Recent advances in standards for collaborative Digital Anatomic Pathology

Abstract

ContextCollaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive.ObjectiveTo define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities.MethodsSpecific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise.ResultsThe DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile “Anatomic Pathology Structured Report” (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts.ConclusionRecent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured reports that are interoperable at an international level. The use of machine-readable format of APSR supports the development of decision support as well as secondary use of Anatomic Pathology information for epidemiology or clinical research.

Standardization Efforts of Digital Pathology in Europe

“…The main research was conducted in the following. IHE Anatomic Pathology has proposed an Anatomic Pathology Structured Report (APSR), based in HL7 Clinical Document Architecture (CDA) [1,2]. In this document, anatomic pathology observations (e.g., breast-specimen collection procedure) and the possible values (e.g., breast excision without wire-guided localization) have been coded using the PathLex coding system.…”

Challenges in the Pathology of Non–Muscle-invasive Bladder Cancer: A Dialogue Between the Urologic Surgeon and the Pathologist

“…However, some urologists and pathologists may find electronic systems less convenient than paper, especially considering the time needed to set them up and train staff. Multiple groups have endeavored to define a common structured data format for oncologic pathology reporting 42,43 and templates from CAP are now widely used. Several studies have shown that using voice recognition technology shortened turnaround time while reducing transcription errors.…”

Digital Pathology: Data-Intensive Frontier in Medical Imaging

“…Numerous protocols have been developed to manage and exchange healthcare information, including the Digital Image Communications in Medicine (DICOM) [72]–[74] in radiology and Health Level Seven (HL7) [18], [73], [74] for clinical data. Nomenclature methods have also been developed to establish a lingua franca for the terminology in data exchange, including Logical Observation Identifier Names and Codes (LOINC) [32] and Unified Medical Language System (UMLS).…”