jesus ellin, h.t./paascp - an early adopters digital pathology experience in the anatomic pathology...
DESCRIPTION
Jesus Ellin from Yuma Regional Medical Center discusses how to incorporate digital pathology solutions, including scanners and software, in to the anatomic pathology laboratory using workflow and LIS integration.TRANSCRIPT
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Going Where No One Has Gone Before – A Grass Roots Approach to Success
In the Digital World
Jesus Ellin, HT, PA, Anatomic Pathology Supervisor, Yuma Regional Medical Center
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Speaker has received a fee from Ventana Medical
Systems, Inc. for this presentation.
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30% of workload scanned to include IHC stains in to Pathologist, 10:30 am at 40x
65 slides in 5.5 hours period
No additional FTE budgeted or required
Searchable electronic QA/QC Data within APLIS, to correlate with traditional workflow and improved outcomes
Positioning facility for Traditional and Digital pathology workflows/ Hybrid!!
Yuma Regional’s Accomplishments to Date
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A Grass Roots Solution
Materials Management (Bar-coding/tracking)
QA/QC of the Process (sample and image combo)
Downstream effect with Imaging (Vendor Collaborations)
Storage and Image Approach (Business case for Success)
Leadership (A practice shift from being largely morphologically based to integrating prognostic information into decision making, collaboration with others providing diagnostic data—radiology, pharmacy, etc.)
WORKFLOW!- Inline vs batching and workflow integration within LIS
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Workflow considerations to minimize “tidal effect” (traffic jams)
Batching drives throughput rate – especially in staining/drying
Batches of 10 slides each, allowed two scanners to image 60 to 80 slides at 40X ( 300 minutes of work) while only adding 20 minutes to the run (redo rate = 0, QA time = 0)
Case size drives throughput rate
Imaging QA time is a major impact throughput rate (scan time + QA time)
Imaging redo kills throughput rate especially at rates above 5% or with large cases
How to Go Digital Without Killing Throughput
Elimination of batching, case reconciliation, low QA time and minimum imaging failures are key
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Changed size of batches between stations and redo rate.
Run the simulation for 0, 1, 2, scanners
Scanner images at 1-2 minutes per slide at 20x
Scanners imaged at 4-6 minute per slide at 40x
Image QA time 0 – 2 minutes (integrated in APLIS)
Image redo rate 0 – 5%
Staff Identifications (Ownership)
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Quality Issues are Amplified in Digital
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Quality Issues are Amplified in Digital
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Quality Issues are Amplified in Digital
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Quality Metrics and Continuous Improvement
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Identifying variance real time
Improvement to process
Quality Metrics and Continuous Improvement
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Real time assessment
Quality Metrics and Continuous Improvement
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Quality Metrics and Continuous Improvement
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Quality Metrics and Continuous Improvement
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Quality Metrics and Continuous Improvement
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Correlation with Traditional QA/QC
Quality Metrics and Continuous Improvement
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Integrated Imaging WorkflowWith the Help of the LIS
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Integrated Imaging WorkflowWith the Help of the LIS
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Integrated Imaging WorkflowWith the Help of the LIS
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Integrated Imaging WorkflowWith the Help of the LIS
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Integrated Imaging WorkflowWith the Help of the LIS
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Integrated Imaging WorkflowWith the Help of the LIS
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Integration of Voice Recognition with applications (Natural Language Processing)
Interface logic to increase efficiency with Digital workflow (SOA)
Digital Education among technologist and support staff to understand the key point of new technology
Establishing new services Digital Pathology can bring to clients (Pathologist Cockpit, Collaborations, E-consultants)
Future Results
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It’s Knocking!!There has never been a greater need for Pathology expertise and resources.
Much Bigger Opportunity Lies Ahead!
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Informatics
Therapeutics
Molecular Testing
Genomics
Impact Medical Outcomes
…through integration of information
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Broaden our sphere of influence
Expand beyond the tissue on the slide—all diagnostic tools are available to you
Market our services for consults
Expand value by influencing prognosis and treatment
Interact with Patients and Clinicians
…as member of the disease management team
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Acknowledgements
Yuma Regional Medical Center (Dr. Victor Alvarez, Dr. Stanley Sprei, Dr. Andrew Kim, Robin Davis and Staff)
Ethel Macrea; Ventana Medical Systems, Inc.
Sunquest Information Systems (Sunquest PowerPath®)
Ventana Medical Systems, Inc.: Jace Doshier
YRMC Histology Department (Liz, Dawn, Maria, Kristy)
Dr Keith Kaplan: Carolinas Pathology Group
University of Nebraska Medical Center (David Muirhead)
Elizabeth Chilpala: Premier Laboratories
Digital Pathology Association
Amanda Lowe: Digital Pathology Consultants
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THANK YOU!