Storage and distribution of pathology digital images using integrated Web-Based viewing systems

Archives of Pathology & Laboratory Medicine, May 2002 by Marchevsky, Alberto M, Dulbandzhyan, Ronda, Seely, Kevin, Carey, Steve, Duncan, Raymond G

Display of Digital Images During Teaching Conferences Using Wireless LAN Technology

Digital images are shown in various teaching conferences using a video projector and a laptop computer equipped with a wireless LAN adapter (Aironet Series Wireless LAN Adapters, Cisco Systems). The images can be retrieved directly from the database during a conference, but this approach is somewhat time-consuming. A more effective solution is to download the images into the laptop prior to the conference and display them using either the browser or as components of PowerPoint presentations. However, our laptop is shared by a staff of 22 residents and fellows and 18 staff pathologists, and use of the hard drive of this computer for storage of large image files by many users would pose maintenance problems. Currently, each pathologist and pathology resident has access to a shared directory on a networked file server, where they can save their materials. These shared files can be accessed over the wireless network during a conference.

Workflow Issues

The workflow of our system for storage and distribution of pathology digital images using the integrated Web/VS is shown in Figure 6. The system simplifies to some extent the acquisition and management of gross photographs, but introduces additional costs in secretarial and/or pathology assistant time that were not fully anticipated initially. The digital photographs are taken by pathology residents and/or pathology assistants and are saved in SmartMedia cards; this task is very similar to film photography. A pathology assistant and/or a trained secretary insert the images in the database. These new tasks are more time-consuming than labeling and filing kodachromes.

Cost Analysis

A detailed cost analysis of the system was not performed, as it difficult to calculate the actual operational costs of this system. Developmental costs for the image database included approximately 200 hours of design and programming. The motorized digital photography system cost less than $10 000. The proportional cost of other hardware is difficult to allocate to this project accurately, as various computers and other components of our LAN and wireless LAN were already operational in our department. Personnel costs are also difficult to allocate accurately. Our department has a large film budget, more than $10000/year, that will progressively dwindle as we implement digital photography on a larger scale. Reviewing and editing the images and inserting them into the database is a time-consuming task that requires approximately 2 to 3 h/wk of a pathology assistants time. This task is more time-consuming than the previous routine of labeling and filing transparencies. It is difficult to accurately estimate the cost savings related to not having to retrieve kodachromes from a file and maintenance of these files, onerous tasks in any large pathology department. To date, the digital photography system has not resulted in any additional full-time equivalent requirements or savings.