Introduction
Digital pathology solutions speed up and simplify the access to histopathology. Comprehensive bidirectional integration with a Laboratory Information Management System (LIMS) is essential to optimally benefit from the improvement in efficiency and quality that digital pathology solutions offer.
LabPON (Hengelo, The Netherlands), being one of the first clinical pathology laboratories to have transitioned fully to digital diagnosis, emphasizes the need for bidirectional integration.
“In transferring from conventional microscopic evaluation of slides to digital viewing we have found a comprehensive integration our Image management System (IMS) and our Laboratory Information Management System (LIMS) essential for patient safety. Moreover, good integration results in further time savings and higher accuracy in the overall process”
At LabPON, every day material arrives from three hospitals and from regional general practitioners. After processing of the material and staining, the slides are dispatched to all pathologists present that day and a diagnosis is made and reported. Digitization of slides was implemented to increase efficiency and reduce the shortcomings of a traditional analog pathology work flow. The Finalist LIMS was already used for a long time to handle specimens in the lab and to track the steps in processing from arrival and registration of a case up until sending of the final report to the requesting physician. To ensure efficient and secure data handling, an adjusted workflow was essential. LabPON was able to create a workflow in which LIMS and IMS are communicating and sharing information bi-directionally. In practice, the use of barcodes ensures that tissue is traceable during the entire route. Every step in the process is logged;from the entry of patient data and clinical information until the authorization of the final report. The barcode generated by the Finalist LIMS is read by the Philips Ultra Fast Scanner (UFS). The barcode information and the image data as yielded by the UFS are coupled by the Philips Image Management System (IMS) server. The IMS in turn exchanges information with the LIMS server. The UFS and IMS are part of Philips IntelliSite Pathology Solution, an open platform for digital pathology. The information transferred to the IMS is shown both in the work list of the LIMS and the IMS case viewer as as well as on the individual slide images within the case. The work list contains all cases that a pathologist needs to review. The system will trigger the LIMS to show the matching report of the cases open in IMS, preventing mix-ups while reporting. It is possible to start with opening a case viewer and reporting from either the LIMS or the IMS. Relevant patient information is shared between the LIMS and the IMS viewer. Cases handled by IMS are checked and evaluated by LIMS and vice versa. The full and bidirectional integration of both systems warrants accurate matching of cases. Any change in one system will lead to appropriate matching in the other.
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