Entscheiderfabrik honours health projects

Digital pathology offers faster, more reliable and reproducible results. Replacing conventional microscopy with computer screen-based findings in conjunction with digital data management promises numerous advantages, such as reducing errors by, for example, mixing up diagnoses.

The team, consisting of industry (Hamamatsu Photonics, Sectra Medical Systems), hospitals (University Hospital Cologne, Hospital Ludwigshafen, Hospital Rechts der Isar as well as the Pathology Department of the Technical University Munich) and an accompanying consultancy (Vosseler Consulting), started with the title: "Digitalization of Pathology – complete electronic workflow with all case-relevant histological slides for digital and thus location-independent reporting".

Future challenges for pathology

In Germany, pathologies are one of the last clinical disciplines that do not yet allow a completely digital processing of a case. Up to now, microscopes have been used for the evaluation of tissue samples. At the same time, the discipline of pathology will experience new challenges in the coming years, which will mean a strongly increasing workload, for example due to an increase in the number of cancer cases due to the age structure of the population, or due to improved treatment methods that enable the individual patient to survive for a longer period of time after repeated follow-up examinations, but also due to the number of pathologists required due to their age structure in Germany.

The slides produced in the laboratory are digitized using a scanner (generating a so-called “Whole-Slide-Image” (WSI)) and then stored, displayed and distributed in a digital image management system (Pathology PACS). From the IT management system of the pathology or laboratory, all images of the case to be diagnosed are automatically opened at the request of the physician, who performs the diagnosis using case data on the monitor using the digital images and dictates the diagnosis into his system.

Advantages of digitized pathology

A complete digitization of the pathology workflow including the digitization of the pathology slides has the following advantages:

– Fast access to second opinions with low turnaround time without physical exchange of slides

– Distributed workflows with flexible personnel planning

– Location-independent reporting ("home office"), especially for frozen sections without further transport

– Reduced handling of slides and fast access to digital pre-shots

– Reproducible measurements and counts through digital image analysis algorithms

– Integrated case discussions of all diagnostic departments involved in the patient’s treatment pathway.

There are now installations worldwide in which it has been possible to map the complete pathology workflow using digital systems. Scandinavia, for example, is almost completely digitalized. In Germany, on the other hand, the introduction of new technical possibilities for clinical routine is only taking place hesitantly.

Sectra, together with Whole-Slide Scanner manufacturer Hamamatsu Photonics, provided a fully digital workflow solution consisting of a NanoZoomer S360 and a Sectra Digital Pathology PACS for digitizing a subset of pathology (e.g. breast tissue and prostate samples) in the participating institutes. The workflow was tested and optimized according to the specifications of IHE PaLM. The integration into the existing information systems was implemented using HL7. DICOM was chosen as image format.

In the course of a year, various adjustments to the workflow were completed. The results fully confirm the approaches.

"The award is both an incentive and an outlook at the same time, so that we can build on it and gladly participate in other "competitions" as well," summed up Dr. Erk Klopp and Florian Hein of Hamamatsu Photonics Germany positively.

Entscheiderfabrik GuiG mbH & Co. KG

In accordance with its objectives and the measures taken to achieve them, the ENTSCHEIDERFABRIK has been performing the incubator function for digitization projects in the health care industry since 2006.

– Every year, hospitals choose the five digitization topics of the health care industry

– Hospitals can "test" the digitization topics for 12 months – digitization projects thus make a beneficial contribution to the success of the company

– Clinics can test "great idea" without the risk of misspending money

– IT and medical technology companies receive pilot or reference installations after successful tests

– Clinics and industry achieve a win-win situation.