The Daily Scan

Kerry Tribe's H.M.

An art installation based on H.M., remarkable:

Kerry Tribe's H.M.

“Earlier this year, I did a bit of technical work for an artist, Kerry Tribe, on her installation/film project called H.M.  It was a remarkable piece.  At its core, it was a documentary about a man who had some experimental neurosurgery that left him with an active memory of 20 seconds.  What made the piece so remarkable was that it played back on two 16mm projectors, the film being delayed by exactly 20 seconds from one to the other.  The film was shot in such a way that the two projections, displaced in time by 20 seconds, worked together uncannily well, sometimes displaying complementary images, and even, in one visually notable part, forming a complete image that spanned over the two screens.  It's pretty great.

Wow, how cool is that?  Cannot wait to see it... stay tuned!

VA's VistA reaches 1B+ images

Wow, HealthImaging reports VA's VistA reaches 1B+ images.

The Department of Veterans Affairs (VA) has reported that VistA Imaging, the medical and healthcare imaging system used in VA medical centers, attained more than one billion stored images in July.

The imaging system captures clinical images, scanned documents, motion video and other non-text data, as well as makes them part of a patient's EHR.  In the course of serving 1.2 million patients a month, the department said it stores 20-25 million images in the VistA Imaging system.  In 2009, a total of 290 million images is expected to be stored.  Storage space in use today is approximately one petabyte, or one million gigabytes.

That's amazing and impressive... just wait until they start including digital pathology images!

Digital IHC - going international!

You may know, Aperio has a comprehensive product for Digital IHC.

What you may not know is that we have translated the product overview video into several different languages:

English	Digital Pathology - What does going digital look like to a pathologist? (English)
German	Digitale Pathologie - Wie sieht die Arbeit eines Pathologen am Bildschirm aus? (Deutch)
French	Pathologie Numérique - A quoi ça ressemble à un pathologiste? (Français)
Spanish	Patología Digital - De cómo lo hace parecerse a un patólogo? (Español)
Portuguese	Como é que pareço para um patologista? (Português) (Português)

Please enjoy in the language of your choice!

chalk tip #23: viewing slides using a mouse

Today’s tip is a little different; I want to talk about viewing slides using a mouse.  People often say that a mouse is the wrong tool for navigating through a digital slide.  This leads to discussions about alterative hardware devices for navigation such as joysticks, trackballs, tablets, touchscreens, etc., or more exotic devices such as 3D mice.

It might be that using a joystick, trackball, tablet, touchscreen, etc. would be better for certain users, and Aperio’s ImageScope and WebScope viewing tools support all of these as “mouse replacements” pretty seamlessly.  You can buy a third-party navigation device, plug it in, and poof! you can navigate through digital slides with it.  ImageScope and WebScope leverage the common support for navigation devices provided by Windows and web browsers.

However… when people say a mouse is the wrong tool for navigating through a slide, what they really mean is that dragging the image is the wrong way to navigate through a slide.  And this is undoubtedly true!  Imagine trying to view a whole digital slide that way; click drag release move-back, click drag release move-back, click drag release move-back.  My wrist hurts just typing those words!

Fortunately ImageScope provides many better ways to navigate, some of which were the subjects of previous Chalk Tips:

Mouse

• Move the mouse to an edge of the image; it will turn into an arrow, then click down to scroll the image.

• Drag the mouse over the thumbnail to move the current view.

• Use Autopan: your mouse becomes a joystick for panning around within an image.  (chalk tip #16: ImageScope joystick mode).

• Click the Tracker’s “Next Un-viewed Region” button to show the entire slide, view-by-view.  (chalk tip #20: systematically viewing all of a slide).

Keyboard

• Use the Arrow keys to scroll the image.

• Hold down the Shift key while typing Arrows to move the image exactly one field.  (chalk tip #2: fast panning field by field).
  
  (the combination of Arrow keys with Shift-Arrows is incredibly efficient, and does not require a mouse.  Try it!)

• Hit the Space Bar as a shortcut for the Tracker’s “Next Un-viewed Region” button.  (chalk tip #20: systematically viewing all of a slide).

Each of these ways can be combined with the Tracker so you can see where you’ve been.  (chalk tip #19: tracking where you've been while viewing).

WebScope also provides better ways to navigate:

Mouse

• Click the Arrow icons in the Toolbar to scroll the image.

• Drag the mouse over the thumbnail to move the current view.

Keyboard

• Use the Arrow keys to scroll the image.

• Hold down the Shift key while typing Arrows to move the image exactly one field.
  
  (the combination of Arrow keys with Shift-Arrows is incredibly efficient, and does not require a mouse.)

People always start by dragging the image for navigating; it is a natural thing to do (and it does work).  But one or more of the techniques listed above are much more efficient for navigating.  Please try them yourself!  (Oh, and next time you hear someone comment that a mouse is the wrong tool for navigating through a slide, please suggest they try some of these other ways to navigate!)

PS as always please feel free to comment with your questions and suggestions.

CellScope, the cellphone microscope

This is pretty amazing: CellScope, the cellphone microscope, now with a UV upgrade:

This device is shown with a Nokia N73, but presumably it can be used with other smartphones that have decent cameras and can capture video, such as the Apple iPhone or Palm Pre.  It isn't clear whether such a device can really offer diagnostic resolution, but if it doesn't today it will only be a matter of time before successors can in the near future.  Very cool.

[Update: HealthImaging asks Can docs accurately diagnose CAD on an iPhone?  The answer seems to be... yes...]

the bio-comedian

TheScientist has a rather entertaining article about The bio-comedian; ecologist-turned-comedian Tim Lee.  "I think the concept of combining Powerpoint with comedy is long overdue".

Here's a YouTube clip of Tim's powerpoint humor...

I love it :)

Johns Hopkins University to offer health informatics degree

Wow, this is cool; MSN Money reports Johns Hopkins University to offer health informatics degree:

Johns Hopkins University is debuting a new master’s degree in health informatics this fall.  The one-year program at the medical school will train students on how to develop information systems used in hospitals, clinics and public health settings.

...

The masters in science degree is one of several new programs the school’s division of health sciences informatics is developing.  The need for additional training in health informatics will grow as policy makers encourage greater use of information technology in health care.  The federal stimulus program allocated $19 billion for the adoption of electronic medical records.

Interesting but I guess not surprising; as informatics becomes more and more important in health care it is inevitable that medical schools have begun teaching classes in it, and that degrees will be offered in this new field.

Repurposing Outpatient Clinics and Medical Procedure Units as Integrated Diagnostic Centers

I know many of you read Bruce Friedman's excellent blog Lab Soft News, but in case you don't please check out this post: Repurposing Outpatient Clinics and Medical Procedure Units as Integrated Diagnostic Centers:

I have been an advocate of the merger of pathology and radiology into what could be described as the new medical specialty of diagnostic medicine.  This merged specialty can also referred to as integrated diagnostics.  The integration of pathology and radiology is related to the idea of the development of Integrated Diagnostic Centers (IDCs).  These are clinics staffed by multidisciplinary teams and focused on the goal of diagnosing disease faster, better, and less expensively than the norm today.

Fascinating.  I guess if Pathology and Radiology really do merge, then instead of Pathologists and Radiologists we'll have Diagnosticians...

Pathology Visions: Posters and Workshops announced

Outstanding Posters Announced

Pathology Visions will host over 40 poster sessions this year.  Congratulations to the presenters!  To view the list of outstanding poster presentations, visit the Pathology Visions Poster Sessions page.

Attend a Pathology Visions Workshop

The Pathology Visions workshops are a great way to enhance your conference experience.  Workshops are available to registered conference attendees at no additional cost.

• Pre-Conference Workshops (September 13)
  • Aperio Product Workshop
  • Definiens Product Workshop
  • HistoRx Product Workshop
  • IMPAC Product Workshop
  • PDS (Preclinical Data Systems)
• Product Workshop Post-Conference Workshops (September 15-16)
  • Multi-site Integration in a Global Environment
  • Image Analysis Workshop: Pathologist-to-Pathologist

Visit the Pathology Visions Workshop page for a detailed listing of available workshops.

Education Lunch Roundtable

Join us for lunch and a roundtable discussion with your peers about how digital histology and pathology are being used to enhance education.   Topics will include classroom teaching, decision support, proficiency testing, and more.  Seating is limited and RSVP is required.  To reserve your seat, please RSVP to info@pathologyvisions.com with "Education Roundtable" in the subject line.

Please Register Now, and for more information, visit www.pathologyvisions.com.

the age of Health Portals

The Cleveland Clinic has launched Cleveland Clinic Health, a medical portal for consumers.  Sort of a branded WebMd...  and similar in concept and execution to Mayo's MayoClinic.com.  All of these sites target people who are increasingly taking health care into their own hands, bypassing or augmenting their primary care physician.  The days when you went to "your doctor" whenever you had something wrong and s/he told you what to do next are going, if they haven't gone already.

Microsoft's Health Vault is designed to provide tools for these sorts of sites, which will become increasingly "deeper" as they build out from providing generic information to storing specific information.  (Microsoft is studying how to incorporate imaging into Health Vault, for example.)

This trend is going to reinforce Electronic Health Record systems used by physicians and labs to communicate with each other; patients are increasingly becoming an important third constituency for these systems.  And of course the ARRA is providing a lot of funding to boost adoption of EHR.

It is hard to see where it is all going - I guess it is going in several directions at once - but it is clear that more electronic records online means more demand for digitizing health information, and more value delivered by digital pathology.