Defense digitizes pathology samples
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Every day, military medical staffs around the world rely on the Armed Forces Institute of Pathology to help them make diagnoses based on samples from tumors, tissue and other specimens.
Every day, military medical staffs around the world rely on the Armed Forces Institute of Pathology to help them make diagnoses based on samples from tumors, tissue and other specimens.Until recently, however, the decades-old process relied heavily on shipping slides from distant facilities back to the Defense Department institute's headquarters in Washington. The slow turnaround discouraged many within the Defense medical community from using the institute's resources.So about two years ago the institute began moving to digital pathology samples, even archiving some of its oldest specimens, said Col. Renata B. Greenspan, the institute's director.The institute hired Information Manufacturing Corp. of Rocket Center, W.Va., to digitize and scan the data, store it and develop a search application.'This wealth of material is very important for education and research,' Greenspan said.So far, Information Manufacturing has stowed away 4.5 million DOD pathology records. The institute plans to keep expanding its pathology database, adding about 2 million records a year, Greenspan said.The sources for the database include the institute's historical medical data, files from now-closed military bases, records from the Automated Central Tumor Registry and other sources.Greenspan said DOD's specimen collection dates to the Civil War. The Army started collecting specimens and information about them in 1862 to study the wounds soldiers suffered during the war. Today, the institute collects anywhere from 60,000 to 80,000 specimens a year and has several million in its inventory.Sorting through all the records has proved arduous, said Barclay Butler, Information Manufacturing's vice president and general manager of health services operations.'They have racks and racks of 3-by-5 cards, like what you used to find in a huge inner-city library card catalog,' Butler said. 'Doctors can use it to find a case similar to one they've received, but it is very labor-intensive and difficult.'The heart of the project involves scanning the records. The company uses optical character recognition tools to capture metadata about the cases, including diagnosis information, Butler said.The OCR products come from Prime Recognition Inc. of Woodinville, Wash.The accuracy of the data collected is crucial to taking advantage of Information Manufacturing's search portal tool, WSSRD, which stands for Web Search Store Retrieve and Distribute, said Tom Murphy, the company's vice president of corporate development.'The portal gives you access to all the file cabinets associated with these data sets,' he said. 'The WSSRD has a proprietary, built-in keyword search engine, and that is the portal that the institute uses to enter the system.'Information Manufacturing's data collection, data storage and WSSRD tools work with any application where paper, or other physical, records need to be digitized, Murphy said.The company has also worked with the National Oceanic and Atmospheric Administration, scanning, storing and providing Web access to thousands of handwritten weather observations. It also converted records from the library of NOAA's National Weather Service.The institute eventually wants to launch a portal for DOD called Ask AFIP, Greenspan said. It will have a Google-like front end to an interactive database that medical professionals will use to conduct tissue research and request consultations.'What's unique about this system is, because our repository is very extensive, we can refer doctors to many cases and even show them unusual presentations,' Greenspan said. 'So we can tell them: 'This is what it is. We have other cases like it, and that's how they look and present, and this is what happened to the patient.' 'To make the system easier for medical personnel to use, Information Manufacturing is crafting a decision support portal that automates inquiries, Butler said. The system will help medical staff working at remote locations, such as temporary military hospitals in Iraq.'Sometimes they'll have a pathologist and sometimes they'll have a technician that is not qualified to make a diagnosis,' Butler said. 'It could be out in the desert that they get a skin lesion that they don't recognize. With this system, they can take a sample of that, do their digitization and send it back. Then the institute can come back with their diagnosis.'
Future online portal could help speed diagnosis of medical conditions in the field, using data that goes back to the Civil War
Decision support portal
'Because our repository is very extensive, we can refer doctors to many cases and even show them unusual presentations.'
'Col. Renata B. Greenspan
Decision support portal