How to create a good case?

Easy online case sharing for second opinion, peer-review or consultation is one of the key objectives of PathXchange. However, creating a good case with complete content, provides valuable information that help a consulting pathologist interpret the case better. Here are a few tips to help Px members create a good case.

• Use whole slide images, instead of photomicrographs- while photomicrographs can be obtained easily, the key is to provide access to a whole slide image. There are several whole slide scanning systems being used at hospitals and labs. If you do not have access to one, you can benefit from PathXchange’s free slide digitization service. For more information click here.
• Include special stains, wherever applicable- Special stains not only add to the completeness of the case, but are often needed to confirm diagnosis. These are especially required for cancer cases.
• Case information- Basic clinical information is always required such as- age, sex, case history; however adding other relevant information, provides better insight into the case. Links to publications, references, etc, can also be included.
• Radiology and gross images- Radiology and gross images visually enhance the presentation of the case and make it more interesting.
• File attachments- Any additional information or previous reports can be scanned and attached to the case for the benefit of other members.

Featured Digital Pathology News

* Aperio Awarded Patent for High Performance Viewing of Digital Slides: Aperio Technologies, Inc., (Aperio), a global leader in digital pathology for the healthcare and life sciences industry, announced today that the United States Patent and Trademark Office has issued the company patent No. 7,738,688 entitled, "System and Method for Viewing Virtual Slides." Read full story.

* Philips and Dako join forces in digital pathology: Royal Philips Electronics (NYSE: PHG, AEX: PHI) and Dako, a Danish company specializing in tissue-based cancer diagnostics, today announced that they have signed an agreement to integrate a selection of Dako’s image analysis applications into Philips’ future digital pathology solutions. Read full story.

* BioImagene Collaborates with America's Best Hospitals, to Advance the Field of Digital Pathology- BioImagene, Inc., the leading provider of innovative digital pathology solutions has added ten new academic medical centers to its roster of collaborators during the last quarter. Many of these collaborators have been named “America's Best Hospitals 2010-2011: The Honor Roll” by U.S. News and World Report. Read full story

* Olympus America Licenses Digital Pathology Patents to BioImagene, Inc. - Olympus America Inc. has signed a nonexclusive worldwide licensing agreement with BioImagene, Inc. of Sunnyvale, California, allowing BioImagene to access an extensive portfolio of Olympus patents in the field of digital pathology and virtual microscopy. This is the most recent of several licenses that Olympus has granted for the technologies, which are considered critical for developing future digital imaging and data handling systems for pathology. Read full story

High Tech in the Tent - A personal account of telemedicine aiding patient care in post-earthquake Haiti

By Mohan Uttarwar

Following the devastating earthquake that rocked Haiti in January 2010, a global relief effort was mobilized to help survivors. In April, I had the chance to visit Haiti and see first-hand the remarkable humanitarian work being done to enhance patient care by some of the first responders, including Project Medishare and the University of Miami Miller School of Medicine.

I have traveled extensively within India and have witnessed poverty in the region. I thought I would be prepared for my visit to Haiti, but the country was far worse than I could ever imagine. Despite the harsh conditions, I was amazed at the level of medicine being practiced in field tents in the capital, Port-Au-Prince. Within 18 hours after the earthquake struck Haiti, the University of Miami mobilized a trauma team to assist in relief efforts. Partnering with Project Medishare, the University of Miami soon opened a 240-bed tent hospital that had a rotating staff of more than 200 volunteers.

Today, months after the earthquake, the University of Miami and Project Medishare continue to provide essential support to help the survival and recovery of the Haitian people. An all volunteer group of physicians, nurses and logistics staff work around the clock in challenging conditions. It is crucial for the ground staff to be able to coordinate care with remote specialists to collaborate on difficult cases.

BioImagene's goal in Haiti was to install a digital pathology system to facilitate telemedicine and provide the field hospital access to the full range of pathology expertise at the University of Miami. Carrying out this task was a challenge because the conditions in Haiti are unlike any installation BioImagene has experienced. Our system, which is designed for a stable hospital and lab setting, would need to function in a tent hospital with limited system requirements.

Our installation team made it work, and we were able to utilize Cisco's satellite internet system to connect with the Miller School of Medicine in Miami. The Miller School of Medicine created a user group on PathXchange pathology portal. Physicians and volunteers in Haiti were able to scan slides of blood, urine and tissue samples of Haitian patients, upload the images on PathXchange and share them with pathologists at the Miller School. PathXchange, dubbed a "Facebook for pathologists," facilitated this collaboration for consultations, remote reads, second opinions and, in some cases, primary diagnosis.

As efforts in Haiti shift to long-term recovery and rebuilding, pathologists there will have access to expertise from around the world that they previously did not have. It is incredible and extremely gratifying to see how technology can be a bridge between the have's and the have not's. The experience was humbling, to say the least.

Mohan Uttarwar is CSO, Co-founder of BioImagene Inc and President of PathXchange.org
This article has been featured by Advance for Administrators of the Laboratory magazine, June edition.
http://laboratory-manager.advanceweb.com/Web-Extras/Online-Extras/High-Tech-in-the-Tent.aspx

First Trans-Pacific Digital Case Conference conducted on PathXchange

PathXchange (Px), a global online pathology community, announced it conducted its first trans-Pacific digital case conference on March 17, 2010. The virtual case conference included two leading hospitals in Mumbai, India -- the Hinduja National Hospital and Lilavati Hospital -- and the University of Nebraska Medical Center in the United States (UNMC). 

Dr. Subodh Lele of UNMC, Dr. Anita Bhaduri of Hinduja Hospital, Dr. R. B. Deshpande of Hinduja Hospital, Dr. Chandralekha Tampi of Lilavati Hospital, and Dr. Meenal Hastak of Lilavati Hospital led the 1.5 hour live discussion over ten cases. The cases were scanned using BioImagene’s iScan Coreo™ system and uploaded on PathXchange. 

“Utilizing PathXchange’s global collaboration capabilities to conference with pathologists half way around the world in real time was a unique and very rewarding experience for me. The cases from India that I saw and shared with my colleagues here in the U.S. were fascinating,” shared Dr. Lele.  

The virtual collaboration meeting was held the day before a major inter-hospital conference – the Senior Surgical Pathologist’s Meeting (SSPM). Eighteen of Mumbai’s major teaching and private hospitals participated in reviewing the same cases during the SSPM, where results from the digital case conference were discussed.

“Hosting the virtual case conference on PathXchange allowed us to facilitate the exchange of information and gave a new dimension to expert opinion from across the globe. The slides looked excellent on screen and the exchange of ideas added value to the interpretative skills,” recounted Dr. Bhaduri.

The cases discussed during this conference can be accessed under the Senior Surgical Pathologist’s Meeting Group on PathXchange.
About PathXchange
PathXchange is a vendor-neutral, not-for-profit Web site for the global pathology community, to promote digital pathology. PathXchange brings the field of pathology into the digital age with Web 2.0 features designed to promote the exchange of pathological cases, ideas, knowledge, information, products, and services. PathXchange is sponsored by BioImagene, a leader in providing innovative digital pathology solutions for clinical diagnostics and drug discovery.

PathXchange (Px) Launches Px Athena - an eLearning Module for Pathologists

SUNNYVALE, Calif. --(Business Wire)-- PathXchange (Px), a global online pathology community, today announced the launch of Px Athena, an eLearning management system with Web 2.0 capabilities. Px Athena utilizes digital pathology technologies to provide a comprehensive online research and education solution to the academic pathology communities.

"As pathology transitions to a digital environment, existing tools and techniques for pathology education such as textbooks, multi-headed scopes, slide-set based learning should be updated to meet the needs of the digital era. PathXchange Athena enables pathology educators to be more efficient and effective in their teaching. The digital tools enable the current generation of technology savvy students to learn pathology in a manner consistent with university teaching," said Steven H. Hinrichs, M.D., Chair of the Department of Pathology/Microbiology at the University of Nebraska Medical Center.

Px Athena allows educators to create and host interactive online courses and provides students instant access to digital teaching sets. Px Athena combines several elements, including course galleries, self-assessments, and interactive teaching tools to promote community based learning, continued medical education, knowledge sharing and professional networking.

"The PathXchange community has grown to include 4,000 members from 130 countries in nine months since its inception," said Mohan Uttarwar, President of PathXchange. "Px has become the largest global online pathology community with the largest user-contributed digital case library. We are positive that digital technology will transform pathology research and education just like it did in radiology." In addition to their education offerings, PathXchange also enables global collaboration for research applications. PathXchange was recently used to facilitate an international inter-observer concordance study on autoimmune pancreatitis (AIP). The study, which was led by Dr. Lizhi Zhang, assistant professor of anatomic pathology at Mayo Clinic; Dr. Suresh Chari, professor of medicine and gastroenterologist at Mayo Clinic, and Dr. Thomas Smyrk, associate professor of pathology at the Mayo Clinic, enabled researchers to conduct a research study with global participants and collect and analyze results in nine weeks.

"More than a dozen pathologists from around the world logged on to PathXchange to review 40 AIP cases in the hopes to arrive at consensus based on their current knowledge of AIP," said Dr. Zhang.

"PathXchange opens doors to an unprecedented level of international collaboration on research studies," said Tao Liang, Ph.D., Director of PathXchange. "Export of human tissue is a major logistical challenge in international research studies. The inter-observer concordance study on AIP is an excellent example of how such studies can be done in weeks as opposed to months, and at a fraction of the cost." Px Athena will be available to members of PathXchange.org free of charge. Custom hosted Px Athena is available for a charge. Visitors at the United States and Canadian Academy of Pathology (USCAP) 2010 Annual Meeting can view a demo of Px Athena at Booth 101. The conference will be held at the Marriott Wardman Park Hotel in Washington, D.C., between March 22-24, 2010.

About PathXchange PathXchange is a vendor-neutral, not-for-profit Web site for the global pathology community, to promote digital pathology. PathXchange brings the field of pathology into the digital age with Web 2.0 features designed to promote the exchange of pathological cases, ideas, knowledge, information, products, and services. PathXchange is sponsored by BioImagene, a leader in providing innovative digital pathology solutions for clinical diagnostics and drug discovery. 

PathXchange for care collaboration

Radiology has been digitized for over a decade now. Digital radiology presents itself as one of the greatest technological advances in medical imaging world. Benefits of digital radiology have been enormous and have helped facilities go filmless. Pathology has similar needs, however, still largely depends on physical examination of the glass slides under a microscope.

Although whole slide imaging technologies are being implemented in pathology practices, the adoption of such technologies has been much slower. Pathology slide images are many times the size of the typical radiology image. One of the major concerns with pathology going digital has been the storage and streaming of such digital slides over the internet. More and more labs are now looking for vendors to take away the burden of storing and managing such huge images.

In an article published by Dr Bruce Friedman he discusses how digital pathology vendors can offer a total basket-of-services including storage of such large image files (See: Digital Pathology Offered as a Service Rather Than a Product). In another article recently posted by Amanda Lowe from Digital Pathology Consultants, she discusses SaaS and cloud computing technologies being applied to digital pathology (See: SAAS- Cloud 9 For Digital Pathology?).

PathXchange brings the field of pathology into the digital age by combining digital pathology, SaaS, and cloud computing technologies to provide, online storage and archival of slide images. It supports from a variety of image formats- including static images and whole slide images. PathXchange is an extremely robust and scalable global hosting infrastructure that:

• Provides unlimited storage for pathology data on high performance off-site servers
• Guarantees 24 x 7 accessibility
• Provides instant content delivery, and
• Requires no IT installation and maintenance

Further, PathXchange combines it with Web 2.0 features to promote exchange of pathological cases, ideas, knowledge, information, products, and services. Pathologists from around the world can network and stay connected. Cases and information can originate from anywhere, from any platform, and shared with the sub-groups of your choice. It enables-

• Online sharing of digital cases
  
• Rapid dissemination of knowledge and information
• Online second opinion consultation
• eLearning
• Forums and discussion

PathXchange creates an environment for care collaboration for pathologists to experience Pathology 2.0 at its best!

Pathology 2.0: Pathology eXchange and more

Pathology community, which till recent past had been unaffected by the web revolution, is slowly waking up to realize what a boon it is to the field and Web 2.0 has changed the whole dynamics of pathology.

What is Pathology 2.0?

The term Web 2.0 is commonly associated with web applications that facilitate interactive information sharing and collaboration on the net. Social networking sites, web based communities, blogs and video sharing sites are all examples of Web 2.0 allowing the users to interact with other users or to exchange user created content.

Like in any field, in pathology too sharing of information is very important. A web based setting enables immediate distribution of digital slide images and pathologists in any corner of the world can view the same simultaneously and share their views on the course of treatment.

"Pathology 2.0 is the application of Web 2.0 tools to provide a collaborative environment for pathologists to share information and interact on the web."

With a majority of the developing countries not having access to quality healthcare, digitalpathology can help pathologists when they come across unconventional cases. Without handing over the slides the two pathologists can share a real-time consultation which is better than a conventional consultation.

This kind of sharing also helps the pharmaceutical companies to expedite research, clinical trials, and facilitate international peer review using a digital pathology platform. A digital slide-sharing network is particularly valuable for pathologists faced with shipping glass slides internationally.

PathXchange is designed to promote exchange of pathlogical cases, information, ideas and knowledge, enables pathologists to upload the slide and share the information online within minutes. The site not only offers the users to take second opinion on difficult cases but also helps them keep abreast with the latest advances in the field. The site also offers an alternative to investing in a costly local digital pathology infrastructure.

It is only a matter of time when Web 2.0, that has becomes such an important part of our lives, also improves the health care collaboration. Online communities like PathXchange are a step in that right direction.