Successful Strategy for Supporting Pathology Imaging at a Large Academic Medical Center
R A Anderson MS, BS; University of Pittsburgh Medical Center; J L Fine MD; University of Pittsburgh Medical Center; A V Parwani MD, PhD; University of Pittsburgh Medical Center;
Content:
Digital imaging has replaced film for almost all gross and microscopic photography in pathology during the past several years. In addition to reducing financial and temporal costs associated with film, digital technology can enhance management, availability, and security of archived images. Laboratory Information System (LIS) software can support these activities through integration of imaging workflow. This report details our institution's experience of supporting pathology imaging at a large, geographically distributed health care organization
Technology:
Most microscopic image capture workstations utilize SPOT Insight digital cameras (various models, Diagnostic Instruments, Sterling Heights, MI) or Sony analog video cameras (Sony Corp., New York, NY). Images can be imported directly into the LIS via TWAIN driver or indirectly as image files (including images captured by almost any digital camera). Image capture workstations are standard pathology PC configurations (Pentium 4, 512MB RAM, Windows, etc.) that are specifically licensed for imaging functionality with our LIS vendor (PicsPlus imaging module and CoPathPlus, Cerner Corporation, Kansas City, MO).
Design:
Gross images are captured at six (6) different locations; microscopic images are captured at more than thirty - (30) sites including pathologists sign-out rooms and offices. Image acquisition is an activity within CoPathPlus (PICSPlus), and involves either direct acquisition or importation of an image file. Once acquired, the image file is converted into JPEG 2000 format. An image file is then copied to an image server, and a link to the file is added to the CoPathPlus database. Authorized users may view, edit and export images from the application. Image application and hardware support is provided by CoPathPlus support personnel and is integrated with general LIS support network. Image server maintenance and tape back ups is available through our Local Area Network (LAN) team. Services are accessible via a web form or by telephone.
Results:
Over 350,000 images have been captured to date, using 70GB of server storage space. Monthly usage is approximately 3,000 images, or 1.2GB. Image utilization varies from campus to campus. Recent (ongoing) migration to a single sign on PC workstation vendor has greatly simplified support and has reduced number of support incidents. Gross and microscopic images are easily and rapidly available to pathologists at the time of sign out and available for inclusion in selected pathology reports (dermatopathology) in addition to other applications (conferences; education; etc.).
Conclusion:
Digital imaging provides a fast, high quality, cost effective, and secure solution for acquiring, managing, and distributing pathology images. Integration with the LIS facilitates utilization of and access to images, as well as streamlines provision of end-user support via already-established mechanisms. Standardization of imaging hardware, including cameras and PC workstations, greatly improves ability to deploy and support these activities. Future expansion of pathology imaging support can include scanned documents, persistent archives of supplemental images associated with departmental academic publications, and whole slide images.
