patients are clamoring for convenience and the arizona ... · robotic microscopy virtual microscopy...
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Patients are clamoringfor convenience and theArizona TelemedicineProgram is answeringthe call. What will therepercussions be for thehealthcare industry?
The S-Curve Framework:Predicting the Future in Anatomic Pathology
Ronald S. Weinstein, M.D., F.C.A.P.Professor and Head
Department of PathologyDirector
Arizona Telemedicine Program
University of ArizonaCollege of Medicine
Tucson, AZ
Disclosures: UltraClinics®, DMetrix, Apollo
S-Curve of InnovationPe
rfor
man
ce
Effort (funds)
S-CURVE
Thomas W. Lawson 19021 2
3
4
5
6
7
1 2 3 4 5 6 7
Perf
orm
ance
Effort (funds)
S-Curve of InnovationS-CURVE
Over-optimistic
Under-optimistic
One tends to be over-optimistic in the short run and
under-optimistic in the long run,
because we can only extrapolate linearly
and progress is always an
exponential curve.
- Arthur C. Clarke
One tends to be over-optimistic in the short run and
under-optimistic in the long run,
because we can only extrapolate linearly
and progress is always an
exponential curve.
- Arthur C. Clarke
NATIONAL BLADDER CANCER PROGRAMCentral Pathology Laboratory
4540
643
3530252015105
521 7 8
Major Discrepancy
Minor Discrepancy
186 118
75
154 185
58
7070
INTER-INSTITUTIONAL QA
1983
College of American PathologistsFoundation Conference IVPathology Practice in a World ofChanging TechnologyJanuary 16-18, 1987 - Hawaii
First use of the word“telepathology” in a
scientific paper.
No.
Site
s/N
o. C
ases
Years
S-Curve of InnovationTelepathology/Digital Pathology
2007
S-Curves of Innovation
Robotic Microscopy Virtual Microscopy
Telepathology/Digital Pathology
Site #3Internet
Virtual Slide Processor
ClientSite #2
Site #1
Virtual slide network1999
Whole slide digital imaging
Virtual Slide Image Acquisition
Raster scanning
Single optical axis light microscope
Virtual Slide Telepathology
TelepathologyReport
Fully Digitized Slide Server
workstation
Aperio virtual slide scanner
Aperio virtual slide scanner
Lab Services Education
What’s next?
• 1987 to 2007• 2007 to 2027
2001
Arizona College of Optical SciencesUltra-Rapid Virtual Slide Processor Program
Working Group: Michael R. Descour, Ph.D, Peter Bartels, Ph.D. Chen Liang, René Slack, Ph.D., Ronald S. Weinstein, M.D.
Aim: Increase the field-of-view of the light microscopeDeliverable: Miniaturized microscope array digital imaging engine
Miniaturized microscope
• Miniaturization• Array microscope• Parallel processing
ArizonaProgram
Conventional Optics vs. Array Microscope OpticsConventional Optics vs. Array Microscope Optics
ArizonaProgram
9 mm
Weinstein et al, Human Pathology, 2001
Miniaturized Microscope ArrayConcept rendering
field-of-view
FOV 1 to 25 FOV 1 to 7
tissue
glass slide
MiniaturizedOptical Bench
Lenslet Array U.S. Quarter Coin
Invention of the lenslet array ensemble
ArizonaProgram
3 stacked lenslet arrays = 1 lenslet array ensemble
Patient Name
S-14926-06
University Physicians HospitalTucson, Arizona
Virtual Slide Breast core biopsy
Scan time - ~ 1 minute
Virtual Slide
S-Curves of Innovation
Single axis LM Array microscopy
Virtual Microscopy
College of MedicineUniversity of Arizona
Tucson, Arizona
University of Arizona Virtual Slide Applications
Virtual Slides in Diagnostic Pathologyat the University of Arizona
DMetrix Virtual Slides
U of A Pathology Quality Assurance Program
DMetrix Virtual Slides
®
SameSame--day Breast Care Servicesday Breast Care Services
•• ““One stop shoppingOne stop shopping””
•• TelemedicineTelemedicine--enabledenabled
•• UltraUltra--rapid labs and radiology servicesrapid labs and radiology services
•• OnOn--line second opinions line second opinions
IBM SYSTEMS JOURNAL 46: 69-84, 2007
®
NBC Tucson, AZ UltraClinics®
Susan G. Komen Race for the Cure - Tucson, Arizona – April 15, 2007
Tucson CitizenApril 16, 2007
Susan G. Komen Race for the Cure - Tucson, Arizona – April 15, 2007
“Patients Vote With Their Feet”
Perf
orm
ance
Effort
Robotic Telepathology Virtual Microscopy
Digital Pathology Laboratories
Discontinuity
? Retail Clinics
