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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.
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.
I attended Pathology Visions last week (more on that later…) which is organized by the Digital Pathology Association (DPA). The DPA released on Tuesday two white papers; 1) Interoperability between Anatomic Pathology Laboratory Information Systems (APLIS) and Digital Pathology Systems and 2) Archival and Retrieval in Digital Pathology Systems.
The white papers are good and provide vendor neutral information to help the digital pathology industry and consumers. Here are the abstracts and a few of my favorite points from each:
Archival and Retrieval in Digital Pathology Systems
This white paper frames the issues related to Archival and Retrieval of images and associated data as Anatomic Pathology laboratories adopt a digital imaging workflow in a research or clinical setting. This overview also includes a brief discussion of some of the solutions being developed and offered in digital pathology systems (DPS’s).
DPS’s start with creation of a whole slide image and provide an imaging workflow for pathologists by associating the images with a patient and case and furnishing the tools to review the cases digitally. Whole slide images (WSI) are very large and will drive the need for extensive storage and information life cycle management. Customers seek options for fast access to high quality and highly available data, when they use the DPS in a business critical application. Most importantly, since DPS’s are deployed in regulated environments, data reliability, privacy, and security need to be built into the solution and its management process.
Solutions that are being developed and deployed in digital pathology systems are also presented.
Favorite points:
Interoperability between Anatomic Pathology Laboratory Information Systems and Digital Pathology Systems
This white paper offers an overview of the current state of interoperability between Anatomical Pathology Laboratory Information Systems (APLIS’s) and Digital Pathology Systems (DPS’s). This overview also includes a brief discussion of future work that will impact interoperability.
Both systems rely on data from the other to efficiently deliver full digital imaging functionality to the healthcare provider. Anatomic Pathology (AP) departments and patients will benefit most from imaging workflow when there is a high degree of integration of Digital Pathology information within AP workflow. Implementations of such data sharing already exist via interfaces and standard communication protocols between APLIS’s and DPS’s, and work continues on these interface standards to improve the degree to which these systems can be used together.
The current state of interoperability provides Pathologists with access to images and image analysis data from within the APLIS or the DPS. This information is then available to the Patient Report.
For over 10 years, the digital pathology industry has been riddled with vendors speaking their own language or languages (aka file format). Today a major milestone in interoperability was achieved with the final approval of Supplement 145; a DICOM universal format for whole slide images. Although vendors will never give up their native tongue, this new supplement creates a universal language everyone can understand in digital pathology, even those outside of our industry.
WG-26, lead by Bruce Beckwith, MD, has worked hard for several years to create supplement 145. Harry Solomon of GE Healthcare contributed a lot of help over the past year to move this to ballot and beyond. Harry put forward the following comments in an email to WG-26 today:
I’d like to add my thanks to the members of DICOM WG-26 for the significant body of pathology domain knowledge that has been added to the DICOM Standard, both in this new Supplement 145, and in Supplement 122 in 2008. That knowledge is now available to further improve interoperability in a field that was early to health informatics standards with the Systematized Nomenclature of Pathology, now known as the Systematized Nomenclature of Medicine (SNOMED), and is now poised for a significant leap with digital pathology. Here are some statistics on that domain knowledge base: One major new DICOM Information Object Definition (Whole Slide Imaging) with new concepts to manage the huge WSI data set A major revision of a DICOM Information Entity (Specimen) with a rigorous information model 56 new data elements added to the DICOM Standard in 14 new or revised modules 7 new or revised DICOM structured data templates and 18 new defined value sets 80 new coded terminology concepts added to SNOMED, and 36 added to DICOM 40 pages of explanatory information about pathology workflow and imaging
I’d like to add my thanks to the members of DICOM WG-26 for the significant body of pathology domain knowledge that has been added to the DICOM Standard, both in this new Supplement 145, and in Supplement 122 in 2008. That knowledge is now available to further improve interoperability in a field that was early to health informatics standards with the Systematized Nomenclature of Pathology, now known as the Systematized Nomenclature of Medicine (SNOMED), and is now poised for a significant leap with digital pathology.
Here are some statistics on that domain knowledge base:
Overall, this is another major step forward in the clinical use of digital pathology. Thank you to everyone who worked hard to make this a reality! The final document will be available within the next week.
Below is an article I wrote for ADVANCE for Laboratory Professionals, Perspectives In Pathology.
By Amanda Lowe
Digital pathology is often described as the scanning of a glass slide into a whole slide image; yet, it is much more. It is so much more, in fact, that pathologists and laboratory professionals find themselves puzzled with how it will affect their future. As technology progresses, we must start to understand how to put the pieces of it together—from acquisition to integration to data management and interpretation.
Acquisition
Acquisition of a whole slide image from a glass slide is done on a slide scanner, which creates the image necessary for interpretation. Important elements of slide preparation and patient information can make the acquisition process simple or complex.
Slide preparation is a crucial and often overlooked element of digital pathology. Pathologists can handle slide artifacts such as folds and air bubbles under a microscope; slide scanners are not always as forgiving. Also, staining has to be perfected, not only for scanning but for accurate interpretation and use with image analysis software. Poor staining can result in tissue not being scanned, inaccurate image analysis data—and in the worst case—a wrong diagnosis.
Traditionally, when glass slides are prepared, they are manually matched with the patient paperwork (including patient history, requisition and gross review), then delivered to the pathologist. With digital pathology, the process looks different. You now have whole slide images that need to be reconciled to the digital patient paperwork, then delivered to the pathologist. The only way to do this is with a laboratory information system (LIS), electronic medical record (EMR) integration, and bar codes. Bar codes will reduce human error, save time on the constant need for verification and re-checks, and improve quality assurance by tracking all specimens throughout the histology process.
Integration
The LIS and often the EMR need to share information with the digital pathology software to create a pathology picture archiving and communication system (PACS) that consolidates all patient paperwork, gross images and whole slide images for interpretation. This is the most important but also the most difficult piece for labs to handle. The process can be costly and require collaboration of two or more vendors, which can be a frustrating and hard process to manage. However, it can be accomplished with a plan, a budget and someone to manage the project.
Data Management
Many hospitals do not have adequate IT resources or the expertise to handle their already stressed storage demands. Yet these whole slide images have to be stored somewhere. Unfortunately, most IT departments do not understand the fundamentals of digital pathology. Pathology leaders and their lab personnel must improve communication with their IT departments and take an active role in educating IT on the realistic needs of the department now and over the next five years. Hospitals have to prepare for the increase in lab data and pathology images that will soon be their future.
To estimate your whole slide image storage needs, divide the number of surgical slides your lab generates per year by 3,500 to get an estimate of terabytes needed annually; 3,500 is the average number of whole slide images per one terabyte.
Healthcare providers are required to save medical records for a specified time; for most, this is a minimum of seven years. Security is not optional, and HIPAA mandates backup and disaster recovery plans for patient records, including all medical images. The specialty of pathology will not be an exception to the rule.
Interpretation
One goal of digital pathology is to enhance the sign-out process for pathologists. Pathologists should be able to sit down at a computer monitor to sign out digital cases retrieved from a pathology PACS system. Easy access to archived cases for disease progression or comparison, rapid case sharing and consultations, data mining for decision support and image analysis will all help improve the diagnostic process.
Powered by the rapid and endless growing portfolio of image analysis algorithms, pathology will transition from a qualitative to a quantitative discipline. Digital pathology partnered with image analysis will create the infrastructure necessary so pathologists can confidently determine the severity of a disease and predict responses to a target therapy.
Digital pathology streamlines laboratory workflow, enhances the sign-out process, and can improve diagnostic outcomes and treatment responses for patients while at the same time forge a new foundation for the use of pathology data to drive translational research and higher standards of care.
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