The Progression of Integrated Diagnostics from Pathology Informatics 2010

Over the past two weeks, Orchard attended and exhibited at two trade shows. Last week, we were at Pathology Informatics 2010 in Boston, and earlier this week we were at CAP 2010 in Chicago.

It seems that this year’s focus was the digitalization of the anatomic pathology slide. With the advancement of the large flat panel monitors, beautiful pictures of stained specimens dotted the landscape of the tradeshow floor.

However, another topic discussed intensively was the integration of the various diagnostic departments—namely clinical, molecular, and anatomic pathology. In one of the sessions, the speaker expressed that pathologists are the consumers of molecular information, yet they lose control of this testing because the molecular equipment and analyzers are hooked into the clinical lab systems. He went on to state that this puts pathologists at a disadvantage because they have to use two different information systems to access patient data for their diagnosing and reporting.

Besides the molecular biomarkers being used by pathologists to assist in cancer diagnosis, today, more and more clinical data is being used by the pathologist for other diagnosis. For example, a positive Pap smear test may be reflexed to a HPV, or a pathologist making a diagnosis on a bone cancer patient might also want access to the patient’s history of CBCs, or in the case of a biopsy of a prostate, the pathologist might want to review the patient’s prior PSAs. With this interdepartmental effort, the speaker went on to elicit the help of the industry’s information system vendors, stating that no one vendor has yet done it and admonished us to figure out ways to better integrate our systems.

The irony of this is that every informatics vendor markets systems that interact and integrate, yet it is clear by the speaker’s request that the products he is familiar with fall short of truly meeting the needs of today’s pathologists doing integrated diagnostics. The reason for this is that, traditionally, lab system vendors have developed two separate systems: one system working on its own database for Clinical Pathology (CP) and another separate system working on its own database designed for Anatomic Pathology (AP).

The true informatics solution for integrated diagnostics is a CP/AP system designed specifically for interdepartmental use and built upon a single database. And the purpose of today’s blog is to inform you that the system described in the previous sentence does in fact exist today. It has existed for the last four years. It is called Orchard Pathology.

Orchard’s own Orchard Pathology was introduced in January 2006 as an all-inclusive CP/AP system to meet the workflow and reporting needs of integrated diagnostics. Besides other advantages, such as rules-based technology and structured data for data mining and easy EMR integration, Orchard Software is the only laboratory information system vendor with a single-database structure that allows the pathologist to access the patient’s entire testing history—clinical, anatomic pathology, and molecular—and easily add any of these results to the final report.

Yes, Orchard Pathology is the only system on the market today specifically designed to handle the complexities of clinical, cytology, histology, molecular, and anatomic testing and reporting. Even with the requests from leading pathologists for integrated solutions, gaining momentum and getting the word out has been difficult; however, we are very pleased with the reception we receive from those who see Orchard Pathology in action. Sometimes change is hard to embrace, even when we want to, and understanding that, we feel we are right in line with the adoption process of a cutting-edge solution.

Kerry Foster
Director of Marketing
Orchard Software Corporation

Comments (0) Sep 30 2010

New Information on HITECH Certification and FAQs

This week the ONC added its third laboratory to the certification process. InfoGard Laboratories, Inc. located in San Luis Obispo, California, was named an ONC Authorized Testing and Certification Body. The ONC stated “The addition of InfoGard Laboratories, Inc. as an ONC-ATCB provides more options for EHR vendors to have their products tested and certified for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year.”

Along with providing you with this new information, Orchard wanted to take a minute and address some of the more frequently asked questions that we are receiving about the HITECH Act and the certification process.

1. I have noticed the current process of certification is being called a temporary program—what does that mean? The “temporary” term is used because the certification program needed to begin in order to meet deadlines before final rules could be completely established. The ONC expects the final rule on certification to be completed by January 1, 2012. In the meantime, the ONC-ATCB and EHR vendors will be utilizing the temporary program. EHR technology tested and certified by an ONC-ATCB under the temporary certification program will remain certified once the permanent certification program replaces the temporary certification program.

2. Have any EHR vendors achieved certification yet? As of this writing the ONC has not announced any vendors who have been certified by the ONC-ATCB. The ONC will maintain on its website a Certified HIT Products List (CHPL) as a single, aggregate source for all certified Complete EHRs and EHR Modules reported by ONC-ATCBs to the National Coordinator.

3. If my EHR vendor and product were previously certified under any other programs or organizations will they be grandfathered in with this new certification process?  The short answer is no. In order to meet regulatory requirements implementing the HITECH Act, including the definition of “Certified EHR Technology,” EHR technology must be tested and certified by an ONC-ATCB. Any other certifications issued by an organization that is not an ONC-ATCB at the time of issuance will be invalid for purposes of meeting the definition of certified EHR technology and cannot be used to qualify for incentive payments under the Medicare and Medicaid EHR incentive programs.

As always, we will continue to update you on this process as certification begins and providers and hospitals begin to apply for incentive reimbursements. For additional information, please visit our website at or contact us (800) 856-1948.

“If interconnected inexpensive computers can be used in medical diagnosis and consulting, it may change medical care.” Andrew S. Grove, 1996 (At the time of the quote, Mr. Grove was the CEO of Intel.)

Curt Johnson
Vice President of Sales and Marketing
Orchard Software Corporation

Comments (0) Sep 23 2010

Quality, Service, and Support

“You better cut the pizza in four pieces, I am not hungry enough to eat six.” – Yogi Berra

This past weekend I heard an advertisement on the Disney Radio Station announcing attendance day, September 17th, for schools in Indiana. The ad was informing parents and children to ensure they were in school on the 17th because attendance that day will be used to determine funding for the schools. All I kept thinking was how can you make such an important decision on how to allocate funds based on one data point? In addition to making the decision on one data point, by advertising on the radio and all their other communications, it is realistic to say that the data may not be accurate or valid.

As I was thinking about this, I started to think about all of us in the lab industry. What if we worked in this manner? “Everyone be on alert, October 6th is get all the results correct day, November 9th is deliver all the reports on time day, and December 31st is ship everything out the door day.” While that last one may be true for some people, you don’t provide service and quality care one time, you do it daily.

We all know quality and service are important in healthcare and specifically in our laboratories. I believe each of us in the laboratory industry strives to provide information to improve patient care. My question is how often do you take the time to look in the mirror and evaluate how you are really doing?  Most people are able to look at others and make recommendations on things that can be changed for the better, but it is far more difficult to do a self evaluation.

If quality and service are built one day at a time, then we need to be doing frequent performance reviews and evaluations to make certain we are meeting our expectations. No one is perfect, and over time, without a review, we might be missing things or missing the opportunity to make changes that could improve our operations.

Since most of us are better at seeing necessary changes in other labs than our own, wouldn’t it make sense to enhance your self evaluation by asking some of your respected colleagues in the area to meet with you and review your lab?  Doing this as a way to improve can be a very positive experience and will give you insights and perspectives you can’t get when working in your own organization.

As you head into the weekend, please remember for quality and service to be truly exceptional, it must be a daily activity, not a one-time event.  One-time events need to be left to the important things like Talk Like A Pirate Day, which by the way is this Sunday, though we here at Orchard will be celebrating on Monday. 

“Always bear in mind that your own resolution to succeed is more important than any other.” Abraham Lincoln

Curt Johnson
Vice President of Sales and Marketing
Orchard Software Corporation

Comments (0) Sep 16 2010