College of American Pathologists
Printable Version







June 2007

Raymond D. Aller, MD
Hal Weiner

How a Nashville medical center provided solutions to a New York hospital system’s problems

Faced with problems of patient data integration and systems incompatibility, a rural health care system in central New York came to sing the praises of a homegrown software solution born at a medical center in Nashville. Bassett Healthcare, a four-hospital system based in Cooperstown, NY, became the first outside entity to use clinical decision support technology developed over a 10-year period by physicians at Vanderbilt Medical Center. About the same time Bassett was seeking economical solutions to more easily access patient data from various systems, Vanderbilt was looking to market its electronic medical record-based software applications.

“It was really luck to a great extent,” says Henry Weil, MD, Bassett’s director of hospital services, referring to how the partners met.

Dr. Weil learned about Vanderbilt’s software while attending the medical center’s information technology “boot camp,” which focused on choosing the right commercial information systems vendor. “And, in doing so, they were telling us about their own innovative approach,” explains Dr. Weil, who is also Bassett’s director of medical informatics. “And it was just obviously very successful in a complex shop and had the kind of plasticity that we were looking for.”

Vanderbilt, which has four hospitals, 120 outpatient practices, and about 1,000 physicians, created a separate company, Informatics Corporation of America, or ICA, to license the software. Bassett arranged to be the first unrelated site to use the full set of applications.

The base application involves an electronic health record that takes data from any system to provide a single point of access for comprehensive patient information, explains Gary Zegiestowsky, CEO of ICA. Additional tools provide documentation and communication functions, along with disease-management and monitoring capabilities.

“So, it’s everything from how do I document a visit if I don’t have a tool to do that, to how do I communicate with another physician [for] a consult or referral, up to how do I proactively manage my diabetes population,” Zegiestowsky says. The electronic health record application was rolled out over a six-week period beginning in mid-January at Bassett’s main hospital in Cooperstown, two other satellite hospitals, and 23 regional health centers. The additional applications are slated to be installed by the first quarter of 2008, Zegiestowsky says.

Zegiestowsky and Dr. Weil agree that the initial rollout went smoothly. “What was most successful about it is we accomplished that deployment across about 300 providers in a very abbreviated time frame, but we also did it with no lost clinic or inpatient time,” Zegiestowsky says.

“One reason we can implement pretty quickly and do it cost effectively is because we are building on existing systems,” he adds. “So, we’re not replacing what you have—we’re just building on it.”

Bassett continues to run its established systems alongside the new EMR because its approach to early adoption allows people to migrate to the EMR by choice, says Dr. Weil. The technology was so intuitive, he adds, “that our system of training was to maybe spend half an hour or 40 minutes with three or four providers at a time, then follow them in the clinic for half a day, and then leave.”

Bassett has already achieved an adoption rate of more than 90 percent. And at least 60 percent of those trained on the electronic health record application use it as their primary access point for patient information, Dr. Weil continues. “And that’s better than I had hoped, really. I’m extremely pleased with how it’s come out,” he says.

Bassett will eventually mandate use of the EMR, but by then, says Dr. Weil, “the value in the EMR and the resulting excessive majority of users will lessen the resistance amongst folks who always have trouble moving.” What is really appealing about the technology, adds Dr. Weil, is how the different systems are interfaced so data from each of them can be reached from a single repository. Vanderbilt developed, and Bassett worked with Vanderbilt to refine, a user interface that sits on top of that repository. This allows users to see the data that have been interfaced in one place.

For example, says Dr. Weil, there is a tab for anatomic pathology within the patient’s chart that will link the user to the repository for pathology data. “So, you will then be, in a split second, looking at only the list of anatomic path samples that have been read for that patient.”

Dr. Weil is optimistic that future applications, such as genomics, will also fit into the system. “We’re [no longer] a hostage to a single enterprise-wide vendor, or even to three vendors,” he adds. “We’re just not a hostage anymore.”

ICA is in the final stages of signing additional prospects to license its software.

Aperio ups support for TIFF, donates to public domain

Aperio Technologies has implemented support for BigTIFF-Tagged Image File Format for files larger than 4 GB across all its products and systems. The company also announced that it has donated these enhancements to the public domain and is working with the TIFF standards body to incorporate them into a future standard release. This enhancement to the TIFF standard allows image files larger than 4 GB to be created and processed in a backward-compatible fashion. “Aperio believes strongly in open standards and anticipates that with this enhancement, TIFF will continue to be the standard for storing and managing very large images, such as digital slides,” says Ole Eichhorn, chief technology officer for Aperio.

Aperio has created a new version of libtiff, an open-source cross-platform library that enables applications software to read and write images stored as TIFF files, to support BigTIFF files. The new version is backward-compatible with previous versions. In many cases, applications software will not have to be changed to create and process BigTIFF files. Aperio has posted information about BigTIFF, including an overview of the changes, sample BigTIFF images, source code and library downloads, and technical details of the changes. Aperio also offers a demonstration of the new capabilities of libtiff at The demonstration can be viewed in any standard Web browser using Aperio’s image-viewing technology.

Brother offers laboratories slide label printing system

Brother International Corp. has introduced a laboratory slide label printing solution that includes its new 23-mm DK-1221 slide labels. Health care professionals can print customized 23-mm laboratory slide labels and a variety of other label sizes in seconds from the Brother QL Series label printers. Users can print labels from a number of applications, including Brother P-touch Editor labeling software, PathLogix anatomic pathology software, MS Word, Excel, and Access. Brother includes P-touch Editor with every Brother QL Series label printer.

Eclipsys introduces blood bank automation software

Eclipsys Corp. has received FDA 510(k) clearance to market its PowerBank Enterprise Edition to hospitals.

PowerBank Enterprise Edition is designed to automate the functions of a hospital blood bank. It is a component of the Eclipsys Sunrise Laboratory information system.


Meditech recently contracted for its fully integrated Magic health care information system with Sunnyview Rehabilitation Hospital, Schenectady, NY.

Meditech also announced that it has contracted for its client/server health care information system with Doctor’s Hospital, Bridgeport, Tex., Miami (Fla.) Jewish Home and Hospital for the Aged, and Christus Health, Houston. Christus will employ the system at Christus Santa Rosa Health Care, San Antonio.

Mediware Information Systems has licensed its HCLL donor blood management product to MCG Health, a not-for-profit corporation that operates the MCG Medical Center, MCG Children’s Medical Center, MCG Sports Medicine Center, MCG Ambulatory Care Center, Georgia Radiation Therapy Center, and related clinical facilities.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles County Public Health Acute Communicable Diseases. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at