Digital Pathology is innovation. Digital Pathology make changes to something established (ie. pathology) by introducing new methods, ideas, and products.   At USCAP last week there were examples all over the exhibit hall of digital pathology being used with other types of innovation including mobile devices, cloud computing, Software As A Service (SAAS), and methods to improve the pathologists workstation experience.

iPads, iPads, and more iPads!

Nikon Live Remote Viewing

I recently blogged about the iPad trend in healthcare (see post iPad Deployment In Healthcare to Reach 70% In 2011). This trend was reinforced by the number of iPads in use at USCAP.  The Information Week article stated that 1/3rd of the 950 respondents listed lab order visualization and results, clinical decision support, and medical image viewing applications as “top priorities” for the use of the iPad in healthcare. All great reasons for digital pathology too!

New Olympus VS800 viewer on an iPad

At USCAP Nikon demonstrated live image sharing (aka telepathology) on an iPad with their digital site camera system, Aperio was showing the mobile site of the Juan Rosai Collection on one, Aurora’s mScope really was “anytime, anywhere” on an iPad, and Olympus was demonstrating the new VS800 software on an iPad too!

WSI’s & more in the Cloud

Aurora's mScope

Software (and/or Storage) As A Service (SAAS) are catching on to help overcome the IT barriers of digital pathology. I blogged on the storage element of this over a year ago (see post SAAS- Cloud 9 For Digital Pathology?) and firmly believe that SAAS has it’s place in healthcare and for digital pathology.   At USCAP, several digital pathology providers were showing examples of SAAS with support for cloud based storage and secure web-enabled software solutions to ease the strain on IT. Aurora is “building communication networks” and overcoming IT barriers through their SAAS model; Aperio’s SecondSlide & Ventana’sPathXchange are cloud based; Apollo launched a collaboration with Hitachi to offer their Enterprise Patient Media Manager in the cloud, and Mikroscan offers a cloud based solution through a collaboration with Simagis.  Why is this becoming more popular? SAAS solutions are accessible from anywhere with an internet connection, do not require installation on a local server or client, can be up and running quickly, and can be rapidly scaled as needed.   Another example of SAAS is as an adjunct to a client-based solution.  Omnyx developed a web-enabled version of their pathology workstation viewer to work with their client based Pathology workstation software.  This will give the pathologist access to cases remotely (home, vacation, etc) and allow for safe, secure sharing of slides outside the hospital network for consultations.

The Pathologist Workstation

The Pathologists workstation experience has become a hot spot of innovation.  Barco (see post Diagnostic Color Displays for Digital Pathology) was beta testing software that could improve the “viewing experience” and provide the speed, image quality, and intuitive interaction needed to diagnosis off of a WSI.  It was amazing, and they were only using simple input devices bought at Best Buy.   The Diagnostic Intelligence and Health Information Technology (DIHIT), a department of CAP STS, were again advocating for and demonstrating their prototype of a pathology diagnostic workstation.  Also a few digital pathology manufacturers, like Aperio and 3DHistech, were showing new and/or compatible input devices.

A beta tester at Barco trying out the speed and ease of viewing

Aperio's Innovation Station w/Compatible Input Devices

3DHistech "Microscope like" Input Device

Digital pathology continues to be at the forefront of innovation.  It was wonderful to see so many digital pathology solutions leveraging other key innovations!

Look for my final post on Monday, USCAP Part 3: Breaking Down The Barriers Of Digital Pathology.

You literally walked right into the world of digital pathology, sandwiched between Aperio and Ventana, when you entered the exhibit hall at USCAP 2011 in San Antonio last week.  A shift in the mindset of pathologists could be felt throughout the meeting and left the digital pathology industry energized about what 2011 will bring. No more just looking and talking about digital pathology, pathologists were truly starting to plan and think about how to adapt to their digital future.

The amount of information I gained last week, specifically about digital pathology (and LEAN too), still has my head spinning.  If you missed the meeting or did not get as much time as you would have liked in the exhibit hall, then read on and follow my three part series on digital pathology at USCAP 2011.

Part 1: The BIG Players in Digital Pathology

When I say BIG- literally, I mean BIG!  To qualify as a BIG player in digital pathology you must have BIG (and very deep) wallets, BIG exhibit booths, BIG scanners, and BIG plans for the future of digital pathology!  The BIG players are (in no particular order):

Aperio

You could not miss Aperio, or their giant projector ball! They were one of the first booths you saw when you entered the exhibit hall.   Their two big initiatives were the NEW ScanScope AT and Spectrum Healthcare. The ScanScope AT is similar to the XT, but with a 400 slide carousel and a new flat loading method that “pushes and pulls” the glass slide on to the stage.  Aperio says the AT has a 25% improvement in scan time with a throughput of 30 slides an hour at 20x.

In addition to the AT, Aperio was showing a sneak preview of their new workflow solution Spectrum Healthcare to a select few. These demonstrations were to gain feedback and impressions of this new product (not yet released). I was fortunate to be one of the select few (Thanks Ole!) to see it. Spectrum Healthcare has a nice clean look, and is designed to provide an intuitive user experience based on the workflow of key clinical applications.

Ventana

“Ventana Digital Pathology Powered by Bioimagene” is the new tag line for the duo.  Although the well known Bioimagene brand was not present in the Ventana booth, their iScan Coreo Au scanner, Virtuoso data management software, and whole slide images were.  A great example of integration of the two brands were large touch screen displays throughout the booth that showcased whole slide images of new antibodys, like ERG for prostate.  It is clear that Ventana has a plan and strategy for digital pathology, and is working hard to fully integrate the Bioimagene team and products into their portfolio.

Omnyx

There were lots of familiar and new faces in the Omnyx booth! Omnyx has been hiring (and is still hiring) a lot of people to support the launch of their digital pathology solutions, currently for research use only.  Omnyx showcased new technology with their VL120 scanner and a new web-enabled viewer for mobile devices (think iPad and laptops) for remote access to their pathologist workstation solution.  The VL120 has the same components as the VL4 but with a flat-bed load and scan system.  There are six stackable trays that each hold 20 slides and can be placed in the VL120.  The VL120 will not be available until Q4 2011.

Olympus

Olympus had an very impressive booth fully equipped with a surgical suite, new microscopes, consumer cameras, and their full digital pathology product line.  The goal was to make pathologists aware that they are more than a microscope provider, they are a healthcare company.  I imagine it worked! You couldn’t help but be curious about the surgical suite and the large array of products on display.  Their DP product line included the VS110 with fluor and 100 slide autoloader; The NanoZoomer RS 2.0 with new fluorescence components, a Visiopharm image analysis workstation featuring HER2-Connect, and their new VS800 scanner.  The VS800 was impossible to miss with it’s large footprint and blue panel.  It has capacity for 300 slides, a custom designed objective, simultaneous parallel slide loading and unloading, real-time auto focus which eliminates the need to create a focal map, and brand new software to run the scanner and manage the data.

Leica Microsystems

Leica’s new tagline is “Total Digital Pathology” designed to create a similar message to their “Total Histology” solutions.  Although Leica was not showcasing any new digital pathology technology, they were demonstrating their total solution with the SCN400, Ariol for clinical breast panel analysis, and SlidePath software to support the data management of either the SCN400 or Ariol scanned slides. Both Genetix (acquired by Danaher in March 2010) and SlidePath (acquired by Genetix in May 2009) are now represented as an integrated part of Leica Microsystems, and their “Total Digital Pathology” solutions.

Philips

Philips demonstrated their high throughput (300 slides) scanner, Pathology PACS workflow software, and a new integrated DAKO HER2 algorithm.  Their system is designed for the “bench” with a simple, intuitive touch screen, large bright lights indicating the scanning process (to be monitored from across the lab), and the batch can be interrupted to pull out finished slides and to load new ones.  Within the PACS software is the Dako algorithm for the Herceptest (HER2).  This was one of my favorite features at Philips.  Based on the slide barcode the software knows what the stain is and “automatically” applies the algorithm to the slide and generates the score.  The user (aka pathologist) only has to delineate an area of interest(s).  The algorithm is calibrated to the stain and is very, very easy to use!  Further image analysis initiatives by Philips include integration with Definiens for specific algorithms; however, Philips will have an open architecture for image analysis. The entire Philips solution is available today but for research use only.  Clinical trials are set to begin at three customer sites in Q2.

Special thanks to Ole at Aperio and his blog for a few of my pictures, and stay tuned for tomorrow’s post- USCAP Part 2: Innovation Trends in Digital Pathology.

“Forget everything you believe about the limitations of remote presence” is the tagline of  Nikon’s new partner, Remote Meeting Technologies (RMT).  Together RMT and Nikon will launch an HD telepathology system called “Be There Be Anywhere” at the USCAP annual meeting this week.  Although Nikon has not been seen as a traditional player in the digital pathology market, they continue to make significant efforts to use digital technology to improve  the practice of pathology.

The Be There Be Anywhere HD Telepathology System eliminates the need for special hardware and client software downloads, is easy to use, and is the only Telepathology system on the market (that I’m aware of) to offer true 1920 x 1080 HD resolution of live images.  The “Be There Be Anywhere” system can even go with you and be moved to any location with the “Phone Home” module.  Phone Home can increase flexibility and reduce the costs necessary to set up and support other locations.

This week I saw a demonstration of “Be There Be Anywhere” and  spoke with RMT founder & CEO, Don Marchon. Don, a Hewlett Packard veteran, is very passionate about his products.  During our conversation he confidently stated,

We are the best kept secret in telepathology!

Although I only had time for a short demonstration, I was very impressed!  Don was using a Nikon 50i microscope, to deliver live, real-time images of a thin prep cytology slide.  The 50i was equiped with RMTs iMEDHD package; the key component of Be There Be Anywhere.   During the demo we launched our webcams, talked via VOIP, and I watched Don (from the comfort of my living room) deliver a powerpoint presentation via RMT’s web conference that could easily rival WebEx or GoToMeeting.  The speed was amazing, but the image quality was like nothing I’ve seen before in telepathology! It really was HD!

Oh, and did I mention that RMT’s solutions are IT friendly? Don, with his wealth of knowledge from Hewlett Packard, designed his products to be secure, scaleable, and able to preform live audits of users and participants.

To learn more visit Nikon’s booth, #348, at USCAP or email Don Marchon for an online demonstration.

A Healthcare Information and Management Systems Society (HIMSS) survey found that iPad deployment in healthcare will reach 70% in 2011. Wow, that’s a huge number! Sounds like a good reason for me to run out and buy one as a tax right off. But is that really practical?

An article in InformationWeek summarized the results of the survey.  The text for the article is below:

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device’s compelling point-of-care applications and uses.Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey’s results were released earlier this month.

Data showed that nearly 70% of the attendees were from hospitals or healthcare organizations with more than 1,500 employees, and 15% of attendees were executive-level staff or physicians.

More than 25% of the HIMSS respondents plan to deploy the iPad and other iOS devices immediately and nearly 70% plan to deploy the devices within the next year.

One-third of respondents identified point-of-care applications — including lab order visualization and results, clinical decision support, and medical image viewing applications — as top priorities, while 18% identified general administration, including billing, coding, and claims applications, as top priorities.

Nearly 75% identified secure configuration and deployment as the number one iPad IT management challenge, and 53% identified mobile application deployment as a key issue.

Lynne Dunbrack, analyst with IDC Health Insights, said security will remain a top concern for healthcare CIOs, especially if clinicians bring in their own devices to access the hospital’s healthcare information systems, such as electronic medical records (EMRs) and computerized physician order entry (CPOE) systems.

“As more patient information is moved into EMRs and made accessible both inside and outside the organization via a range of devices, including mobile devices and tablets, the risk of a privacy breach rises. Organized deployment and virtualized clients will help to mitigate this concern,” Dunbrack said.

Dunbrack also noted that the iPad, which has a sleek design, an intuitive user interface, and a large screen (relative to a smartphone), is becoming increasingly popular among clinicians. As the iPad gains traction among healthcare providers, EMR vendors will develop bidirectional integration between their EMR applications and clinicians’ mobile point-of-care devices such as smartphones and tablets.

Vendors are also developing EMR applications specifically for the iPad, Dunbrack observed. One example is St. Louis-based ClearPractice, a company that develops Web-based ambulatory EMR and revenue cycle management applications. ClearPractice recently launched Nimble, a comprehensive EMR application designed and developed specifically for the iPad.

Alan Snyder, BoxTone’s CEO, said in a statement that the iPad is redefining how organizations leverage mobile technology in the enterprise and the healthcare community is leading this paradigm shift.

“As these devices are used more frequently at the point of care, IT must ensure both data security and privacy, as well as superior remote connectivity,” Snyder said.

What I find interesting is that for One-third of respondents their top priorities for use of the iPad were lab order visualization and results, clinical decision support, and medical image viewing applications.  All good reasons for physicians and pathologists too.  What do you think? Please take the poll below or feel free to leave a comment.