2005 Scientific Session Abstracts
Digital Imaging in Anatomic Pathology – Determinants of Use
Rodney A. Schmidt, MD, PhD, ( schmidtr@u.washington.edu); University of Washington, Dept. of Pathology, Seattle, WA
Context : Digital imaging may be used to capture gross photos, microscopic images, and scans of paperwork. By measuring actual utilization and surveying users, we wished to assess the practical value of each, the factors most important to utilization, and the costs of imaging.
Technology : AP-LIS: PowerPath (Impac Medical Systems, Mountain View, CA). Photomicroscopy: SPOT cameras through TWAIN interfaces (Diagnostic Instruments, Sterling Heights, MI). Gross photography: C-5050 digital cameras (Olympus America, Mellville, NY) via Impac’s interface. Document scanning: DR-3080 CII scanner (Canon USA, Lake Success, NY) using a TWAIN interface.
Design : PowerPath imaging licenses were deployed in rough proportion to expressed user need with 5 dedicated to microscopy, 2 to gross photography, and 1 to scanning paperwork. After training, we measured costs and the number of images captured over a 3 month period and surveyed users to elucidate the factors influencing utilization.
Results : The number of images captured differed radically by type of image. Paperwork scanning (17,877 images) was an immediate workflow and functional success. Gross photography (1841 images) was limited by technical camera issues (close-ups) and minor workflow problems. Relatively few microscopic images were captured (260) and fewer were included in reports. Factors influencing use included specialty service, training, workflow, and follow-through of initial interest. Annualized one-time licensing costs, the largest expense, ranged from $0.36/image (scanning) to $91/image (microscopy).
Conclusion : In our experience with digital image adoption rates at one institution using one vendor’s product, we found that document imaging was embraced because of workflow benefits and modest cost. Gross imaging was also beneficial. Microscopic imaging was lower volume and largely confined to specialized niches because of ease of use, training, and incomplete follow-through on initial interest. Overall, users’ perception of benefit and workflow most influenced adoption of digital imaging.