College of American Pathologists
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May 2009

Raymond D. Aller, MD
Hal Weiner

Patient cases take center stage in online radiology ‘theater’ Patient cases take center stage in online radiology ‘theater’

IBM and Brigham and Women’s Hospital, Boston, are collaborating on a Web-based radiology “theater” in which patients will be the main at-traction.

The technology will allow clinicians in multiple locations to collaborate on a patient’s case using standard browsers. Physicians will be able to review and discuss patient information via live streaming audio and video and simultaneously update patient information.

“The whole idea is to replicate the power of face-to-face communication without sacrificing the quality of human interaction and ensure that the technology doesn’t get in their way,” says David Boloker, chief technical officer for IBM’s Emerging Internet Technology group. Patients will receive better care because physicians are consulting with each other in real time, he adds.

The software is being built on IBM’s experimental Blue Spruce Web-based collaboration platform, which allows for cobrowsing, so multiple users can manipulate a Web page simultaneously. The application pulls together information from various Web sites and integrates it in the browser, much the same way a real estate Web site incorporates such information as geographical maps and market value data from disparate sources, Boloker says.

Physicians using the theater will be able to make virtual rounds on patients by accessing a secure Web site, where they can review data from CT and MRI scans, EKGs, and blood tests. For example, a radiologist will be able to, from any location, circle an area on a CT image using a mouse. Other physicians, such as a surgeon and pathologist, in different locations will be able to see that circle on their browser, as well as see and hear the radiologist through live streaming, and whiteboard back to the radiologist simultaneously. All data that appear on the Web site are encrypted to protect patients’ privacy and comply with HIPAA regulations, Boloker says.

The project, which began a year ago, is in the prototype stage. The next step involves adapting the technology to meet specific needs, such as those of research projects that share different types of information across multiple sites, says Francine Jacobson, MD, who is collaborating with Boloker to develop the software. Dr. Jacobson, who is a thoracic radiologist at Brigham and Women’s Hospital, foresees an operating room application, where data from the OR could be streamed via cameras into the radiology theater, allowing a surgeon, radiologist, and pathologist to consult on a case in real time.

“The software will be especially helpful as increasing amounts of patient data are stored digitally on electronic medical records,” says Dr. Jacobson. “It’s just like a theater that brings together, in sets and the way the play is constructed, the information you need to follow the story,” she adds.

So far, Boloker says, there have been no major glitches. One concern, however, is whether a user at a remote location, such as a home office, will have enough computer bandwidth to download large image or data files, he notes.

IBM owns the rights to the technology, which is slated to undergo research and proof of concepts for another year. The project may then be handed over to an IBM product group to be developed into marketable software. IBM, which has been working solely with Brigham on this project, is planning to collaborate with other enterprises as well to further develop the technology. Eventually, Boloker says, IBM will work with as many as 10 organizations to determine how the software can be used in various settings.

“We have a lot to learn,” says Boloker, “but we’re pretty far along in terms of what we’ve done and how we’ve done it.”

Novovision offering advanced digital FISH reporting module Novovision offering advanced digital FISH reporting module

Novovision has introduced a fluorescence in situ hybridization test module for its NovoPath anatomic pathology lab workflow management, specimen tracking, and reporting platform.

The new module eliminates the need to manually score Urovysion FISH results on paper charts and scan them as attachments to electronic patient files. With the application, all results are scored digitally, and information can be fully integrated into standard urine cytology test data as well as the comprehensive patient file for immediate reporting and future reference.

A growing number of labs “are utilizing FISH tests along with urine cytology,” says Wally Soufi, CEO of Novovision. “But recording results by hand creates a significant workflow bottleneck and forces labs to work in two different formats. We recognized this as a major gap in the marketplace and jumped in to fill the void with an advanced digital solution.”

The application also includes historical trend graphs to help create a comprehensive anatomic pathology laboratory report.

Telcor and McKesson partner Telcor and McKesson partner

Telcor and McKesson Provider Technologies’ revenue management solutions group have come together to offer Telcor’s billing information system with McKesson’s billing and practice management services.

“With this new relationship, clients will have an additional choice of using -McKesson’s outstanding billing and accounts receivable services coupled with a billing information system that has proven results,” says Mitch Fry, senior vice president of Telcor.

Haemonetics acquires Altivation Haemonetics acquires Altivation

Haemonetics Corp. has purchased Altivation Software, a provider of resource-management systems for the blood banking industry.

Altivation markets Hemasphere, a real-time database that provides a dashboard of operational information for blood center management and automates numerous components of a mobile blood drive.

“As a result of our combination with Haemonetics’ software solutions business, our U.S. marketing is strengthened and we can expand further into global markets,” says Michael Reale, president and CEO of Altivation. “We are pleased to be joining Haemonetics and adding to its portfolio of software applications for improving blood management throughout the entire supply chain continuum.”

Altivation will continue to operate from its headquarters in Chico, Calif.

McKesson introduces software to aid laboratory test ordering McKesson introduces software to aid laboratory test ordering

McKesson Corp. has announced the availability of its advanced diagnostics-management software, which connects pathology laboratories, payers, and clinicians to help physicians order lab tests.

The software, from McKesson’s RelayHealth network, allows providers to gain electronic access to labs’ test catalogs and health plans’ rules for eligibility, automatic preauthorization, network coverage, and price estimation. By connecting to laboratories and payers, providers can inform their patients instantly of how much a test will cost, whether health insurance will cover it, and which laboratories are best qualified to perform the test.

The application includes decision-support software from McKesson’s InterQual unit. InterQual molecular diagnostics criteria cover more than 270 high-volume molecular and genetic tests for in-fectious diseases, oncology, and inherited diseases.

SNOMED, LOINC, and NPU collaborate on terminology SNOMED, LOINC, and NPU collaborate on terminology

The owners of the Logical Observation Identifiers Names and Codes (LOINC), Nomenclature, Properties and Units (NPU), and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) have teamed up to develop standardized laboratory test terminology.

The Regenstrief Institute and LOINC Committee, owners of LOINC; International Federation of Clinical Chemistry and International Union of Pure and Applied Chemistry, owners of NPU; and International Health Terminology Standards Development Organization, owner of SNOMED CT, are undertaking a six-month operational trial to unify their efforts and ensure that SNOMED CT operates effectively with LOINC and NPU.

During the trial, which began April 1, the owners of LOINC and NPU will create new laboratory test terminology. SNOMED CT and LOINC will collaborate to develop laboratory procedure concepts within their respective health care terminologies. LOINC and NPU will create laboratory test terminology content that will be represented in SNOMED CT in a specific hierarchy developed for the trial.

Users of the standards can continue to submit requests for new laboratory test terminology to the appropriate organizations during the trial.

South Plains Biomedical Services to resell Aspyra systems South Plains Biomedical Services to resell Aspyra systems

Aspyra has entered into a nonexclusive 12-month letter of agreement with South Plains Biomedical Services, allowing SPBS to represent and resell Aspyra’s laboratory and radiology information systems and picture archiving and communication systems to SPBS customers.

SPBS services and sells new and refurbished laboratory, medical imaging, biomedical, and surgical instrumentation. With locations through-out New Mexico, Oklahoma, and Texas, SPBS will further extend Aspyra’s reach in the southwestern United States, says Rob Pruter, senior vice president of sales and marketing for Aspyra.

The reseller arrangement is effective until February 2010.

3M contracts with health information exchange 3M contracts with health information exchange

The Louisville Health Information Exchange has selected 3M Health Information Systems to provide an electronic health record banking sys-tem and interoperability solution for exchanging health information across the greater Louisville, Ky., area. 3M and InterComponentWare will design, build, and pilot test the integrated health information network.

Dr. Aller is director of automated disease surveillance and team lead for disaster preparedness Focus B, Los Angeles County Department of Public Health. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at