College of American Pathologists
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August 2006

Raymond D. Aller, MD
Hal Weiner

How two hospitals are using video technology to share interpreters
Misys releases new version of laboratory information system
Clarient to purchase Trestle Holdings
Web-based anatomic pathology practice management system
ASTM International endorses SNOMED CT
Cardinal Health acquires MedMined
Bio-Rad enhances quality control portal
New digital pathology software for educators

bullet How two hospitals are using video technology to share interpreters

Faced with declining resources, two California hospitals in racially and ethnically diverse areas 30 miles apart have teamed up to share interpreter services via videoconferencing technology.

San Francisco General Hospital and Alameda County Medical Center, Oakland, have extensive interpreter programs, but the ever-present threat of cutting departments that don’t generate revenue prompted the two to consider sharing services for languages that are of low demand, says Gloria Garcia Orme, who directs interpreter services for San Francisco General.

“Both of us don’t have to have, for example, a Serbo-Croatian interpreter or a Hindi interpreter,” she says, explaining that for such languages one interpreter could be used for both hospitals. “So, we really save each other money and are making an effort to be more financially responsible.”

Last year the hospitals received a grant from The California Endowment, a Los Angeles-based private health foundation, to test transmission technology that would allow patients and providers at one place to “meet” with an interpreter at the other. The process, referred to as videoconferencing medical interpretation, or VMI, incorporates the use of a video monitor at both hospitals. The video is transmitted via a T-1 line between the two hospitals, explains Bruce Occena, a program coordinator with the Health Access Foundation, Sacramento, which provides consulting services for the project.

The project has gone smoothly in part because the two providers have a similar demographic makeup. Both are county hospitals with large populations of limited-English-proficient patients. San Francisco General has 21.6 full-time-equivalent interpreters as well as on-call interpreters who provide services for 43 languages, the most common of which are Cantonese, Mandarin, Vietnamese, Spanish, and Russian. Alameda employs 23 interpreters at its Highland Hospital and 21 in its community clinics. Spanish and Chinese are two of the more prevalent languages among the medical center’s patient population.

When an interpreter is needed, the requesting department calls the hospital’s interpreter dispatcher, who in turn contacts the appropriate interpreter. However, the interpreter is not made available until the physician and patient are ready at the other end. “There’s a lot of waiting involved when [the session] is in person. With VMI, you cannot call unless the provider is right there in the room,” Garcia Orme says.

During the testing phase, San Francisco General and Alameda have connected to share interpreter services twice a week. “So far, it’s worked out really well,” says Garcia Orme. “It’s really exciting technology, and we’re very happy with it.”

The testing phase has gone smoothly, confirms Health Access Foundation’s Occena, adding that the two hospitals were more concerned about differences in the styles of their interpreter sessions than technical difficulties. “There is no problem there,” he says.

The testing phase of the program is scheduled to end late this summer, with routine interpreter exchanges between the hospitals jumping from two to five days a week. San Francisco General is in the process of outfitting its ambulatory care clinics and three of its 10 community health centers with the VMI equipment. Alameda uses the technology at one of its hospitals and all of its community clinics. Future plans at both organizations call for outfitting the emergency rooms and installing the equipment or expanding its use in inpatient care units.

The technology for the project is supplied by Tandberg, Oslo, Norway, and Cisco Systems, San Jose, Calif.

bullet Misys releases new version of laboratory information system

Misys Healthcare Systems has introduced Misys Laboratory 6.2, an enhanced version of its Misys Laboratory system.

Enhancements to Misys Laboratory 6.2 include updates to outreach, microbiology, blood bank, blood donor and specimen management, routing and tracking, and the general lab application. Misys Laboratory 6.2 also includes comprehensive business intelligence tools, with reports for patient data analysis, as well as client problem tracking to provide personalized service to physicians and primary caregivers.

bullet Clarient to purchase Trestle Holdings

Clarient has entered a definitive agreement with Trestle Holdings to purchase substantially all of Trestle’s assets.

Clarient, a provider of cancer diagnostic services, will offer Trestle’s technology along with its own automated cellular image analysis systems. Clarient will acquire Trestle’s product line and inventory, including virtual systems, as well as manufacturing capabilities, high-speed scanning technology, and related intellectual property.

“This acquisition will provide Clarient with the capacity to provide a virtual pathology network linking Clarient with our customers, regardless of location, and allowing international access to our expert pathologists,” says Kenneth J. Bloom, MD, Clarient’s chief medical officer.

bullet Web-based anatomic pathology practice management system

WebPathLab’s Web-based anatomic pathology practice management system provides a variety of clinical and billing functionality.

The system offers online reporting with organ maps. Referring physicians can view a report online or by fax immediately following diagnosis. The organ map feature allows pathologists to provide a detailed diagram with point-and-click capabilities.

With a built-in wysiwyg editor, image uploader, and PDF report generator, transcriptionists can use WebPathLab to create professional reports in various file formats ready for delivery. With the integrated billing component, staff can submit bills electronically in standard ANSI format for direct billing or insurance claims.

bullet ASTM International endorses SNOMED CT

ASTM International’s Committee E31 on Healthcare Informatics has cited SNOMED International’s SNOMED Clinical Terms, or SNOMED CT, as a preferred controlled vocabulary for representing data elements in the ASTM Continuity of Care Record.

“The CCR will change the way in which health care professionals preserve and transfer health care information about their patients,” says Franklin R. Elevitch, MD, chair of the SNOMED International Authority, a division of the College of American Pathologists. “Endorsing SNOMED CT for use in the CCR will further improve interoperability for all data exchange in health care,” he adds, “and ultimately help to improve quality of care and enhance patient safety as well as practice efficiency.”

The CCR is a core data set, or patient snapshot, that is sent to health care providers when patients are referred, transferred, discharged, or otherwise access their services. The CCR is intended to reduce medical errors and contain costs by providing practitioners with timely and accurate information at the first patient encounter. SNOMED CT provides the core terminology for the electronic health record.

In a separate announcement, SNOMED International reported that it has signed an agreement with the National E-Health Transition Authority, or NEHTA, that will allow SNOMED CT to be used in health information management throughout Australia.

The agreement gives Australia national access to SNOMED CT and allows NEHTA to pursue its national health information management projects using SNOMED CT.

bullet Cardinal Health acquires MedMined

Cardinal Health recently announced that it has purchased MedMined, a provider of technology and services that identify and prevent hospital-acquired infections.

The acquisition extends Cardinal Health’s portfolio of patient safety solutions for hospital-acquired infections and antimicrobial management. Terms of the agreement were not disclosed.

bullet Bio-Rad enhances quality control portal

Bio-Rad Laboratories has released QCNet version 4.0, the latest edition of its Internet-based laboratory quality control portal, and Unity Real Time, its quality control data-management software.

QCNet version 4.0 offers a new content-management system that provides the latest industry news feeds, expert articles, reference materials, product information and bulletins, continuing education courses, and an events calendar. It also includes links to various professional organizations and international QC content pages.

Unity Real Time helps labs comply with regulatory and accreditation requirements such as ISO 15189 and CLIA. The system can be easily interfaced with existing laboratory information systems and lab instruments to consolidate quality control data-management in one platform.

Unity Real Time provides statistical process control with comprehensive audit trails, facilitates run-time and supervisory data review, offers advanced charts and reports for data analysis, and monitors ongoing performance of quality control rules with analytical goal options. Users can also participate in the Unity interlaboratory program to compare laboratory QC results against large peer groups. Unity Real Time can be used with the Westgard Advisor add-on module to automatically recommend and implement QC rules for each test.

bullet New digital pathology software for educators

Aperio Technologies’ new KickStart Software for Educators allows educators to create, annotate, and share digital slides in a Web-based setting. The software provides a simple means for instructors and students to view and share digital slides. The package offers scanning for 50 glass microscope slides, instructions for configuring customers’ third-party Web server software, software for local and remote viewing of digital slides, and Aperio’s Digital Slide Studio software for creating publication-quality digital images.

The software works on an open-platform, third-party, commercial Web server, which allows users to view images remotely over a network or standard server. The viewing software does not require a license fee. Instructors can post digital slides for subsequent discussion that a student can access easily from any location. Aperio’s ImageScope viewing software, included with KickStart, allows users to rapidly access any portion of a digital slide at any magnification.

bullet Contracts

Fletcher-Flora Health Care Systems has contracted for its LabPak laboratory information system with Southwestern Virginia Mental Health, Marion; Dandridge (Tenn.) Family Practice Center; and Baptist Memorial Hospital, Huntingdon, Tenn.

Banco de Sangre de Servicios Mutuos, San Juan, Puerto Rico, has signed an agreement to purchase Information Data Management’s IDM Select Series blood center information system and Prelude donor room management system. The blood bank supports more than 20 hospitals in Puerto Rico.

The University of Pittsburgh Medical Center has announced that it is implementing TheraDoc’s Expert System Platform, Antibiotic Assistant, Infection Control Assistant, and Intervention Assistant.

Vachette Pathology has signed a contract to provide such services as practice management assistance, billing auditing, managed care negotiation, and group revenue strategy to Gainesville (Fla.) Pathology Group.

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