology 2.0 to work for you. 

For one low price—just $249—you and your entire team can take part in this fast-paced, insightful webinar. Best of all, you'll be able to connect personally with either of the panelists when we open up the phone lines for live Q&A.

Here's just some of what you’ll learn during this in-depth 75-minute webinar:

  • Why digital imaging and digital pathology change everything.

  • How Pathology 2.0 increases your professional capabilities.

  • How you can use both social networking and Pathology 2.0 to market yourself to referring physicians.

  • Avoiding the biggest mistakes pathologists make with their Facebook and MySpace pages.

  • Steps pathology residents can take with social networking to increase recognition of their skills and sub-specialty competencies.

  • Dangers and benefits of communicating with patients and physicians via social networking methods.

    …and much more!

Individuals who benefit from this webinar:

  • Pathology chief residents, residents and fellows 
  • Academic pathology chairs 
  • Residency program directors 
  • Pathology department administrators 
  • Undergraduate and graduate medical educators 
  • Pathology and laboratory professionals

How to Register:
1. Online
2. Call toll free: 800-560-6363

Your webinar registration includes:

  • A site license to attend the webinar (invite as many people as you can fit around your computer at no extra charge)
  • Downloadable PowerPoint presentations from our speakers
  • A full transcript emailed to you soon after the conference
  • The opportunity to connect directly with our speaker during the audience Q&A session

    Register Now! Or for more information, call us toll-free at 800-560-6363.

Distinguished Expert:

Keith J. Kaplan, MD is a pathologist and Chief Information Officer (CIO) of Carolinas Pathology Group, Celligent Diagnostics and Diligent Billing and Management. As CIO, he is responsible for all aspects of informatics strategies, operations, and projects and processes that encompass laboratory, healthcare and research information systems for Carolinas Pathology Group. Dr. Kaplan is board certified in anatomic and clinical pathology. His subspecialty interests include gastrointestinal and hepatic pathology, cytopathology and pathology informatics as well as research interests in gastrointestinal and hepatobiliary pathology, hyperspectral imaging, image analysis and the use of Web 2.0 tools in pathology. Prior to joining Carolinas Pathology Group, Dr. Kaplan was a surgical pathologist at Mayo Clinic and held the academic post of associate professor of pathology of Mayo Medical School. Dr. Kaplan is a graduate of Northwestern University Feinberg School of Medicine and completed residency training in anatomic and clinical pathology at Walter Reed Army Medical Center. While at Walter Reed, he was named Resident of the Year, and in conjunction with the Armed Forces Institute of Pathology, founded and directed the Army Telepathology Program. This program connected 25 hospitals internationally for consultation using telepathology. Dr. Kaplan is a member of the College of American Pathologists, American Society of Clinical Pathology and the American Society of Cytopathology as well as the American Pathology Foundation. He is also an executive board member of the Digital Pathology Association. 
 

 

 


 

Where do Pathologists fit into Accountable Care Organizations? – Part 5

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In the fourth installment of my series entitled “Where do pathologists fit into Accountable Care Organizations (ACOs)?, I mentioned that I personally had not come across much information on oncology and ACOs.  In this post, I highlight some information about the potential plans of a large, single-specialty integrated oncology practice. Ben Calhoun MD PhD. 

As a surgical pathologist specializing in breast pathology, I assume that oncology will be a major area in of intersection between tumor pathology and ACOs (and the rest of oncology care delivery) in my daily practice.  How will ACOs affect those of us who spend most of our time looking at biopsies and resections for cancer?  That question is difficult to answer right now, but another way to approach the question could be to ask: What do we know about ACOs and oncology in general?

The short answer is: not much.  But, I ran across a recent (January, 2011) article by Judy Packer-Tursman on AISHealth.com about US Oncology and it’s potential as a single-specialty Medicare ACO (reprinted from ACO Business News).  Dr. Leonard Kalman, one the Medical Directors for US Oncology (recently purchased by McKesson), discusses an ACO-like arrangement involving US Oncology and the likely initial scope of ACOs in oncology (most likely limited to states or regions, with the possibility of a national approach later).

Dr. Kalman envisions some exclusivity to ACOs designed to deliver cancer care: “When cancer becomes the primary diagnosis, the oncologist basically handles the patient’s primary care, Kalman explains. ‘Remember, the majority of an oncology patient’s care is cancer care,’ he says. So while ACO patients may require occasional care from other sources, including primary care physicians or specialists such as cardiologists or rheumatologists, only oncologists would be affiliated with a Medicare oncology ACO as he envisions it.”  I guess if primary care physicians and specialists are excluded, that takes some of the mystery out of where pathologists would fit in…hospitals aren’t mentioned, either.


Two other points are worth noting:

1.  US Oncology is already involved in an ACO-like venture in Texas that involves Aetna, Inc. and a subsidiary of US Oncology.  “Meanwhile, Kalman says a seven-month-old ACO-type project in Texas — involving Aetna Inc., Texas Oncology (an affiliated US Oncology practice of 300-odd oncologists); and Innovent Oncology, a subsidiary of US Oncology — is expanding and has ‘the potential to go national.’”

2.  US Oncology is in the process of identifying large hospitals and commercial insurance carriers as potential partners for ACOs after the rules are written and released in January 2012. Dr. Kalman tells ACO Business News that “…..a major hospital in Miami has approached his 40-physician practice about handling cancer care in such a way. ‘Our ACO partner is a dominant hospital system where we put basically all of our patients,’ he says, declining to name it.”  Dr. Kalman adds that “the time is ripe for oncology practices to approach commercial managed care organizations and begin ACO discussions, setting the fee schedule and expenditure targets and a shared-savings arrangement. ‘We’ve picked out a commercial insurance plan as a potential partner,’ he notes.”

Another article in the Oncology Business Review (OBR) on Oncbiz.com discusses oncology and ACOs.  In the January 2011 issue of OBR, Allison Shimooka lists 5 key areas for investment in developing oncology ACOs: physician alignment, payer contracting, knowledge management (this means IT), facility strategy (integrating providers and healthcare systems), and patient engagement/activation.  She refers to plans recently announced by US Oncology and Milliman, a Seattle-based actuarial and consulting firm, to “develop a model for physician-led oncology organizations to contract around risk, either through episode rates, bundled payments, or capitation.”  She also mentions that United HealthCare is “piloting a new episode-based payment methodology with 5 private practice medical oncology groups.”

So, it’s clear that regional and perhaps national oncology ACOs are being contemplated by major players.  What, if any, developments should we expect with regional and national pathology groups and ACOs in general and oncology ACOs specifically (assuming such ACOs eventually exist)? 

 

Toronto Set to Become a World Class Medical R&D Centre

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By Rachel Smith 

http://www.businessreviewcanada.ca/sectors/medical-devices-products/toronto-set-become-world-class-medical-r-d-centre

GE Healthcare’s first global Pathology Imaging Centre of Excellence to advance digital imaging pathology solutions worldwide

Toronto will be the home of GE Healthcare’s first global Pathology Imaging Centre of Excellence, a cutting-edge, one-of-a-kind R&D facility that will advance both the technology and adoption of digital pathology solutions, for pathologists world-wide.

The world-class Pathology Imaging Centre of Excellence will be funded by the digital pathology joint venture Omnyx, which is a partnership between GE Healthcare and The University of Pittsburgh Medical Center.

"The Omnyx joint venture was inspired in 2008 by a ground-breaking discovery at GE's Global Research Centre,” said John Rice, Vice Chairman, President and CEO, Global Growth & Operations, GE.

“The breakthrough technology is part of our global $6 billion healthymagination initiative to improve cost, quality and access in healthcare. Our partnership with the Ontario government has facilitated today's investment."

Omnyx will invest $7.75M along with a $2.25M grant from the Health Technology Exchange (HTX), a funding arm of the Ontario Network of Excellence.

Planned collaborative research and development (R&D) partnerships will bring an additional $7.2M, for a total investment of $17.2M over the next 3 years.

"The Centre is a perfect example of how HTX funding can facilitate medtech investment and job growth in Ontario,” said John Soloninka, HTX President & CEO.

“There is an incredible opportunity for Ontario to support the transformation of pathology with the global leader in this emerging field. We are in discussions with several other MNEs about how they too can gain commercialization advantage through Ontario."

GE Healthcare chose Toronto for its imaging R&D assets and infrastructure that are capable of supporting design, development, validation, and deployment of a global digital pathology (DP) initiative.

The global Pathology Imaging Centre of Excellence will be a boon for Canada’s health network and makes Toronto one of the leading medical research and development hubs in the world.

http://www.businessreviewcanada.ca/sectors/medical-devices-products/toronto-set-become-world-class-medical-r-d-centre


 

Early Register for APF 2011 Spring Conference Now

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APF Email Header 
 

American Pathology Foundation's  

2011 Spring Conference   

"Seasons of Change For Pathology; 

Meeting the Challenges of Our New Environment" 

March 9-11, Four Seasons Hotel, Las Vegas

 

One Week Remaining for Early Registration Rates
 Two Weeks Left for Preferred Hotel Room Rates  
 
Make plans to join the American Pathology Foundation this March in Las Vegas for our 2011 Spring Conference.  Spring Conference attendees can look forward to three days of information-rich sessions on best practices in the business of pathology and plenty of practical "take home" ideas and suggestions for better managing their time, practice and resources.

The APF Program Committee has been hard at work selecting timely topics and speakers to help you address critical management issues.  Half-day program blocks will focus on health care reform, tools and techniques to position your practice for the future, improving the bottom-line for your business and new /emerging pathology and laboratory technology.   APF conferences provide ample networking opportunities for you to share experiences and craft solutions with your colleagues.

 

APF 2011 Spring Conference
For online conference registration visit http://www.apfconnect.org

 

You may also register over

the phone by calling the

APF National Office toll-free at

(877) 993-9935, ext 202 

  

A complete conference brochure

can be downloaded using the link below:  

 

 

     NEW FOR 2011 -  Full Day Pre-Conference:

 Medical Coding"Practical Coding & Advice for Pathology    Providers"

Wednesday, March 9  

Participants in the 2011 "Practical Coding" Pre-Conference will gain a thorough understanding of the CPT and ICD9 coding issues specific to pathology.  Dennis Padget, MBA, CPA, FHFMA is the primary presenter for this full-day course which will cover common coding dilemmas, present strategies to implement change and maximize reimbursement. The pre-conference will also cover critical aspects of coding for molecular and special tests and a primer on confronting and correcting claims denials.     

Hot Topics Breakfast Roundtable Sessions
Friday, March 11
breakfastGet your day off to a great start with a full breakfast and
a chance to discuss hot topics of the day with Spring Conference faculty and your colleagues.   Due to the popularity of these sessions, additional discussion groups have been added.  Topics include:  Health Care Reform, Legal Issues, Pathology Contracting, Billing and Digital Pathology Topic tables are limited to 10 attendees.
       

            
   Exhibit Hall  Networking past, present, future    

Join us for special events planned each day; including our signature wine tasting at Wednesday's Welcome Reception, Thursday's "On Par" Reception, the Foundation's 5th Annual Eilers Fund Silent Auction benefiting resident education and our 2011 Charity Golf Tournament.

  
APF logolas vegas sign
 We Look Forward to Seeing You
 in Las Vegas at the
 APF 2011 Spring Conference!

 

Development and evaluation of a virtual microscopy application for automated assessment of Ki-67 expression in breast cancer

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The aim of the study was to develop a virtual microscopy enabled method for assessment of Ki-67 expression and to study the prognostic value of the automated analysis in a comprehensive series of patients with breast cancer. 

Methods: Using a previously reported virtual microscopy platform and an open source image processing tool, ImageJ, a method for assessment of immunohistochemically (IHC) stained area and intensity was created. A tissue microarray (TMA) series of breast cancer specimens from 1931 patients was immunostained for Ki-67, digitized with a whole slide scanner and uploaded to an image web server.

The extent of Ki-67 staining in the tumour specimens was assessed both visually and with the image analysis algorithm. The prognostic value of the computer vision assessment of Ki-67 was evaluated by comparison of distant disease-free survival in patients with low, moderate or high expression of the protein. 

Results: 1648 evaluable image files from 1334 patients were analysed in less than two hours.

Visual and automated Ki-67 extent of staining assessments showed a percentage agreement of 87% and weighted kappa value of 0.57. The hazard ratio for distant recurrence for patients with a computer determined moderate Ki-67 extent of staining was 1.77 (95% CI 1.31-2.37) and for high extent 2.34 (95% CI 1.76-3.10), compared to patients with a low extent.

In multivariate survival analyses, automated assessment of Ki-67 extent of staining was retained as a significant prognostic factor. 

Conclusions: Running high-throughput automated IHC algorithms on a virtual microscopy platform is feasible. Comparison of visual and automated assessments of Ki-67 expression shows moderate agreement.

In multivariate survival analysis, the automated assessment of Ki-67 extent of staining is a significant and independent predictor of outcome in breast cancer.

Author: Juho KonstiMikael LundinHeikki JoensuuTiina LehtimakiHarri SihtoKaija HolliTaina Turpeenniemi-HujanenVesa KatajaLiisa SailasJorma IsolaJohan Lundin

Credits/Source: BMC Clinical Pathology 2011,11:3

Standardization and Validation of Digital Pathology in Clinical Laboratories

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The following post was submitted by Dr. Holger Lange, CTO of Flagship Biosciences, who is working with a number of pharmaceutical partners on regulatory companion diagnostics development.

Digital Pathology is a new technology, a new industry, where organizations like CLIA, CAP and the FDA provide limited guidance, and the manufacturers still have to learn what it means to provide instruments into a clinical laboratory.

With Digital Pathology now entering the clinical laboratories, it is crucial for physicians and laboratory professionals to understand the regulatory requirements and how to best implement Digital Pathology in their clinical laboratories.

For the past 4-5 years I have worked for a leading Digital Pathology manufacturer. I was responsible for their first product in the clinical market – a digital IHC workflow solution, and their portfolio of FDA clearances. Now I have put together a presentation that summarizes my experience in the clinical market. I hope it will help many physicians and laboratory professionals to quickly get up to speed on how to deal with the implementation of Digital Pathology in their clinical laboratories.

These are the subjects that are covered in the presentation:

Clinical Laboratory Regulations

A discussion on how the CLIA standard and the CAP checklist apply to Digital Pathology. A review of the new ASCO/CAP guidelines for HER2 and ER/PgR for the latest thoughts on standardization and validation in clinical laboratories.

Medical Device Manufacturer Regulations

An overview of the existing US Food and Drug Administration (FDA) clearances for Digital Pathology with an example of a successful study design. A discussion on the FDA advisory panel meeting on Digital Pathology Whole Slide Imaging (WSI) for the latest thoughts on what it takes to validate Digital Pathology systems for primary diagnosis.

Digital Pathology Systems

Practical tips on how to implement a digital pathology system in a clinical laboratory and how digital pathology manufacturers could make it easier. A demo of how a digital pathology system can help with the logistics of its own validation. A discussion on how going digital could be a game changer for the standardization of pathology, looking at the example of the automatic standardization of staining, using standard controls and automatic image analysis.

Go to the Flagship Biosciences product page for digital pathology regulatory products.

You get an 1½ hour video presentation on a DVD and the presentation transcript.

Save yourself many hours of research and reading! Get the insights you need by viewing this video presentation. Get access to material that cannot be found anywhere else.

DVDCover_20Jan11 TranscriptCover_20Jan11

Last Weekend to View the Amazing Museum of Everything Exhibition #3, London

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This is absolutely the last weekend to view the much heralded (and not just by me) Museum of Everything Exhibition #3 in London. And, in a bittersweet farewell to this amazing exhibition, the folks at The Museum of Everything have put together a thoroughly action-packed final weekend featuring a variety of exciting programming.

Full details for the weekend's activities follow; and please, I implore you, if you live near London and have not yet seen this exhibitions, do yourself a favor and go! You won't be sorry. I promise.

>> VALENTINE’S WEEKEND <<

As far as we’re concerned, Valentine’s Weekend starts at 10:30am on Friday 11th February 2011; so fire up your hot-tub, cover yourself in love-gel and prepare yourself for what may well be the greatest weekend in the history of weekends.
For your delectation we shall have muzac - all day, every day - our favourite artistes performing in nooks and crannies right across the museum, be it accordion solos, tubas, one man bands, human jukeboxes, Punches, Judies, or perhaps just a lonely snare drum announcing the reveille.

And if you pop down at 4:00pm on Sunday 13th February 2011 you might be treated to a private viewing of that rarely seen gem - Pop Goes the Easel - directed by that randy rambunctious ruddy red rolicker, Ken Russell, as part of The Midgets & Giants Film Festival.

Who knows, the movie may even be introduced by Sir Peter Blake himself ...

For it is Sir Peter Blake who we have to thank for this astonishing show, for his brilliant eye, his enduring aesthetic, his wit, his love and his support. They say you never forget your first love and he is most certainly ours.

"The Museum of Everything was the highlight of my London trip, I can’t believe you’ll close! "Cindy Sherman, January 2011

Cindy’s right, this really is your very last chance to see the astonishing tapestries of Ted Willcox, the animal empire of Walter Potter, the magical funfair of Joby and Anna Carter and the miniature fairgrounds of Arthur Windley.

Come Monday monring, it’s adieu dear friends - perhaps for a few weeks, perhaps forever – because our plans are up in the air, we can’t commit, although we do have our roving eyes on Russia, the Americas, the Middle Yeast, even London’s glittering West End. The world is our Oyster Card ...

Until next time, we remain yours in Everything:

The Museum of Everything
right behind the library on the corner of Sharpleshall
Street & Regents Park Road in Primrose Hill London NW1
http://www.musevery.com

For more on the Museum of Everything #3, see this recent post.

Images are all drawn from postcards available at the Museum of Everything gift shop. A lovely (if slightly expensive) book is available also. Click here for more.

Tonight!!!! A: Head on B: Body: The Real Life Dr. Frankenstein," Observatory

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Tonight at Observatory! I advise coming early, as this one is sure to sell out; Hope to see you there!

A: Head on B: Body: The Real Life Dr. Frankenstein
A screening and lecture with film-maker Jim Fields and Mike Lewi
Date: TONIGHT, Thursday February 10
Time: 8:00 PM
Admission: $5
Presented by Morbid Anatomy

In an eventful and successful career spanning 40 years, Dr. Robert White–pioneering neurosurgeon and Professor at Cleveland’s Case Western Reserve University–did many things. He participated in Nobel Prize-nominated work, published more than 700 scholarly articles, examined Vladimir Lenin’s preserved brain in Cold War Russia, founded Pope John Paul II’s Committee on Bioethics, went to mass daily, and raised 10 children. He also engaged in a series of horrifying and highly controversial experiments reminiscent of a B-Movie mad scientist, experiments which pushed the limits of medical ethics, infuriated the animal rights community, and questioned notions of identity, consciousness, and corporeality as well as mankind’s biblically-condoned dominion over the animal kingdom.

Tonight, join film-maker Jim Fields–best known for his 2003 documentary “End of the Century” about the legendary punk band The Ramones–and Mike Lewi for a screening of Fields’ short documentary about the life and work of this real-life Dr. Frankenstein whose chilling “full body transplants” truly seem the stuff of a B-Movie terror. Fields will introduce the film–which features a series of interviews with Dr. White discussing his controversial experiments–with an illustrated lecture contextualizing the doctor’s work within the history of “mad scientists” past and present, fictional and actual; scientists whose hubris drove them to go rogue by tampering with things perhaps best left alone.

Jim Fields made a few documentaries, one of which, “End of the Century: the Story of the Ramones” is particularly long. He’s currently a video journalist at Time Magazine and Time.com.

Mike Lewi is a filmmaker, event producer, and disc jockey.

You can find out more about this event on the Observatory website by clicking here and can can access the event on Facebook here. You can get directions to Observatory--which is next door to the Morbid Anatomy Library (more on that here)--by clicking here. You can find out more about Observatory here, join our mailing list by clicking here, and join us on Facebook by clicking here.

Image: Drawing by Dr. Harvey Cushing, early 20th Century, found on the Yale Medical Library website.

"Physica Sacra," Johannes Jacob Scheuchzer, 1735

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The incredible images above are drawn from a book which has long intrigued me, Johannes Jacob Scheuchzer's 4-volume early 18th Century extravaganza of art, science and mysticism entitled Physica Sacra.

As described by Christie's Auction House:

'In Scheuchzer's gigantic work, Physica Sacra, the Baroque attains, philosophically as well as artistically, its high point and its conclusion' (Faber du Faur, German Baroque Literature, p. 472). Scheuchzer, a doctor and natural scientist from Zurich, planned the Physica sacra as an explanation of and a commentary on the Bible on natural-scientific grounds. He himself oversaw the illustrations which were largely based on his own natural history cabinet or on other famous European cabinets of rare specimens...

This book seems like a fitting final response to yesterday's very stimulating "Art and the Curiosity Cabinet" Conference at Seton Hall University, where a lot was said about these ways in which early cabinets (and pre-modern inquiry) resided at the borders of art and science, fact and mysticism. I don't think I have ever seen a more elegant expression of these ideas than the content and illustrations of this book, which blends bible commentary with natural history in a bombastic interest in all of the known world of its time, spanning Memento Mori to the Thesaurus of Snowflakes to biblical miracles, all given equal treatment and weight.

Click on images to see much larger and more detailed images; worth your while, I promise! You can see 737 of the images from the book (!!!) (from which the above 7 are drawn) in Greyherbert's amazing Flickr stream by clicking here.

Inspired by this recent post on the Ptak Science Books blog discussing the book; Text from Christie's Auction house description of the book when recently auctioning off a complete 4-volume set.

Images above, top to bottom:

  1. Homo ex Humo ('man from the ground', or 'dust')
  2. Memento Mori
  3. Ventriculi
  4. Heart
  5. Columna Ignis
  6. Solea cum Squamae
  7. Thesarus of Snowflakes