April 25, 2012

Cloud Computing: PathX LIS Mobile Edition

BY Dr. Keith J. Kaplan

Worklist1Frequent readers know I am a fan of cloud computing, cloud hosting services, particularly those offering HIPAA compliant cloud hosting and/or software, SAAS, IAAS, PAAS, web-based computing, etc…

Of course, cloud computing or any of the other acronyms or names is not new. The idea of utilizing remote servers or applications is as old as the most primitive networks. That is the premise for networks.

More recently, remote services, technology, applications that are maintained and served have become increasingly common for everything from enterprise e-mail solutions through Microsoft, for example, to image analysis applications.

As a consumer, I can get the latest version without the hassles of updates, upgrades or routine support that may normally be necessary with local applications or installations.

As a healthcare provider, particularly for organizations without a deep IT bench, the ability to outsource functionality to another provider can often mean lower costs without sacrificing reliability, support, security or access.

Digital pathology allows for "anytime, anywhere" review of pathology images (slides, cases) that can be viewed by the right person at the right time.  These images themselves can be locally served or hosted to be viewed but in order to report the diagnosis/findings in order to create a final surgical pathology report and a legal document requires access to the appropriate laboratory infromation system in order to do so.

Prostate1This can be accomplished with remote services such as Citrix connectivity, remote desktop protocols, terminal server configurations or a host of others to allow for secure remote access.

Or we can leverage the power of the cloud and hosted functionality that provides a platform for remote signout over the web.  

Many laboratory information system vendors offer web-based signout to facilitate shared access regardless of where a particular individual may be, as mentioned previously on this blog, including a post about signing out cases from 35,000 feet, above the cloud(s).

Recently I had a chance to take a look at a hosted LIS available as a mobile application on my 4G iPad 3 from PathX.

A little skeptical of actually signing out cases from my iPhone or iPad, I assumed a very rudimentary experience that would look nothing like a conventional worklist-driven solution to present cases for review and signature.  Instead what I saw was just that – worklist of cases pending signature and release in the palm of my hand.  

Once you launch the application, you are presented with your worklist of completed cases which you can select, preview and verify.

Within the application is some other functionality including a Twitter feed from the vendor as well as Dark Daily updates, ability for clients to order supplies and some setting controls that are user defined.

Prostate2Considering the value proposition of digital pathology, that one is no longer tethered to their microscope, their histology laboratory, and now their LIS, the added functionality of mobile review and signout facilitates a critical component of "anytime, anywhere" review AND signout.

This technology raises a major question in my mind, namely, what/where constitutes the point of service, a critical component of CLIA regulations in terms of "where the pathologist was sitting when he/she made the diagnosis".  Legitimately, this could still have been in a professional office setting with a CLIA license when the diagnosis was rendered, dictated and transcribed.  The act of verifying/certifying that report as accurate may or may not be another matter.  More on this in a subsequent post. 

In the meantime, if you are in the market for an LIS solution and considering a hosted solution, consider PathX, with the added functionality of mobile sign-out.

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