Editor’s note: This is the first in a four-part series
My interest in what is now called “cloud computing” was sparked from my 2005 encounter with a very destructive cloud named Hurricane Katrina. A week after arriving in New Orleans to assume my new position as anatomic pathology director at the Ochsner Clinic, the megastorm hit and leveled destruction unseen in modern U.S. history.
Essentially everything was destroyed, and among that “everything” was paper medical records-millions of them. After struggling for years to entice doctors to use the new institutional electronic medical record system, adoption literally occurred overnight, as all paper records were gone. Fortunately, the servers hosting the EMR were safely backed up in a remote location allowing for no interruption of services.
After my direct witness of the EMR being an actual lifeboat for a healthcare system, my “What if?” questioning began. What if there was an anatomic pathology information system that didn’t have to be run on a very exposed local server housed in some data unsafe location in a practice’s office and which didn’t cost $50-$100,000 for each version upgrade? Translation in our current parlance-what if there was a cloud-based AP information system (APIS)?
Fast forward through a few years and a move to Seattle, when I was forced to answer this question while dealing with upgrades to my new practice’s CoPath system. Out of the cloud fell WebPathLab-the first true cloud APIS, which, after a few months of internal “selling,” I convinced my partners to try. The defining selling point was cost. Faced with a $250,000 CoPath upgrade versus a recurrent monthly subscription model of a few thousand dollars a month, the math was done, and the system was deployed in a few months.
Finally, the dream was real. All of us could log in, sign out, and search cases safely and securely from anywhere as long as we had an Internet connection. Our data was safely and redundantly stored in secure data centers in California and Texas. The system interfaced beautifully with the hospital EMR. Setting up access for our clients to get outpatient reports was as easy as giving them a secure username and password.
While we were very happy with WebPathLab, the one limitation, at the time, was its inability to integrate it with our specimen tracking system (a function now deployed with WebPathLab). Succumbing to my innovation impulse, I entered into a development consultancy relationship with a new cloud-based AP information system called PathCentral. Our practice went live with PathCentral in early 2010, and successfully integrated the system with the Ventana Vantage specimen tracking system. PathCentral has since been acquired by Xifin, a company specializing in cloud-based solutions for diagnostic medicine and is now called “LIS Anywhere.”
At Home in the Cloud
My group and I have never looked back in the 6 years since we made our professional home in the cloud. In fact, at meetings when I hear colleagues discussing the inflexibility and cost of their traditional LIS systems, I confess with a measure of guilt that I feel like a Tesla driver listening to the problems of horse-drawn carriage drivers.
When I advocate a cloud-solution, my enthusiasm is such that I have to very clearly announce to them, as I do here, that I am not a sales rep for any cloud LIS company, nor do I have any financial interest in one. While our initial drivers to migrate to the cloud were cost containment and the desire to unshackle ourselves from LIS system management, we have experienced several unanticipated benefits. All of these systems are HIPAA compliant, and management of that compliance is the charge of the company. Upgrades are free, monthly, and so seamless that generally, the only way we know they have occurred is via e-mail notification or checking the version number of the software. Flexibility of reporting structure is inherent in both systems, and we can, with relative ease, tailor different report formats for different clients.
We can even use different “skins” for different reports originating from different practice entities. For instance, we utilize the LIS Anywhere system to sign out cases under three different practice entities.
Dr. Henderson practices anatomic pathology and laboratory medicine in Seattle, Wash. He specializes in breast and gynecologic pathology and is founder and president of Pacific Pathology Partners, partnered with LabCorp to serve five states in the Northwest. He is also founder of PathForcedx (www.pathforcedx.com), the first virtual group of digital pathologists providing services to international patients.
Category: Anatomic Pathology, Clinical Laboratories, Clinical Pathology, Digital Pathology News, Informatics, International, Laboratory Informatics, Laboratory Information Systems, Pathology News, TeleHealth, Web/Tech, Whole slide