One day in mid-2001 I was sitting in my office at Walter Reed Army Medical Center in Washington, DC when I was approached by a tall gentlemen with a South African accent who had with him about 10-12 sheets of paper in his left hand. He introduced himself as Tim Marshall and asked if I had a few minutes to answer some questions. At the time I shared the small office with a modest desk, microscope table, my microscope, PC and another equally modest (heavily used) desk used for a robotic telepathology system.
Tim had met with folks at the AFIP and then knowing of my interests in digital imaging, proceeded to ask me several questions that started with "What if" such as "What if you could scan a whole slide in 5 minutes?" or "What if it a computer could analyze a immunohistochemistry slide?" or "What if you could look at a frozen section slide from a distance?" He asked me 8 or 10 questions as I recall. I did not know it at the time but as Tim was collecting this data from several folks, Dirk Soenksen, the Founder and CEO of Aperio was hard at work (perhaps still in his garage) perfecting the first generation Aperio scanner.
A reliable hardware platform that could create a digital image of a 1×3 glass slide was born. Each subsequent generation was better than its predecessor with added slide scanning capacities and capabilities for oil immersion & fluorescence microscopy.
In 2001, the term "virtual microscopy" was popular. Within a few years "digital pathology" was increasingly in use. And Aperio from its inception has been the market leader in digital pathology. One could go so far as to say they had to create the market based on their vision of the technology and what it offered to healthcare.
They reported late last year that their install base consists of over 700 devices in more than 30 countries. I gather more slides are scanned on their devices in research and pharmaceuticals than anyone else. None of this would have happened without hardware that has been tried and tested with success.
But for digital pathology as a market to succeed, the scanning hardware is only part of the solution. Software to incorporate managing, reviewing, analyzing and sharing these images is paramount.
In a post about a week ago I mentioned how Aperio's latest release of their workflow software, Spectrum creates for tighter integration with clinical processes and diagnostic sign-out for pathologists. The press announcement for Release 11 mentioned improvements to the product based on "broad usage and feedback from our customers". This is an important process and one that Aperio may not have been focused on in recent years based on feedback from Spectrum users. Positive to see the improvements are being made.
It reminds me of a quote from somebody named Gates who wrote a book entitled "Business @ the Speed of Thought". Allegedly this guy "Bill Gates" also started out in a garage. He claims "Your most unhappy customers are your greatest source of learning".
Ask any practicing surgical pathologist one the of key drivers for adoption in the clinical space is making digital pathology as fast as glass for viewing. This involves the requirement for an environment that provides the images as well as the clinical metadata from the LIS as well as bidirectional interfaces for order entry and result review. Again, the latest version is improving the software capabilities for the market leading digital pathology company today. Clinical workflow processes are complex and vary widely from laboratory to laboratory.
As I have heard from one software company in healthcare, "If you have seen one lab, you have seen one lab." Add to that the nuances of hospitals and private labs, each unique and the nuances of individual pathologists and one can understand why these software applications have to be customizable to penetrate the market.
Now, almost 10 years after those due diligence questions were posed to me, Aperio continues to provide superior scanning devices further enhanced by enabling software to facilitate clinical workflows.
In the next 12 to 18 months it will be interesting to see how these improvements impact Aperio's business and how some of the newer vendors will be perceived with increasing focus on optimizing clinical workflow through software.
