Courtesy of the Digital Pathology Association.

Answers to many key questions you may have been afraid of asking.

1. Q: Is digital pathology FDA approved for primary diagnosis?  

A: No, digital pathology is not FDA approved for primary diagnosis.  However, several manufacturers have received 510(k) clearances or specific uses.  Please refer to theregulatory page for more information.  

2. Q: What CPT codes can apply to digital pathology?

 A: (Reference chart below) 

*No manufacturers at this time are FDA approved for primary diagnosis. Refer to the Regulatory page for more information.  
** Some manufacturers have obtained 510(k) clearances for manual and/or quantitative analysis of Immunohistochemistry and/or FISH.  Please refer to the 510(k) clearance list [link to page] and the Regulatory page for more information.

3. Q: Do I need to validate my digital pathology system for clinical use? 
A: It is recommended by the College of American Pathologists (CAP), a CLIA accredited organization, that all institutions or practices considering the implementation of digital pathology for clinical diagnostic purposes must carry out their own validation.  For more information please refer to the Regulatory page.

 4. Q: Do I need to preform a validation if I am only doing the professional component (PC) of the diagnosis? 

A: It is recommended by the College of American Pathologists (CAP), a CLIA accredited organization, that all institutions or practices considering the implementation of digital pathology for clinical diagnostic purposes must carry out their own validation. However, it is up to the institution or practice who has implemented the digital pathology system to determine the scope of the validation study; specifically what will and will not be included as an intended use. Refer to the institution preforming the technical component (TC) for information on their validation of the digital pathology system and weather it is validated for the professional component (PC) of a primary or secondary diagnosis.

5. Q: How can digital pathology benefit patients? 
A: Often pathologists do not meet the patients they serve.  However, digital pathology provides the tools and innovation necessary to bridge the gap between a patient, their diagnosis, and their pathologist.  Digital pathology can illustrate and document key findings within a patient diagnosis to promote better communication between pathologists, other physicians, and patients.  Examples include a digital image imbedded into the pathology report, the delivery of a prognostic score based on computer assisted quantitative analysis, whole slide images of a patient case being discussed at a tumor board, or simply improving the turnaround time of a patient diagnosis.

6. Q: Is viewing a whole slide image on a computer monitor the same as viewing a glass slide under a microscope?  
A: Many pathologists believe the viewing experience of a whole slide image is better then a microscope.  When you look through the eye pieces of a microscope you have a limited field of view and can only view one slide. With digital pathology you can see more slides and more of the tissue all at once. In addition you can move the slide around, change objectives, and even focus up and down through the tissue - just like a microscope!

7. Q: What is the file size of a whole slide image and how should they be managed? 
A: Most scanners support capture resolutions of 0.5 microns/pixel (effective viewing magnification: 20X) or 0.275 microns per pixel (effective viewing magnification: 40X). The image file associated with a 20X scan of a 15mmx20mm tissue specimen is as large as 3.6GB and a 40X scanned image can be as large as 14.5GB. The images are compressed to more manageable sizes (25:1 compression or greater) such that there is an optimization between image quality, image file size, network bandwidth usage, and server and client resource utilization. For example, the 20X scan could be stored in a JPEG2000-compression file of size 144MB. The 40X image described above could be stored in a JPEG2000-compressed file of size 576MB. Digital Pathology images are about 10X that of Radiology images and will require more storage management through their useful life cycle.  For more information on how they should be managed please refer to the DPA white paper “Archival and Retrieval in Digital Pathology Systems.” 

8. Q: Is cloud (SaaS) storage secure and fast for digital pathology? 
A: Yes, cloud technology or Storage as a Service (SaaS) is growing in popularity and offers some significant benefits for primary storage and for replication of data.  Cloud based storage can lower storage costs, maintain or improve security and data integrity including HIPPA compliance, improve flexibility, and expand capacity when capacity resources are strained.  More information on cloud replication of data is provided in the DPA white paper “Archival and Retrieval in Digital Pathology Systems.”

9. Q: Are whole slide images DICOM compatible? 
A: Yes, however digital pathology solution manufacturers must support DICOM Supplement 145: Whole Slide Microscopic Image IOD and SOP Classes, finalized by the DICOM Standards Committee, and Working Group 26 for Pathology in 2010.

10. Q: Is digital pathology HIPAA compliant? 
A: The metadata associated with a whole slide image, but not the whole slide image itself, can contain protected health information (PHI) which is at the center of HIPAA compliancy.  However, most digital pathology manufacturers can support a HIPAA compliant solution by encrypting PHI sensitive metadata such as slide labels, hospital / patient / case / specimen information, etc.  Furthermore, procedures must be in place to protect PHI within the digital pathology system to reduce the risk of unauthorized access to the computer system.

11. Q: How long does it take to scan a glass slide? 
A: Scan time is calculated by the time it takes to acquire the high resolution whole slide image of the tissue represented on the glass slide; most manufacturers have scan times  under 3 minutes a slide.  Scan time will typically include the overview image, focus, and acquisition of the whole slide image at either 0.5 microns/pixel (effective viewing magnification: 20X) or 0.275 microns per pixel (effective viewing magnification: 40X).  Scan time does not take into account post processing time, which is the time it may take to compress the image and transfer the image to a data management solution for viewing of the whole slide image remotely.  Other variables that contribute to variation in scan time include tissue size, capture resolution, if z-plane scanning is added, brightfield versus fluorescence, and the manufacturers specification since scan time will vary from scanner to scanner.

12. Q: Can whole slide images be integrated with my Laboratory Information System (LIS) or a snapshot put into my pathology report? 
A: Yes, the current state of integration between digital pathology systems (DPS) and anatomic pathology laboratory information systems (APLIS) provide 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. More detailed information on this topic can be found in the DPA white paper “Interoperability between Anatomic Pathology Laboratory Information Systems and Digital Pathology Systems.”

Courtesy of FierceHealthIT

By Dan Bowman  Comment |  Forward | Twitter | Facebook | LinkedIn

Recent review article on whole slide imaging/virtual microscopy for use in education.

The need, impact, importance and disagreement rate for second opinion pathology referrals has been a constant topic of discussion for many years.  These second opinions generally come in two flavors.  The first is a consultation of a particularly challenging case by a pathologist or clinician.  Patients can also initiate these consults if they are uncomfortable with a diagnosis.  The second flavor is the review of pathology diagnoses of patients now seeking treatment at a new institution who were originally diagnosed by an outside pathologist from the referring institution.  The popular press contains many stories about misdiagnoses in patients and mismanagement until second opinion/expert review identified a problem with the original pathology review.  The pathology literature contains dozens of studies and meta-analyses looking at disagreement rates from referral centers looking at "us versus them", working off the notion that the second opinion/referral/expert diagnosis is "the right one", "the gold standard" or represents "the absolute truth" for treatment, management, outcomes measurements and classification for subsequent tissue/molecular studies.  In a similar, but distinctly different scenario, pathologists, clinicians and patients can each seek a "second opinion" or consultation on challenging cases or diagnoses they are uncomfortable with.

Here is the typical scenario and how this works:

"Most people never consider the possibility of getting a second opinion on the pathology report from which the diagnosis was made, but the entire plan of treatment depends on what kind of cancer you have and how far it has spread, both of which usually depend in part or whole on the pathologists interpretation of the biopsy or surgical specimen. Changes in the interpretation of the pathology can dramatically change both the treatment and the prognosis.

At the same time, most patients probably do not need a second pathology opinion. There are some common sense cues that can let you know if it might make sense. I think that if you have a really rare cancer, it is always advisable to get a second pathology opinion.

If your pathology report doesn't give a definite diagnosis, a second opinion is probably in order.

Your hospital/group name here Pathology Department has the expertise to diagnose and classify all types of cancer, which helps oncologists choose the most effective treatment method for their patients. We provide second opinion evaluation of tissue samples submitted by physicians and pathologists for patients outside Your health care system name here.

We have experts in a wide range of cancer subspecialties, including:

• Breast
• Dermatopathology
• Gastrointestinal
• Genitourinary
• Gynecological
• Head and neck
• Neuropathology
• Bone and soft tissue
• Thoracic

Fees must be paid at time of the review. Many insurance carriers will reimburse the costs of second opinion consultations. If payment is a problem, we can work with you. Follow-up reviews are payable separately. Please remember that our service is for pathology second opinions only. We cannot discuss or recommend treatment options."

Consultations in pathology are an integral and routine part of daily practice.  Except for the pathologist or the group that claims "I/we don't send anything out".  That person/group may not but informed patients/clinicians will.  As a resident I was warned if you don't show cases to others or get consults from external sources you are doing your patients and yourself a disservice.  

Institutions/individuals who provide second opinion reads as part of or exclusively as their practice of pathology have from time to time, in many subspecialties made claims about disagreement rates that justify the practice for risk management and appropriate patient management with published disagreement rates from 2-5%, depending on the specimen tissue source or part type.  There is also the issue of defining what constitutes a "disagreement", although most studies cite a difference that would alter prognosis or treatment.

Teleconsultations using whole slide imaging, as frequent readers know, I think are one of the many use cases/applications for digital pathology.  Mitigating slide handling issues, improving turn around time, retaining original glass slides onsite, reviewing cases with your consultant in real-time and education/training from external review at another site.

A recent paper shows that, in general, there is a very high level of agreement among pathologists for secondary review of pathology for referral patients, in this study, a rate of 99.4% agreeement.  While small (0.6%), the diagnostic differences may be highly clinically significant, arguing that secondary review of pathology materials should be standard of care.  This high agreement rate should allay concerns of patients and clinicians (and perhaps some pathologists) alike regarding the value and consistency of diagnoses rendered by the pathology community at large.

With such high agreement, why not digital pathology for second opinions/specimen review for patient referrals/slide review prior to additional surgery/treatment?

And in some cases, with follow up case sharing, even outsmart the consultant?

Ryan Swapp, M.D., Marie Christine Aubry, M.D., Diva Salomao, M.D., and John Cheville, M.D., all of Mayo Clinic’s Division of Anatomic Pathology, recently released a study, “Outside Case Review of Surgical Pathology for Referred Patients: The Impact on Patient Care,” that can now be found as an early online release in CAP Archives of Pathology & Laboratory Medicine.

The Division of Anatomic Pathology reviewed the pathology of nearly all patients that were referredto Mayo Clinic for treatment from 2005-2010. The objective was to identify the rate of major disagreements with diagnoses from external institutions and to characterize the nature and impact of discordant diagnoses on patient care.

Interestingly, they also concede that that their review diagnosis was not always the correct one.

Summary:  Major disagreements occurred only 0.6% of the time (457 of 71,811 cases) from 2005-2010.  The most frequent areas of disagreement were gastrointestinal (80 cases; 17.5%), lymph node (73;16.0%), bone/soft tissue (47; 10.3%), and genitourinary(43; 9.4%).  The disagreeing diagnosis was not always the correct one.  In a subset of these cases for which additional tissue was taken (n=86 disagreements from July 2009 – Dec 2010), this subsequent tissue showed that the original diagnosis was correct 15.1% of the time (13 of 86 cases).

View Full Study

• Affiliations
• Contributions
• Corresponding author

The Digital Pathology Association has established a regulatory committee; the committee goal is to create a sense of urgency within regulatory agencies and to bring clarity to the digital pathology clearance and approval process. 

At Pathology Visions 2011 a Regulatory Panel of experts convened with representatives from the U.S. Food and Drug Administration (FDA), the Centers for Medicaid and Medicare Services (CMS), and the College of American Pathologists (CAP).  The DPA regulatory committee presented a series of questions for the panel to address.  DPA members can view the panel experts presentations and the panel recording “Navigating Digital Pathology’s Path to Patients” within the Member Community.

Choose one of categories below:

FDA

CMS/CLIA

CAP

FDA

In the United States, technology manufactured for digital pathology (i.e. scanners, software) are considered medical devices and are regulated by the U.S. Food and Drug Administration (FDA). Manufacturers may market their digital pathology technology for Research Use Only (RUO) unless the FDA has issued a clearance or approval to a specific manufacturer and for an intended use of the digital pathology hardware and software.  Several manufacturers have received one or more FDA 510(k) clearances, however no manufacturer has yet received an FDA approval of their technology for primary diagnosis.
 
The FDA remains focused on the safety and the effectiveness of digital pathology.  Safety is defined in 21 CFR 860.7(d)(1) as the “Reasonable assurance, based on valid scientific evidence, that the probable benefits to health from use of the device for its intended uses and conditions of use, when accompanied by adequate directions and warnings against unsafe use, outweigh any probable risks.”   Effectiveness is defined in 21 CFR 860.7(e)(1) as “Reasonable assurance, based on valid scientific evidence, that in a significant portion of the target population, the use of the device for its intended use and conditions of use, when accompanied by adequate directions for use and warning against unsafe use, will provide clinically significant results.”

In October 2009 the FDA Hematology and Pathology Devices Panel held a meeting to gain expert opinion and industry feedback on the replacement of H&E glass slides and conventional microscopy by whole slide images (WSI), specifically for rendering a routine surgical pathology diagnosis of a disease or condition.  No formal guidance document has been issued by the FDA for digital pathology, however one is expected soon.  In the meantime the FDA has provided two guidance documents, IVD 
Diagnostic products Labeled for Research Use Only and Mobile Medical Applications, that are relevant to digital pathology. 

- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- Digital Pathology 510(k) Clearances
- FDA October 2009 meeting materials and transcriptions
- FDA issued guidance documents relevant to digital pathology
    1. IVD Diagnostic Products Labeled for RUO/IUO
    2. Mobile Medical Applications

CMS/CLIA

Centers for Medicare and Medicaid Services (CMS) oversees the Clinical Laboratory Improvement Amendments (CLIA) which regulate all non research, laboratory tests preformed on humans in the U.S. The goal of CLIA is to insure quality laboratory testing, and therefore quality control (QC) portions of CLIA will apply to digital pathology;  including the analytic phase of testing which requires monitoring the testing personnel, the test system, and the laboratory environment. Other requirements that apply to all testing include calibrations, establishing or verifying performance specifications, test system or equipment maintenance, test results comparisons, corrective actions, having a back-up plan for instrument failure, and a procedure manual.  Validation of a digital pathology system is also necessary, and labs should follow CLIA requirements for test reports. 

In February 2012 Clinical Laboratory Improvement Advisory Committee (CLIAC) held a meeting which discussed emerging issues in digital pathology. CLIAC provides scientific and technical advice and guidance to the Secretary of Department of Health and Human Services (HHS); the Assistant Secretary for Health; the Director of Centers for Disease Control and Prevention (CDC); the Commissioner of the Food and Drug Administration (FDA); and the Administrator of the Centers for Medicare and Medicaid Services (CMS). The advice and guidance pertain to general issues related to improvement in clinical laboratory quality and laboratory medicine.  CLIAC may also provide advice and guidance on specific questions related to a possible revision of CLIA standards. 

- Validation of Digital Pathology in a Healthcare Environment
- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- Current CLIA Regulations
- Summary of CLIAC February 2012 Meeting

CAP

The College of American Pathologists (CAP) is a CLIA accredited organization composed of board-certified pathologists with a mission to serve patients, pathologists, and the public through the advocation of excellence in pathology and laboratory medicine worldwide. 

CAP issues laboratory accreditation checklists which support the accreditation process.  The checklists align with the CLIA mandate of high quality laboratory testing by providing a solid foundation for excellence in patient safety, and compliance with policies, procedures, and laboratory processes.  The Anatomic Pathology, Laboratory General, and Cytopathology checklists have items that can apply to digital pathology systems.  

In 2011 a CAP Center working group was formed to create guidelines for digital pathology.  Thirteen guidelines were developed to assist the pathology community with validating WSI for clinical diagnostic use.  The thirteen guidelines, which are still under development, were presented at Pathology Visions 2011.  The final version of the guidelines has not been issued but is expected soon.  

Download the DPA white paper, Validation of Digital Pathology in a Healthcare Environment, for more specific information about the CAP checklist items and the draft guidelines. 

- Validation of Digital Pathology in a Healthcare Environment
- Pathology Visions 2011 Presentations (Members Only)
- Regulatory Panel | Navigating Digital Pathology’s Path to Patients (Members Only)
- The College of American Pathologists' Laboratory Accreditation Program (CAP-LAP) Practical World View on Digital Pathology from a CLIA Accreditation Provider (Members Only)
- Recommendations for Validating Whole Slide Imaging in Pathology: College of American Pathologists (CAP) Pathology and Laboratory Quality Center (Members Only)
- CAP Checklists

CENTER VALLEY, Pa., July 12, 2012  - Olympus America Inc. and Carl Zeiss Microscopy GmbH, Jena, Germany, have signed a nonexclusive worldwide licensing agreement allowing Zeiss to access an extensive portfolio of patents held by Olympus in the field of digital pathology and virtual microscopy. The patents included in the licensing deal cover methods and equipment for creating, storing and delivering virtual microscopy slides. The technology enables individuals to view and share high-resolution virtual microscopy images over the Internet.

"Global adoption of digital slide scanning continues to expand into new medical and scientific applications," said Brad Burklow, Executive Director Business Development, Scientific Equipment Group, Olympus Corporation of the Americas. "Olympus is the holder of many important patents in this area, and we feel it is vital to allow broad access to these technologies in order to advance the field of pathology and medical research. We are confident that leveraging these technologies will enhance healthcare for patients around the world."

"The handling of digital data has become a major driver of the development of modern microscopy," said Dr. Bernhard Ohnesorge, Member of the Board and General Manager BioSciences Division of Carl Zeiss Microscopy. "Integrating the virtual slide functionality into our research microscope systems will enable our customers to become more efficient and to explore new scientific approaches. This will help them to better understand the root causes of the most challenging diseases."

The companies are not making specific terms and conditions of the agreement public.

About Olympus America Inc., Scientific Equipment Group

Olympus America Scientific Equipment Group provides innovative microscope imaging solutions for researchers, doctors, clinicians and educators. Olympus microscope systems offer unsurpassed optics, superior construction and system versatility to meet the ever-changing needs of microscopists, paving the way for future advances in life science.

About Olympus

Olympus is a precision technology leader, designing and delivering innovative solutions in its core business areas: Medical and Surgical Products, Life Science Imaging Systems, Industrial Measurement and Imaging Instruments and Cameras and Audio Products. Olympus works collaboratively with its customers and affiliates worldwide to leverage R&D investment in precision technology and manufacturing processes across diverse business lines. These include:

Gastrointestinal endoscopes, accessories, and minimally invasive surgical products;

Advanced research, clinical and educational microscopes and research and educational digital imaging systems;

Industrial research, engineering, test, inspection and measuring instruments; and

Digital cameras and voice recorders.

Olympus serves the healthcare field with integrated product solutions and financial, educational and consulting services that help customers to efficiently, reliably and more easily achieve exceptional results. Olympus develops breakthrough technologies with revolutionary product design and functionality for the consumer and professional photography markets, and also is the leader in gastrointestinal endoscopy and clinical and educational microscopes. For more information, visit http://www.olympusamerica.com .

About Carl Zeiss

Carl Zeiss

The Carl Zeiss Group is an international leader in the fields of optics and optoelectronics. In fiscal year 2010/11 the company's approx. 24,000 employees generated revenue of about 4.237 billion euros. In the markets for Industrial Solutions, Research Solutions, Medical Technology and Consumer Optics, Carl Zeiss has contributed to technological progress all over the world for more than 160 years. With its innovative technologies and leading-edge solutions, Carl Zeiss is successful in the fields of Semiconductor Manufacturing Technology, Industrial Metrology, Microscopy, Medical Technology, Vision Care and Consumer Optics/Optronics. Carl Zeiss AG is fully owned by the Carl Zeiss Stiftung (Carl Zeiss Foundation).

Microscopy

The Microscopy business group at Carl Zeiss is the world's only manufacturer of both light and electron microscopes. The company's extensive portfolio enables research and routine applications in the life and materials sciences. The product range includes light and laser scanning microscopes, electron and ion microscopes and spectrometer modules. Users are supported for software for system control, image capture and editing. The Microscopy business group has sales companies in 33 countries. Application and service specialists support customers around the globe in demo centers and on site. The business group is headquartered in Jena. Additional production and development sites can be found in Oberkochen, Gottingen and Munich, as well as in the UK and the USA. The company has around 2,500 employees and generates revenue of 620 million euros.

Source: Olympus America Inc.

Stereological and classical image analysis approaches help to more accurately quantify neuropathology and model treatment efficacy.

Westminster, CO — July 9, 2012 — Flagship Biosciences, a leading provider of tissue analysis for pharmaceutical and medical device development, has expanded services with dedicated staff and novel techniques in neuroscience pathology services.

The central nervous system is a fundamental part of the human body’s response system. As life expectancy lengthens, a wide range of disorders (including Alzheimer’s, Parkinson’s, Huntington’s, MS, dementia and depression), are becoming increasingly widespread in the population creating an ever greater need for new pharmaceutical therapies.

The ability to measure changes associated with these disorders relies on two dimensional observations taken from histology sections and observed by trained scientists or pathologists. Flagship’s brightfield and fluorescence whole slide imaging, combined with powerful custom image analysis techniques increases throughput, decreases variability and allows the evaluation of changes to both labeled and unlabeled neuronal and non-neuronal cells.

To drive Flagship’s expansion in the neurodegenerative disease area, Dr. Anthony J Milici has joined the company as Director of Neurosciences and Inflammation. Dr. Milici was previously head of a neuroscience imaging lab with Pfizer, where he directed a team of researchers and novel histopathology imaging techniques in neuroscience, oncology, and inflammation areas. He is a well-respected leader in histopathology imaging in the neurosciences community with his work on amyloid plaque quantitation presented at multiple conferences.

“It is exciting to apply Flagship’s novel whole tissue section mapping software to neurodegenerative and neurotoxicological problems,” said Dr. Milici. “The ability to utilize automated computer-based algorithms in applying the most appropriate image analysis or stereological technique has the potential to open up a greater understanding of the pathological basis of disease.”

“The critical piece in delivering excellence in a disease area like neuroscience is the biological domain expert scientist and leader who can bring together the strengths of pathology, histology, image analysis, and biostatistics,” said Dr. Steven Potts, CEO of Flagship Biosciences. “Dr. Milici has been a leader and pioneer in the application of new whole slide imaging techniques in neurobiology for a number of years, and we are honored to have him join our team.”

In addition to quantitative tissue assays like plaque load, tau, Huntingtins, astrocyte or microglial activation, Flagship is also developing a number of new approaches utilizing cross-sectional cell mapping to quantify endpoints such as cerebral microhemorrhage, vascularity changes, cell loss and synaptic changes. These assays will assist small molecule and biological drug development programs in the evaluation of efficacy and toxicity

With the recent acquisition of IHCtech histology services, Flagship adds a strong capability in neurological sectioning and immunohistochemistry techniques. IHCtech has optimized over 350 IHC research antibodies for use in research areas of neurology, oncology, inflammation, diabetes and other areas.

Flagship Biosciences is a fast-growing histopathology services firm staffed with world-class talent in image analysis, MD and veterinary pathology, and pharmaceutical science. Flagship supports multiple ongoing projects in the area of tissue-based companion diagnostics development.

In what is by far the biggest venture capital deal in health IT this year, One Equity Parters, the equity investment branch of JPMorgan Chase, has agreed to take M-Modal (NASDAQ:MODL) private, buying all of its shares for $1.1 billion in cash.

M-Modal, which offers a cloud-based voice recognition program that uses natural language processing (NLP), recently announced a new product that it said could convert doctors' dictation into discrete data in electronic health records. The "speech-to-text platform," called Fluency, is a refinement of its earlier NLP software.

Two EHR vendors, Allscripts and Greenway, have announced they will use M-Modal's platform to make it easier for physicians to document findings in their EHRs. Allscripts has already integrated the application into its Sunrise acute-care EHR. Another vendor, eClinicalWorks, toldInformationWeek Healthcare that it is developing a new EHR feature that does the same thing, using Nuance's NLP engine.

Another area where NLP is gaining ground is in computer-assisted coding (CAC), used in a growing number of hospitals. M-Modal recently signed a licensing agreement with 3M Health Information Systems that allows 3M to interface M-Modal's CAC solution with the 3M Coding and Reimbursement System.

Medquist, a medical transcription company based in Franklin, Tenn., purchased M-Modal last August for $130 million and assumed M-Modal's name. The company began trading its stock on NASDAQ in January.

Under terms of the agreement with One Equity Partners, that firm will make a tender offer for all shares of M-Modal no later than July 17. The M-Modal board has unanimously recommended that all shareholders accept the offer.

In a statement, the JPMorgan Chase subsidiary explained why it's buying the company. "M-Modal presents a unique opportunity to acquire a market leader in clinical documentation at a time when the company has successfully released its new generation of speech understanding solutions for healthcare," said Dick Cashin, managing partner of One Equity Partners.

To learn more:
- here's the announcement about the acquisition
- read the InformationWeek Healthcare article

Related Articles:
ICD-10 triggers computer-assisted coding adoption
3M, Nuance partner to create computer-assisted physician documentation

MyDermPath is the first comprehensive resource for dermatopathology with clinical correlation built specially for mobile devices such as the iPhone and iPad co-authored by Drs. Singh, Elston and Ferringer. The entire subject matter has been presented in a novel algorithmic format prompting the user to answer multiple questions and thus come to a final diagnosis. The final diagnosis page gives a short but complete histological and clinical description of each entity along with a histological and clinical image. A link to PubMed at the bottom of the page will take the user directly to Pubmed with a list of all references on that topic. Of the approximately 1100 entities described most also have a link to a virtual slide stored on the cloud. The user also has the ability to take is own notes on each topic by clicking on myNotes and storing them on the mobile device, thus making the app as a constantly updating tool. The app also has algorithms for immunohistochemistry, special stains and immunofluorescence.

In the immunohistochemistry section each immunostain has a brief description of where it is most useful, along with an illustration of the stain. This section also has an algorithm that suggests immunomarkers through a multitude of real-life diagnostic dilemmas. There are algorithms that address commonly asked questions such as which immunostains to use in spindle cell neoplasms, epithelioid neoplasms or round cell neoplasms.

The immunofluorescence section provides a list of the various diagnoses in which immunofluorescence has value. Each entity is discussed in detail, including histological and immunofluorescence findings and supplemented with an immunofluorescence image.  In addition, there is an algorithm of the different patterns of immunofluorescence, allowing you to arrive at a diagnosis based on the answer to patterns visualized.

The Special stain page contains a list of the common special stains typically used in dermatopathology. Once you know what you are looking for, the app can help in deciding what stains to use and also show an image as to how the stain will look.

If the user wants to go directly to a diagnosis and not use the algorithm, the Search by Diagnosis button will enlist all the entities in the app like the index of a book. A quick click will take the user directly to the diagnosis.

For the beginner a glossary of terms provides a list of all the common terms used in dermatopathology with a concise description and image. An animated video also walks the user through the normal histology of the skin along with descriptions of the desmosomes and basement membrane structure.

Finally, a Pop Quiz randomly selected images from the data base of more than 2000 static images and presents them in a multiple choice format.                                                        Download from iTunes

This app is the first of its kind not only in dermatopathology, but also in Pathology. Future versions will have a host of additional features making it a great resource to have in your pockets and literally on your fingertips. It will be useful for all dermatologists and pathologists, especially who see skin cases in their practice. Besides plastic surgeons, podiatrists, family practitioners who see dermatology patients can also benefit from the information provided in the app. For the medical student it is a good tool to get a good overview of dermatology and learn how to approach patients with clinicopathological correlation.

Download from iTunes

Courtesy of LiU-News:

Pathology is central to health and medical care, not least to cancer patients, yet the field today faces serious challenges due to an excessive workload. The digitalisation of microscopy images opens up new possibilities.

A consortium led by the Centre for Medical Imaging and Visualisation (CMIV) at Linköping University (LiU) has just been granted Vinnova (Sweden’s Innovation Agency) funding for research and development in image-based pathology. The aim is to create new, efficient workflows and IT tools, partly through advances in image analysis and visualisation.

In addition to CMIV, the consortium includes:

• County councils in Östergötland, Jönköping, Kalmar and Gävleborg
• Swerea IVF Research Institute
• Sectra, a medical technology firm

The grant of just over SEK 9 million comes from Vinnova’s call for “Challenge-driven innovation”, and the project is one of 30 granted funding in competition with projects from all over the country.

Sheffield, United Kingdom -- Phase Focus Limited has announced that it has raised £3 million from the Ombu Group and £220k from Fusion IP plc in an equity based funding round to accelerate revenue generation of its revolutionaryimaging and microscopy technology – the Phase Focus Virtual Lens.

The Phase Focus Virtual Lens aims to eliminate the limitations and imperfections of conventional lenses, and reveals with high fidelity and accuracy an additional dimension of information about the specimen that is otherwise usually hidden. The Virtual Lens technology transfers the task of image-creation from a lens to a sophisticated computer program. It can be integrated inside existing microscopes, and can also be used as the basis for next-generation microscopy products. Currently being used for the analysis of specimens that are conventionally difficult to measure, such as transparent soft contact lenses and unstained living cells, the Virtual Lens is expected to revolutionize the viewing of atomic-scale features.

This new investment will allow Phase Focus to accelerate the commercialization of its technology across its existing application areas as well as invest in R&D to develop new tools and applications.

The University Health Network (UHN) in partnership with the Kuwait Cancer Control Center (KCCC) and the support of the Ministry of Health, have installed cutting-edge telepathology equipment in the KCCC laboratories

This story illustrates in a nutshell, make more significant by the transatlantic referral, the value proposition for telepathology.  The right diagnosis on the right patient and the right time without delays in slide handling while protecting patient health information between those who need it. Another win for Pathology 2.0.

Source: AMEinfo.com

Courtesy of: Pathology Informatics from the Trenches