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Enterprise Imaging: Pathological Slide Wars?

September 28, 2017
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For several years the prospect of true enterprise imaging applications has been evasive.  Enterprise imaging can be thought of as an extension of classical imaging areas such as radiology picture archiving and communications systems (PACS), or cardiovascular PACS applications.  Many would describe this as the application of vendor neutral archives (VNA) and universal viewers (UV) to other imaging areas such as visible light images. 

While some have tried within the industry, there to date have not been areas of sufficient interest or need to act as a breakthrough to justify expansion of PACS beyond the classical imaging areas.  Most enterprise imaging efforts have instead been initiatives to replace individual PACS archives and clinical viewers with centralized applications. 

All that is potentially about to change.  In April, 2017 the U.S. Food and Drug Administration (FDA) approved the marketing of the Philips IntelliSite Pathology Solution (PIPS).  This is the first whole slide imaging (WSI) system that allows for review and interpretation of digital surgical pathology slides prepared from biopsied tissue.  

According to one study, the global digital pathology market was valued at more than $350 million in 2016 (http://www.grandviewresearch.com/industry-analysis/digital-pathology-systems-market).  The U.S. market is expected to be the largest market for digital pathology. 

The key to digital pathology will be the slide digitizer, which may account for a significant portion of the market.  The addition of digital pathology will itself create greater demand for enterprise imaging, vendor neutral archives primarily.  Given the size of a digitized pathology slide, this will be a significant increase in storage requirements. 

While other areas such as dermatology, ophthalmology, etc. offer the potential for enterprise imaging applications, digital pathology’s requirements are potentially larger.  FDA approval is what pathologists have been waiting for in the U.S., and this will open the floodgates for expansion.  What do facilities need to do to prepare? 

First and foremost, facilities need to entertain implementation of a true enterprise imaging application, as opposed to creating yet another silo of data.  While digital pathology may not put a large demand on enterprise image viewing, it would still make sense to implement an enterprise application, as it will position the organization for additional future applications. 

Pathology is similar to other “ology” areas in that there is no order management process for such studies.  There will therefore need to be some mechanism for identifying the pathology exam so it can be associated with the correct patient, and become part of the patient’s “clinical content.” 

Facilities will need to identify how many pathology studies are done to size enterprise archive storage requirements, and they will also need to establish storage rules for slides, which may vary from other service lines. 

It is best for IT departments to be proactive about digital pathology, now that the cat is out of the bag.  Making plans now to accommodate the inevitable will in the long run produce a better enterprise solution.  Let the “slide wars” begin!

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