Digital Pathology Blog

The American Recovery and Reinvestment Act (ARRA) 2009 introduced the Health Information Technology for Economical and Clinical Health (HITECH) Act with the aim to incentivize “meaningful” implementation and usage of Electronic Health Records (EHRs) throughout the nation. Under HITECH, two incentive programs for Medicare and Medicaid were introduced which allow eligible professionals (EPs) to claim thousands of dollars in incentives over several years, if they could meet the requirements set out for different stages of Meaningful Use.

Growing up as an avid member of the 60’s TV generation, one of my favorite genres included nature shows. In the years long before YouTube, we often arranged our week to be home in time to watch Marlin Perkins’ Mutual of Omaha's Wild Kingdom on Sunday evenings. And of all the spectacular scenery shown, a very specific type of photography captured my imagination – time-lapse video. 

You’ve seen the same amazing footage.  It begins with a barren desert that looks almost choked off from life, with the exclusion of a few scraggly cacti and perhaps a plodding reptile or two.  Next comes the torrential rainstorm, and a vivid rainbow of breathtaking plants seem to blossom out of nowhere.  Clearly, the stunning display was hiding in place all along.  With the “magic” of time-lapse photography, we are given the rare opportunity to view the entire picture from start to finish.

I’ve spent a lot of time in Starbucks, and over the years, it seems little has really changed with the basic operations. The line to the register is flanked by food options and souvenirs leading to someone who takes your order and your money (The Register). Your order moves to someone standing at the espresso machine (On Bar). Other Starbucks associates are simultaneously working the Drive-Thru customers (On Drive-Thru).

Another associate is grinding beans, ensuring the coffee urns are full, teas are brewed, cups, lids and cup protectors are in place, and coolers are well stocked with sandwiches, croissants and breakfast sandwiches (Customer Support).

So, who has the most important job at Starbucks? The Register? On Bar? On Drive-Thru? Customer Support?

My grandfather was born on Groundhog Day in 1915. If he had not passed away 10 years ago, he would have been 102 this year. Given what he ate, drank and smoked, it is a miracle he lived as long as he did. When I was about 8 or 9 years he told me to “Never bet against Notre Dame football, Joe Louis or the New York Yankees”. Today he would have to replace the entries on that list with, among others, the New England Patriots.

During this year’s game, how many people went to Netflix or their e-book reader half way through the third quarter? I tweeted that, apparently, the balls were harder to catch when fully inflated and “Go Patriots!”

Liquid biopsy is defined as, “A test done on a sample of blood to look for cancer cells from a tumor that are circulating in the blood or for pieces of DNA from tumor cells that are in the blood. A liquid biopsy may be used to help find cancer at an early stage. It may also be used to help plan treatment or to find out how well treatment is working or if cancer has come back. Being able to take multiple samples of blood over time may also help doctors understand what kind of molecular changes are taking place in a tumor.”*

Often times the test is regarded as “non-invasive” as it can be performed with simple venipuncture specimens or voided urine samples.

These tests are gaining traction within the industry as a viable alternative to traditional screening methods for cancer. Study results are turning up positive data in favor of the tests, and a recent report by financial services firm Cowen & Co. said annual sales for the tools could surpass $10 billion.

Regardless of your politics or mine, on January 20th a new administration will assume leadership of our country. A few months ago, if you told me I would be hearing “The Cubs won the World Series” and “Donald J. Trump will be our next President,” I would have thought the likelihood of either or both happening would be unlikely. It has been quite seachange of events since November. Although too early to think about the next election process, I am predicting the Cubs to win the World Series in 2017.

During training, I had an attending who actually called the autopsy the "awfultopsy," as in "awfultopsies are not that bad if you only have to do one every other year" – which I think was his personal goal. Sometimes the autopsy pathologist would be out and others would cover if there happened to be a case; so many of my attendings did not have conducting posts as part of their routine practice.

It doesn't even seem like a real number but the year 2017 is close.  High school freshman this year were not born yet on September 11, 2001, which does not seem like that long ago.  15 years have passed since the day when my generation will always recall where they were when they heard/saw what was unfolding – much like my parent’s generation can tell you about Kennedy’s assassination like it was yesterday.

If the dialogue at ASCO this month was any indication, oncologists, who I tremendously respect, actually know about digital pathology.  In many instances their research and/or clinical facilities already use the technology.  Oncologists were familiar with whole slide scanning, image analysis and analytics, and the ability to have cases reviewed quickly without the need to transport glass slides – having seen it successfully used for tumor boards and education in their own institutions. 

On a recent trip, to present at grand rounds at a well-known midwestern medical school, I noticed a dapper gentleman on my flight.  He was wearing a three-piece suit and carrying an impressive attaché case. He stood out among the many travelers dressed in shorts and flip-flops, and who probably wished they hadn’t when we reached our destination where the weather was not as friendly.