Digital Pathology for Improved Patient Care

Ole EichhornChief Technology Officer, Aperioole@aperio.com

Pathology VisionsOctober 2010

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glassslide

Optical Microscopy Digital Pathology

Digital slide

• Requires microscope to view• One slide at a time• Limited to manual analysis• Burdensome archival & retrieval• Remote viewing not possible• Standalone• A “piece of the puzzle”

• View via computer monitor• Multi-slide integrated viewing• Analyze by software algorithms • Instant archival & retrieval• View anywhere, anytime• Integrated with LIS• Supports consolidated viewing

Digital Pathology…

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… for Improved Patient Care

Education

Research

Clinical

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Educationapplications for Digital Pathology

• Digital Teaching Sets• Annotations• Interactive Teaching Tools• Remote Viewing /

Conferencing

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Researchapplications for Digital Pathology

• Drug Discovery• Tissue Microarrays• Biomarker Analysis• Peer Review

• Preclinical Studies• Predictive Toxicology• Automated Screening• Remote Viewing / Conferencing

• Clinical Studies• Propagate Standards• Remote Viewing / Conferencing

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Lab Anatomic Pathology Workflow

Slide Preparation

Sample* Collection

Order Additional Tests

Algorithm Analysis

Frozen Sections

Gross Exam Case ReviewCase Assembly

Tumor Board

Present Diagnosis to Patient

Internal / ExternalConsult

Release Result

Retrieval of Past Cases

Storage and Archiving

Discuss Case with Clinician

Patient Referrals

Incoming

Histology Lab, In-hospital or outsourced

At academic center, resident reviews case prior to anatomical pathologist

For clinical and educational use

Start here

Lab AP Workflow

Sample* Collection

Frozen Sections

Gross ExamSample* Collection

Frozen Sections

Slide Preparation

Gross ExamSample* Collection

Inter-OperativeConsults

Order Additional Tests

Slide Preparation

Gross ExamSampleCollection

Outgoing

Storage and Archiving

Retrieval of Past Cases

Storage and Archiving

Tumor Board

pre-diagnosis

Internal / ExternalConsult

prognostic

Algorithm Analysis

post-diagnosis

Case Review

Inter-OperativeConsults

Case Assembly

Present Diagnosis to Patient

Discuss Case with Clinician

reporting

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Archival / Retrievalsave consult cases – risk management

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Archival / Retrievalmanage active cases

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Archival / Retrievalresident teaching sets

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Archival / Retrievalcase archives – decision support

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Archival / Retrievalvalue of Digital Pathology

• Risk Management• Easily retrieve all case information

• Decision Support• Instantly retrieve / compare to previous cases for same patient

• Quality Control• Simplifies selection / routing of cases

for internal overreads

• Clinician Communications• Improves turn around time for patients

• Education• Involve residents in review of cases

when not physically presentpathology reading lab, major medical center

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Intra-Operative Consultsreduce travel, simplify logistics

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Intra-Operative Consultsremote interpretation

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Intra-Operative Consultsvalue of Digital Pathology

• Enables remote interpretation• Reduces travel / simplifies logistics• Enables realtime consultation with colleagues or specialists• Save / replay sessions for resident training

surgical pathology lab at major cancer center

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Tumor Boardspreparation

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Tumor Boardsremote access / participation

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Tumor Boardsvalue of Digital Pathology

• Reduce time / simplify process for preparation• Enable remote access / participation• Improve presentation of case information

access all slides for case, display interactively

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Consultationsshipping and handling

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Consultationsrouting

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Consultationsvalue of Digital Pathology

• Faster turn around time, leads to competitive advantage• Improved workflow• Save cost / effort of mailing cases• Permanent record of consultation• Physical slides never lost

consult cases ready to ship at major medical center

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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IHC Quantificationworkflow and accuracy

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IHC Quantificationvalue of Digital Pathology

• Faster turn around time, leads to competitive advantage

• Improved workflow• More accurate results,

leads to improved patient care• Attractive reports

Digital IHC quantification is U.S. FDA approved

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Digital SignoutPathologist’s cockpit

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Clinicalapplications for Digital Pathology

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification• • Digital Signout

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Digital Pathology for Improved Patient Care

Education Clinical• Digital Teaching Sets• Annotations• Interactive Teaching Tools• Remote Viewing / Conferencing

Research• Drug Discovery

• Tissue Microarrays• Biomarker Analysis• Peer Review

• Preclinical Studies• Predictive Toxicology• Automated Screening• Remote Viewing / Conferencing

• Clinical Studies• Propagate Standards• Remote Viewing / Conferencing

• Archival / Retrieval• Risk Management• Decision Support• Quality Control• CAP / CLIA Compliance• Clinician Communication• Education

• Intra-Operative Consults• Tumor Boards• Consultations• IHC Quantification