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

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

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

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

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

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

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

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

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

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