Technical Issues Implementing WSI

1
Technical IssuesImplementing WSI

• John Gilbertson MD
• Associate Chief of Pathology
• Massachusetts General Hospital
• Boston

2
Overview

• Over time, this has become a very difficult talk
  to give
• Based on experience implementing multiple systems
  at multiple universities
• I hope this will be more of a discussion than a
  lecture

3
(No Transcript)
4
Basic Components

• Scope
• Architecture
• Resources/People
• Preparing the Ground
• Operations
• Questions Discussion

5
Scope

• Why are you doing this? (Edu, Clinical Doc,
  Telepath, IHC Analysis, slide archive management)
• WSI only (general use of boutique)
• WSI, Gross and ConM?
• Document Management?
• Clinical vrs Edu/Research or Both
• Multiple hospitals
• Who is in charge. Written Scope Document and Plan

6
Architecture

• More important than the machine itself
• Metadata Specimen and Image ID
• Image Management capture, handling, archive,
  display
• Data Management LIS, De-ID
• Materials Management
• Why will the work be done

7
Resources

• The imager is the cheap and easy part
• Is this the best use of resources? Is it the
  right set of resources?
• Initial Funding (People, Research, Space, IT)
• Ongoing Funding (storage, maintenance upgrades,
  charge backs)
• Documentation Audits
• Space
• Associated Costs (Monitors, RAM), Web Sites,
  Academic Computing Personnel

8
Resources

• Is this the best use of resources?
• Know the answer to this question

9
People

• This is potentially a clinical system
• Operational People
• IT Support (engineering)
• LIS/Interface/Billing/De-ID(analyst)
• Photographer / Technician
• Slide operations
• Trainer
• Maintenance / Tuning (capture D. R/Network)
• Web site(s)
• Vendor (will the vendor have a defined role,
  define it)
• Super-users
• Users
• Backstops

10
Steering Committees

• Departmental Leadership
• Hospital Leadership
• IT Leadership

11
Preparing the Ground

• Know why you need this
• Committee and formal process
• Knowing the industry
• Chose operational people first
• Get Space
• On site, multiple day demonstrations
• Connect to your network, Use your PCs
• Use it!!!!! Believe no one
• Site Visits
• Who to talk to

12
Preparing the Ground

• Talk to (make sure they understand)
• Central IT (get the right person)
• Histology
• Slide Room
• Residents
• Faculty (especially if directly effected)
• Financial
• Potential Operational People
• Enterprise PACS

13
Preparing the Ground

• Manage Expectations

14
Vendors

• Prior to purchase
• Support
• Upgrades
• Shared Vision / Plan
• Pre-nup
• Payments
• One or many
• Importance of standardsHL7 DICOM IHE

15
Operations

• Clinical Systems
• Validation / Testing (people and systems)
• Charge Backs (ops / storage)
• Documentation and Audits (Outcomes)
• Documentation (Lab Manual) Written Policies
  (clinical systems)
• Training
• Schedules
• Storage Policies
• Security (electronic and physical)

16
Associated Systems

• Bar Coding
• LIS
• Network (1Gb 100Mb) (Switched)
• Servers
• Web Server
• Storage/Archive(s)
• PACS (enterprise)
• Pathologists PC (RAM, Video Board, Monitor)
• Pathologists Office
• VPN
• Slide Room (blue dot)