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Pathology microscope slides digitised with aid of LIMS

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Region Skåne, the authority in charge of primary and secondary public health care for the whole southern part of Sweden, is replacing its microscopes with digital imaging in its pathology laboratories. In doing so, it is digitising the histopathological workflows for the whole region, a unique undertaking both in its scope and scale.

The data will be managed by a LIMS platform from Software Point, a LIMS supplier in the Nordic market and part of the LabVantage Group. The complete system will be possibly the largest such installation in the world and among the first of its kind in northern Europe.

Digitising pathology means turning traditional microscope glass slides into digital images, which are then analysed by pathologists directly from the computer screen, instead of using regular microscopes. This is a similar revolution in pathology as which has already taken place in radiology. The contracted delivery not only digitises the slides but will completely renew the IT support for all workflows of the pathology laboratories in the Skåne region.

The four pathology laboratories run by Region Skåne produce about 400,000 histological microscope slides a year. Currently, the samples are prepared into microscope slides and are then physically distributed to pathologists. Slides are then analysed using regular microscopes. There is currently limited IT support for the workflow, making it difficult to track the status of pending cases and to identify the bottlenecks in the production workflow.

Skåne is challenged by the workload of pathologists spread over four laboratory sites in the region. The challenges are mostly related to physical slides, which can only reside – and be analysed – in one place at a time. With the digital pathology in place, all pathologists from all laboratories of Skåne can gain access to all cases and related slides. Together with the introduction of digital pathology, another goal of Region Skåne is to introduce so-called lean workflows.

'It is really exciting for me to get to lead the Pathology department into a completely new digital era, which should provide us with improvements both for quality and patient safety by better utilising the competencies of all of our pathologists in the whole region,' comments Lena Luts, division chief for Clinical Pathology in Region Skåne.

Swedish law requires Region Skåne to keep all slides for a minimum of 20 years, and today this requires a lot of physical space. In the digitised format, the annual production of about 400,000 glass slides will consume a respectable 300 terabytes of storage each year.

A key component in the delivery is a new workflow management system, which will manage both the pre-analytical and analytical stages of the laboratory process. An adapted version of Software Point's C5 LIMS will be in total charge of managing the workflows and tracking all events within. It will maintain a real-time status of each sample, slide and case, and will ease the work of both laboratory technicians and pathologists with advanced functionalities such as integration to laboratory automation, datamatrix labelling of all objects, and speech recognition for pathologists.

The digitised slides are seamlessly integrated into the C5 LIMS workflows and are directly accessible from all pathologist workstations in the region. The digital slides will reside in Hitachi’s Content Platform, which employs distributed object storage. All of the images will be kept exceptionally well-protected, duplicated across several physical discs. This makes the traditional backing up of data unnecessary.

The total delivery also includes diagnostic workstations and a speech recognition system for pathologists' use. The work of the pathologists will be further eased by the introduction of computerised image analysis algorithms, which can automate tasks such as cell counting.

The system will be delivered under total responsibility of Software Point. It will be taken to limited production before end of 2011 and full production will begin in 2012. Software Point will also provide Region Skåne with extensive maintenance services to ensure the continuous operation of the system.