Journal Article
. 2016 May; 7:23.
doi: 10.4103/2153-3539.181767.

Digital pathology and anatomic pathology laboratory information system integration to support digital pathology sign-out

Huazhang Guo 1 Joe Birsa 2 Navid Farahani 1 Douglas J Hartman 1 Anthony Piccoli 3 Matthew O'Leary 3 Jeffrey McHugh 3 Mark Nyman 2 Curtis Stratman 2 Vanja Kvarnstrom 2 Samuel Yousem 1 Liron Pantanowitz 1 
  • PMID: 27217973
  •     14 References
  •     12 citations


Background: The adoption of digital pathology offers benefits over labor-intensive, time-consuming, and error-prone manual processes. However, because most workflow and laboratory transactions are centered around the anatomical pathology laboratory information system (APLIS), adoption of digital pathology ideally requires integration with the APLIS. A digital pathology system (DPS) integrated with the APLIS was recently implemented at our institution for diagnostic use. We demonstrate how such integration supports digital workflow to sign-out anatomical pathology cases.

Methods: Workflow begins when pathology cases get accessioned into the APLIS (CoPathPlus). Glass slides from these cases are then digitized (Omnyx VL120 scanner) and automatically uploaded into the DPS (Omnyx(®) Integrated Digital Pathology (IDP) software v.1.3). The APLIS transmits case data to the DPS via a publishing web service. The DPS associates scanned images with the correct case using barcode labels on slides and information received from the APLIS. When pathologists remotely open a case in the DPS, additional information (e.g. gross pathology details, prior cases) gets retrieved from the APLIS through a query web service.

Results: Following validation of this integration, pathologists at our institution have signed out more than 1000 surgical pathology cases in a production environment. Integration between the APLIS and DPS enabled pathologists to review digital slides while simultaneously having access to pertinent case metadata. The introduction of a digital workflow eliminated costly manual tasks involving matching of glass slides and avoided delays waiting for glass slides to be delivered.

Conclusion: Integrating the DPS and APLIS were instrumental for successfully implementing a digital solution at our institution for pathology sign-out. The integration streamlined our digital sign-out workflow, diminished the potential for human error related to matching slides, and improved the sign-out experience for pathologists.

Keywords: Digital pathology; integration; interface; laboratory information system; whole slide imaging.

Implementation of whole slide imaging in surgical pathology: A value added approach.
Mike Isaacs, Jochen K Lennerz, +3 authors, John D Pfeifer.
J Pathol Inform, 2011 Oct 05; 2. PMID: 21969920    Free PMC article.
Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.
Jonhan Ho, Stefan M Ahlers, +6 authors, Anil V Parwani.
J Pathol Inform, 2014 Sep 25; 5(1). PMID: 25250191    Free PMC article.
Digital imaging in pathology.
Seung Park, Liron Pantanowitz, Anil Vasdev Parwani.
Clin Lab Med, 2012 Oct 20; 32(4). PMID: 23078660
Whole-slide imaging: routine pathologic diagnosis.
Toby C Cornish, Ryan E Swapp, Keith J Kaplan.
Adv Anat Pathol, 2012 Apr 14; 19(3). PMID: 22498580
Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013.
Sten Thorstenson, Jesper Molin, Claes Lundström.
J Pathol Inform, 2014 May 21; 5(1). PMID: 24843825    Free PMC article.
Digital imaging and electronic patient records in pathology using an integrated department information system with PACS.
Thomas Kalinski, Harald Hofmann, Dagmar-Sybilla Franke, Albert Roessner.
Pathol Res Pract, 2002 Dec 25; 198(10). PMID: 12498223
Going fully digital: Perspective of a Dutch academic pathology lab.
Nikolas Stathonikos, Mitko Veta, André Huisman, Paul J van Diest.
J Pathol Inform, 2013 Jul 17; 4. PMID: 23858390    Free PMC article.
21(st) century workflow: A proposal.
Jeffrey L Fine.
J Pathol Inform, 2014 Dec 24; 5(1). PMID: 25535592    Free PMC article.
Picture archiving and communication systems in digital cytology.
Sandra Morelli, Mauro Grigioni, +2 authors, Daniele Giansanti.
Ann Ist Super Sanita, 2010 Jun 23; 46(2). PMID: 20567063
A PACS maturity model: a systematic meta-analytic review on maturation and evolvability of PACS in the hospital enterprise.
Rogier van de Wetering, Ronald Batenburg.
Int J Med Inform, 2008 Aug 30; 78(2). PMID: 18752988
Systematic Review.
Anatomic pathology laboratory information systems: a review.
Seung Lyung Park, Liron Pantanowitz, Gaurav Sharma, Anil Vasdev Parwani.
Adv Anat Pathol, 2012 Feb 09; 19(2). PMID: 22313836
Optimizing the pathology workstation "cockpit": Challenges and solutions.
Elizabeth A Krupinski.
J Pathol Inform, 2010 Oct 30; 1. PMID: 21031008    Free PMC article.
Standards to support information systems integration in anatomic pathology.
Christel Daniel, Marcial García Rojo, +5 authors, Bruce A Beckwith.
Arch Pathol Lab Med, 2009 Nov 06; 133(11). PMID: 19886721
Linking whole-slide microscope images with DICOM by using JPEG2000 interactive protocol.
Vilppu J Tuominen, Jorma Isola.
J Digit Imaging, 2009 May 06; 23(4). PMID: 19415383    Free PMC article.
Enterprise Implementation of Digital Pathology: Feasibility, Challenges, and Opportunities.
D J Hartman, L Pantanowitz, +3 authors, G R Lauro.
J Digit Imaging, 2017 Jan 25; 30(5). PMID: 28116576    Free PMC article.
Turning Microscopy in the Medical Curriculum Digital: Experiences from The Faculty of Health and Medical Sciences at University of Copenhagen.
Ben Vainer, Niels Werner Mortensen, +4 authors, Flemming Fryd Johansen.
J Pathol Inform, 2017 Apr 07; 8. PMID: 28382225    Free PMC article.
Digital pathology imaging as a novel platform for standardization and globalization of quantitative nephropathology.
Laura Barisoni, Charlotte Gimpel, +8 authors, Stephen M Hewitt.
Clin Kidney J, 2017 Jun 07; 10(2). PMID: 28584625    Free PMC article.
Digital pathology in nephrology clinical trials, research, and pathology practice.
Laura Barisoni, Jeffrey B Hodgin.
Curr Opin Nephrol Hypertens, 2017 Sep 01; 26(6). PMID: 28858910    Free PMC article.
Routine Digital Pathology Workflow: The Catania Experience.
Filippo Fraggetta, Salvatore Garozzo, +2 authors, Esther Diana Rossi.
J Pathol Inform, 2018 Feb 09; 8. PMID: 29416914    Free PMC article.
Implementing the DICOM Standard for Digital Pathology.
Markus D Herrmann, David A Clunie, +19 authors, Jochen K Lennerz.
J Pathol Inform, 2018 Dec 12; 9. PMID: 30533276    Free PMC article.
Implementation of Digital Pathology Offers Clinical and Operational Increase in Efficiency and Cost Savings.
Matthew G Hanna, Victor E Reuter, +9 authors, S Joseph Sirintrapun.
Arch Pathol Lab Med, 2019 Jun 08; 143(12). PMID: 31173528    Free PMC article.
A Regulatory Science Initiative to Harmonize and Standardize Digital Pathology and Machine Learning Processes to Speed up Clinical Innovation to Patients.
Hetal Desai Marble, Richard Huang, +14 authors, Jochen K Lennerz.
J Pathol Inform, 2020 Oct 13; 11. PMID: 33042601    Free PMC article.
A literature review of quality, costs, process-associated with digital pathology.
Yoo Jung Kim, Eul Hee Roh, Sangchan Park.
J Exerc Rehabil, 2021 Mar 18; 17(1). PMID: 33728283    Free PMC article.
Artificial Intelligence in Pathology: From Prototype to Product.
André Homeyer, Johannes Lotz, +5 authors, Peter Hufnagl.
J Pathol Inform, 2021 May 21; 12. PMID: 34012717    Free PMC article.
Dissecting the Business Case for Adoption and Implementation of Digital Pathology: A White Paper from the Digital Pathology Association.
Giovanni Lujan, Jennifer C Quigley, +16 authors, Doug Bowman.
J Pathol Inform, 2021 Jul 06; 12. PMID: 34221633    Free PMC article.
A Survival Guide for the Rapid Transition to a Fully Digital Workflow: The "Caltagirone Example".
Filippo Fraggetta, Alessandro Caputo, +3 authors, Vincenzo L'Imperio.
Diagnostics (Basel), 2021 Oct 24; 11(10). PMID: 34679614    Free PMC article.