At Drexel Medicine’s Advanced Pathology Imaging Lab, Director Mark Zarella strives to deliver the same high-quality service patients might find at larger institutions.  To reach that standard, Zarella committed to digital pathology almost 20 years ago, on the promise it would streamline clinical reporting workflows. Faster reporting would, in turn, give clinicians more time to focus on the work that directly involves patients.

The Challenge

Drexel’s original digital pathology solutions were rigid, slow, and cumbersome.  They lacked the features needed to bring Drexel’s ideal reporting workflow to life.  Adding to the challenge, their solutions were developed with proprietary code, making an in-house workaround impossible.  Drexel needed a new solution, one supporting a fast, fluid, and adaptable reporting workflow.

The Solution

To overcome these barriers, Zarella decided on PathcoreFlow (Flow), Pathcore’s workflow solution for collaborative digital pathology teams.  Thanks to Flow’s folder-based data organization and customizable report templates, Drexel finally had the reporting features they needed. “The reporting capabilities in Flow are really excellent.  We’ve been able to add more information – and organize that information – in a way that really works for the clinicians” says Zarella. “Pathologists are now able to focus on their core functions without having to manually perform every step to get data into a system”.  Looking forward, Zarella is confident Pathcore’s open system and responsive support can adapt to all of Drexel’s future needs.

Check out the full article for more on PathcoreFlow’s reporting features below, and how they helped streamline Drexel’s use-case.

The Full Story

Mark Zarella, PhD, is a digital pathology veteran and innovator.  As Director of the Advanced Pathology Imaging Lab at Drexel University, Zarella turned to digital pathology almost 20 years ago.  Then and today, his goal is the same: supporting the divergent workflows of Drexel’s physicians, pathology residents, and life science researchers in the name of high quality patient care.  “Drexel is a great example of how a smaller academic department can use innovative technology to improve the quality of all its programs, with patients being the most important driver”, Zarella explains.  “We strive to offer the same high-quality services to our underserved patient population that larger institutions do”.

These days, Drexel’s digital pathology infrastructure runs on PathcoreFlow.  Flow is Pathcore’s robust workflow solution for whole slide images (WSIs), with powerful data organization and collaboration features.  According to Zarella, Flow has meant less time wrestling with workflows, and more time for the things that matter: “Pathologists are now able to focus on their core functions without having to manually perform every step to get data into a system”.

Before adopting PathcoreFlow, wrestling with workflows was Drexel’s digital pathology reality.  As a digital pathology veteran, Zarella has as much experience with the field’s growing pains as he does the benefits.  Digital pathology moves fast, and as Drexel’s workflows evolved in parallel, their existing solutions began to show serious limitations.  “The technology we were working with just did not fit the digital workflows as we imagined them. We were wasting resources trying to reverse engineer processes.”

“We strive to offer the same high-quality services to our underserved patient population that larger institutions do”

In particular, Drexel’s reporting workflow needed serious overhaul to fully realize the potential of their clinical workflow.  It was clear Drexel needed an equipment upgrade – one that was fast, fluid, and adaptable.

Drexel’s Priority: Optimized Reporting

Patients are priority number one at Drexel, so an optimized reporting workflow was crucial.  According to Zarella, Drexel’s original digital pathology platform wasn’t up to the task. “The types of reports we were able to create, and the ability to organize the data with our old system was inefficient and did not suit our vision”, he says.

Reporting isn’t an isolated issue, though – from Zarella’s point of view, reporting workflows hinge on data organization: “… with immunohistochemistry (IHC) and quantitative image analysis on about 200 slides a day, a lot of data are generated.  And those data have to be readily searchable”. It was clear to Zarella and his team that all the reporting functionality in the world wouldn’t matter much if their data was unorganized and searching it was impossible – criteria that are important in general, but grow more important by the day.  “Standards for pathologic diagnosis are getting more complex, and so is the information that clinicians need in pathology reports”. As Drexel found, digital platforms that fail to advance with those standards in mind get left behind.

Reporting and data organization were Drexel’s specific needs, but as an agile, growing clinic, Zarella was looking for a solution backed by a similarly agile company.  The hope was a partner, not just a purchase; a company willing to work with Drexel as their use-case evolves. “As experienced users with a vision, we wanted not only a state-of-the-art system, but to partner with a group that was going to listen to our needs”.

Pathcore seemed like a natural fit. “Pathcore convinced us that they were committed to developing products that their clients would want to use”, says Zarella.  PathcoreFlow, Pathcore’s browser-based solution for collaborative WSI workflows, was capable of solving Drexel’s reporting and organization needs.

Implementation

Like remodeling an old home, upgrading technology can be a source of pain and celebration.  Ripping out old roots during implementation is a hardship for all parties, but the result of new furnishings/technology is always a net positive when the dust settles.  Fortunately, practice makes perfect, and past implementation experience on both sides made for a smooth transition to PathcoreFlow within Drexel. “Everyone at Drexel was on-board and familiar with integrating these types of systems into the laboratory information system”, Zarella says.

Flow’s reporting templates did require a few tweaks before they met Drexel’s requirements completely.  But Flow’s customizable core made it easy for the platform to keep pace with Drexel’s needs “… we were able to readily make changes and customize the system to work for us.  Pathcore’s use of API rather than proprietary code really helps integrations with other systems”.

Flow’s API makes possible a completely unified digital pathology workflow
Where Reporting Meets the Road

Implementation was smooth overall, and with the pieces in place, Drexel was eager to put Flow to the test.  According to Zarella, all the promised benefits hit their mark, particularly for Drexel’s big-ticket need: reporting.  “The reporting capabilities in Flow are really excellent” Zarella explains. “We’ve been able to add more information – and organize that information – in a way that really works for the clinicians”.

“We’ve been able to add more information – and organize that information – in a way that really works for the clinicians … Flow has made the work better, which is great for morale”

Flow supports dashboards and folders just like most operating systems, with infinite layers of subfolders.  For Zarella’s team, presenting data like this “is really important, not just an aesthetic”, he explains. “Clinicians want to see the pathologist’s interpretation first, then the images of the IHC stains and scores from image analysis.”  With a familiar folder system and comprehensive tagging and searching, it’s easier than ever for clinicians to interface with data – and thus make more informed decisions. “That wealth of data helps clinicians better understand the tumor’s potential biologic behavior, which directly impacts patient care.”  And the benefits are felt on both sides of the fence: “Flow has made the work better, which is great for morale”. Beyond morale, smoother processes have created new opportunities for Drexel’s staff – “our main imaging technician now able to do other work (flow cytometry and molecular testing) about half the time”.

While thus far a success, Drexel is only a few months into their Pathcore-assisted clinical workflow.  The full-extent is still evolving, but Zarella is confident Flow will adapt as Drexel’s reporting use-case expands.  Annual regulatory reporting, for example – a key process that Zarella is eager to give the Pathcore treatment with Flow’s flexible features.  “Based on what I’ve seen customizing the clinical reports, I expect the regulatory reporting to be fairly straightforward.” And if there are hiccups?  No problem: “the Pathcore support team is incredibly responsive. We often have same-day responses to technical questions and bugs.”

“our main imaging technician is now able to do other work (flow cytometry and molecular testing) about half the time”

Going Forward

Digital pathology is here, and what was once referred to as the future is now.  With a robust reporting workflow far beyond analog capabilities, Zarella can attest – but digital pathology is as much about the here and now as it is the future.  And with the support and flexibility of Pathcore, that future is looking bright: “agile companies and technology with vendor-neutral solutions like Pathcore’s are going to play a key role in the coming evolution”, he concludes.