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Editorial: A synoptic electronic order set for placental pathology: A framework extensible to nonneoplastic pathology |
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Adela Cimic, Maria Mironova, Scarlett Karakash, Sahussapont Joseph Sirintrapun J Pathol Inform 2020, 11:25 (21 August 2020) DOI:10.4103/jpi.jpi_24_20
Accurate pathologic assessment in placental pathology is mostly dependent on a complete clinical history provided by a clinical team. However, often, the necessary clinical information is lacking, and electronic order sets (EOSs), if implemented correctly, create an opportunity for entering consistent and accurate clinical data. In this viewpoint piece, we describe a framework for synoptic EOS in placental pathology. We outline the necessary data and create optional clinical data that get entered as a dropdown menu of free text. While EOSs are the best way to approach and diagnose placenta and other nonneoplastic pathologic specimens, the barriers for implementation include paper requisitions and a cultural mindset resistance. The aspiration for our synoptic EOS is to become an effective tool for communication between proceduralists and pathologists for proper diagnosis of placental specimens. Through our EOS, the appropriate and complete clinical context is conveyed from the clinical teams to the pathologist. The pathologist can easily and rapidly extract the necessary information to render an accurate and precise diagnosis. The captured data likewise become a valuable research resource.
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Editorial: Is the time right to start using digital pathology and artificial intelligence for the diagnosis of lymphoma? |
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Mohamed E Salama, William R Macon, Liron Pantanowitz J Pathol Inform 2020, 11:16 (26 June 2020) DOI:10.4103/jpi.jpi_16_20 |
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Editorial: The future of pathology: What can we learn from the COVID-19 pandemic? |
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Bethany J Williams, Filippo Fraggetta, Matthew G Hanna, Richard Huang, Jochen Lennerz, Roberto Salgado, S Joseph Sirintrapun, Liron Pantanowitz, Anil Parwani, Mark Zarella, Darren E Treanor J Pathol Inform 2020, 11:15 (9 June 2020) DOI:10.4103/jpi.jpi_29_20 |
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Editorial: Value of public challenges for the development of pathology deep learning algorithms |
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Douglas Joseph Hartman, Jeroen A. W. M. Van Der Laak, Metin N Gurcan, Liron Pantanowitz J Pathol Inform 2020, 11:7 (26 February 2020) DOI:10.4103/jpi.jpi_64_19
The introduction of digital pathology is changing the practice of diagnostic anatomic pathology. Digital pathology offers numerous advantages over using a physical slide on a physical microscope, including more discriminative tools to render a more precise diagnostic report. The development of these tools is being facilitated by public challenges related to specific diagnostic tasks within anatomic pathology. To date, 24 public challenges related to pathology tasks have been published. This article discusses these public challenges and briefly reviews the underlying characteristics of public challenges and why they are helpful to the development of digital tools.
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Editorial: 2020 vision of digital pathology in action  |
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Sylvia L Asa, Anna C Bodén, Darren Treanor, Sofia Jarkman, Claes Lundström, Liron Pantanowitz J Pathol Inform 2019, 10:27 (14 August 2019) DOI:10.4103/jpi.jpi_31_19 PMID:31516758 |
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Editorial: New European union regulations related to whole slide image scanners and image analysis software  |
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Marcial Garcia-Rojo, David De Mena, Pedro Muriel-Cueto, Lidia Atienza-Cuevas, Manuel Dominguez-Gomez, Gloria Bueno J Pathol Inform 2019, 10:2 (24 January 2019) DOI:10.4103/jpi.jpi_33_18 PMID:30783546
Whole slide imaging (WSI) scanners and automatic image analysis algorithms, in order to be used for clinical applications, including primary diagnosis in pathology, are subject to specific regulatory frameworks in each country. Until May 25, 2018, in the European Union (EU), in vitro diagnostic (IVD) medical devices were regulated by directive 98/79/EC (in vitro diagnostic medical device directive [IVDD]). Main scanner vendors have obtained a Conformité Européenne mark of their products that in Europe were classified as General Class IVDD, so that conformity is only based on a self-declaration of the manufacturer. This contrasts with the initial classification of the US Food and Drug Administration (FDA) of WSI system as Class III medical devices, although the first digital pathology WSI system to be cleared by FDA was classified as Class II, with special controls. Other digital pathology solutions (automated cervical cytology slide reader) are considered of higher risk by US and European regulations. There is also some disparity in the classification of image analysis solutions between Europe and the United States. All IVD-MDs must be approved under the new European regulation (in vitro diagnostic medical device regulation) 2017/746 after May 26, 2024. This means the need of a performance evaluation, including a scientific validity report, an analytical performance report, and a clinical performance report. According to its clinical use (e.g., screening, diagnosis, or staging of cancer), a WSI slide scanner can be now classified as Class C device. A special regulation is applied to companion diagnostics. The new EU regulation 2017/746 contemplates the use of standard unique identifiers for medical devices and the creation of a European database on medical devices (Eudamed). Existing validation studies and clinical guidelines already available in the literature are a sound basis to avoid that this new regulation becomes a barrier for digital pathology development in Europe.
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Editorial: Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017  |
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David Clunie, Dan Hosseinzadeh, Mikael Wintell, David De Mena, Nieves Lajara, Marcial Garcia-Rojo, Gloria Bueno, Kiran Saligrama, Aaron Stearrett, David Toomey, Esther Abels, Frank Van Apeldoorn, Stephane Langevin, Sean Nichols, Joachim Schmid, Uwe Horchner, Bruce Beckwith, Anil Parwani, Liron Pantanowitz J Pathol Inform 2018, 9:6 (5 March 2018) DOI:10.4103/jpi.jpi_1_18 PMID:29619278As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products.
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Editorial: Computer science, biology and biomedical informatics academy: outcomes from 5 years of immersing high-school students into informatics research  |
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Andrew J King, Arielle M Fisher, Michael J Becich, David N Boone J Pathol Inform 2017, 8:2 (28 February 2017) DOI:10.4103/2153-3539.201110 PMID:28400991The University of Pittsburgh's Department of Biomedical Informatics and Division of Pathology Informatics created a Science, Technology, Engineering, and Mathematics (STEM) pipeline in 2011 dedicated to providing cutting-edge informatics research and career preparatory experiences to a diverse group of highly motivated high-school students. In this third editorial installment describing the program, we provide a brief overview of the pipeline, report on achievements of the past scholars, and present results from self-reported assessments by the 2015 cohort of scholars. The pipeline continues to expand with the 2015 addition of the innovation internship, and the introduction of a program in 2016 aimed at offering first-time research experiences to undergraduates who are underrepresented in pathology and biomedical informatics. Achievements of program scholars include authorship of journal articles, symposium and summit presentations, and attendance at top 25 universities. All of our alumni matriculated into higher education and 90% remain in STEM majors. The 2015 high-school program had ten participating scholars who self-reported gains in confidence in their research abilities and understanding of what it means to be a scientist. |
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Erratum: Erratum: Antibody supervised deep learning for quantification of tumor infiltrating immune cells in hematoxylin and eosin stained breast cancer samples |
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J Pathol Inform 2016, 7:41 (28 September 2016) DOI:10.4103/2153-3539.191031 PMID:27761297 |
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Editorial: The coming paradigm shift: A transition from manual to automated microscopy  |
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Navid Farahani, Corey E Monteith J Pathol Inform 2016, 7:35 (1 September 2016) DOI:10.4103/2153-3539.189698 PMID:27688926The field of pathology has used light microscopy (LM) extensively since the mid-19 th century for examination of histological tissue preparations. This technology has remained the foremost tool in use by pathologists even as other fields have undergone a great change in recent years through new technologies. However, as new microscopy techniques are perfected and made available, this reliance on the standard LM will likely begin to change. Advanced imaging involving both diffraction-limited and subdiffraction techniques are bringing nondestructive, high-resolution, molecular-level imaging to pathology. Some of these technologies can produce three-dimensional (3D) datasets from sampled tissues. In addition, block-face/tissue-sectioning techniques are already providing automated, large-scale 3D datasets of whole specimens. These datasets allow pathologists to see an entire sample with all of its spatial information intact, and furthermore allow image analysis such as detection, segmentation, and classification, which are impossible in standard LM. It is likely that these technologies herald a major paradigm shift in the field of pathology. |
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Editorial: An industry perspective: An update on the adoption of whole slide imaging  |
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Michael C Montalto J Pathol Inform 2016, 7:18 (11 April 2016) DOI:10.4103/2153-3539.180014 PMID:27141323This manuscript is an adaptation of the closing keynote presentation of the Digital Pathology Association Pathology Visions Conference 2015 in Boston, MA, USA. In this presentation, analogies are drawn between the adoption of whole slide imaging (WSI) and other mainstream digital technologies, including digital music and books. In doing so, it is revealed that the adoption of seemingly similar digital technologies does not follow the same adoption profiles and that understanding the unique aspects of value for each customer segment is critical. Finally, a call to action is given to academia and industry to study the value that WSI brings to the global healthcare community. |
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Editorial: How can we improve Science, Technology, Engineering, and Math education to encourage careers in Biomedical and Pathology Informatics?  |
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Rahul Uppal, Gunasheil Mandava, Katrina M Romagnoli, Andrew J King, Amie J Draper, Adam L Handen, Arielle M Fisher, Michael J Becich, Joyeeta Dutta-Moscato J Pathol Inform 2016, 7:2 (29 January 2016) DOI:10.4103/2153-3539.175375 PMID:26955500The Computer Science, Biology, and Biomedical Informatics (CoSBBI) program was initiated in 2011 to expose the critical role of informatics in biomedicine to talented high school students. [1] By involving them in Science, Technology, Engineering, and Math (STEM) training at the high school level and providing mentorship and research opportunities throughout the formative years of their education, CoSBBI creates a research infrastructure designed to develop young informaticians. Our central premise is that the trajectory necessary to be an expert in the emerging fields of biomedical informatics and pathology informatics requires accelerated learning at an early age.In our 4 th year of CoSBBI as a part of the University of Pittsburgh Cancer Institute (UPCI) Academy (http://www.upci.upmc.edu/summeracademy/), and our 2nd year of CoSBBI as an independent informatics-based academy, we enhanced our classroom curriculum, added hands-on computer science instruction, and expanded research projects to include clinical informatics. We also conducted a qualitative evaluation of the program to identify areas that need improvement in order to achieve our goal of creating a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics in the era of big data and personalized medicine. |
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Editorial: 2014 American Telemedicine Association clinical guidelines for telepathology: Another important step in support of increased adoption of telepathology for patient care  |
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Andrew J Evans, Elizabeth A Krupinski, Ronald S Weinstein, Liron Pantanowitz J Pathol Inform 2015, 6:13 (24 March 2015) DOI:10.4103/2153-3539.153906 PMID:25838965 |
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Editorial: Regulatory barriers surrounding the use of whole slide imaging in the United States of America  |
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Anil V Parwani, Lewis Hassell, Eric Glassy, Liron Pantanowitz J Pathol Inform 2014, 5:38 (21 October 2014) DOI:10.4103/2153-3539.143325 PMID:25379344 |
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Editorial: Twenty (forward looking) questions  |
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Lewis A Hassell, Elizabeth A Wagar J Pathol Inform 2014, 5:27 (30 July 2014) DOI:10.4103/2153-3539.137731 PMID:25191626 |
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Editorial: Tryggo: Old norse for truth - The real truth about ground truth: New insights into the challenges of generating ground truth maps for WSI CAD algorithm evaluation
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Jason D Hipp, Steven C Smith, Jeffrey Sica, David Lucas, Jennifer A Hipp, Lakshmi P Kunju, Ulysses J Balis J Pathol Inform 2012, 3:8 (16 March 2012) DOI:10.4103/2153-3539.93890 PMID:22530176 |
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Editorial: The need for the pathology community to sponsor a whole slide imaging repository with technical guidance from the pathology informatics community  |
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Jason D Hipp, Jeffrey Sica, Barbara McKenna, James Monaco, Anant Madabhushi, Jerome Cheng, Ulysses J Balis J Pathol Inform 2011, 2:31 (26 July 2011) DOI:10.4103/2153-3539.83191 PMID:21845229 |
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Editorial: Why a pathology image should not be considered as a radiology image  |
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Jason D Hipp, Anna Fernandez, Carolyn C Compton, Ulysses J Balis J Pathol Inform 2011, 2:26 (14 June 2011) DOI:10.4103/2153-3539.82051 PMID:21773057 |
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Editorial: Computer aided diagnostic tools aim to empower rather than replace pathologists: Lessons learned from computational chess  |
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Jason Hipp, Thomas Flotte, James Monaco, Jerome Cheng, Anant Madabhushi, Yukako Yagi, Jaime Rodriguez-Canales, Michael Emmert-Buck, Michael C Dugan, Stephen Hewitt, Mehmet Toner, Ronald G Tompkins, David Lucas, John R Gilbertson, Ulysses J Balis J Pathol Inform 2011, 2:25 (14 June 2011) DOI:10.4103/2153-3539.82050 PMID:21773056 |
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Editorial: Post-Informatics pathology  |
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Jules J Berman J Pathol Inform 2011, 2:18 (31 March 2011) DOI:10.4103/2153-3539.78499 PMID:21572506 |
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Editorial: Re: Barriers and facilitators to adoption of soft copy interpretation from the user perspective: Lessons learned from filmless radiology for slideless pathology. J Pathol Inform, 2011;2:1, Patterson et al.  |
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Andrew J Evans J Pathol Inform 2011, 2:8 (26 February 2011) DOI:10.4103/2153-3539.77170 PMID:21383932 |
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View Point: Informatics research using publicly available pathology data  |
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Jules J Berman J Pathol Inform 2011, 2:5 (29 January 2011) DOI:10.4103/2153-3539.76154 PMID:21383929The day has not arrived when pathology departments freely distribute their collected anatomic and clinical data for research purposes. Nonetheless, several valuable public domain data sets are currently available, from the U.S. Government. Two public data sets of special interest to pathologists are the SEER (the U.S. National Cancer Institute's Surveillance, Epidemiology and End Results program) public use data files, and the CDC (Center for Disease Control and Prevention) mortality files. The SEER files contain about 4 million de-identified cancer records, dating from 1973. The CDC mortality files contain approximately 85 million de-identified death records, dating from 1968. This editorial briefly describes both data sources, how they can be obtained, and how they may be used for pathology research. |
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Editorial: The 13 th world congress on medical and health informatics, Cape Town, South Africa: Partnerships for effective e-Health solutions  |
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Andrew Georgiou J Pathol Inform 2011, 2:4 (29 January 2011) DOI:10.4103/2153-3539.76152 PMID:21383928The 13 th World Congress on Medical and Health Informatics (Medinfo) was held in 2010 between 12 and 15 September in Cape Town, South Africa. This triennial international gathering is the official conference of the International Medical Informatics Association (IMIA) and brings together leading health informatics leaders, scientists, clinicians, researchers, vendors, developers and government and health care planners from around the globe. The conference attracted 905 submissions and resulted in a program that included 260 oral presentations, 349 posters presentations and 21 scientific demonstrations representing contributions from 58 countries. The Medinfo program covered all aspects of health informatics from traditional areas, such as hospital information systems, patient registries, nursing informatics, data integration, standards, interoperability issues and decision support, to innovative topics, such as translational bioinformatics, text mining, intelligent data analysis, emerging technologies, quality, social networking, workflow and organizational issues. The outgoing President of the IMIA, Professor Reinhold Haux, presented on health informatics challenges into the future, reinforcing that today and in the future, health care has to be considered as part of a continuous and coordinated life-time journey and not just as episodes of disease. Medical informatics has a key role to play in this paradigm shift. The new IMIA President, Professor Antoine Geissbuhler, was announced at the closing ceremony. The next Medinfo congress will take place in Copenhagen, Denmark, in September 2013. |
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Editorial: The coming wave of change: ICD-10  |
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Ji Yeon Kim, Bruce A Beckwith J Pathol Inform 2010, 1:28 (23 December 2010) DOI:10.4103/2153-3539.74183 PMID:21221173 |
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Editorial: Ten important lessons we have learned as pathology bloggers  |
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Keith J Kaplan, Bruce A Friedman, Mark D Pool J Pathol Inform 2010, 1:20 (1 October 2010) DOI:10.4103/2153-3539.70709 PMID:21031009 |
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Editorial: Optimizing the pathology workstation "cockpit": Challenges and solutions  |
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Elizabeth A Krupinski J Pathol Inform 2010, 1:19 (1 October 2010) DOI:10.4103/2153-3539.70708 PMID:21031008The 21 st century has brought numerous changes to the clinical reading (i.e., image or virtual pathology slide interpretation) environment of pathologists and it will continue to change even more dramatically as information and communication technologies (ICTs) become more widespread in the integrated healthcare enterprise. The extent to which these changes impact the practicing pathologist differ as a function of the technology under consideration, but digital "virtual slides" and the viewing of images on computer monitors instead of glass slides through a microscope clearly represents a significant change in the way that pathologists extract information from these images and render diagnostic decisions. One of the major challenges facing pathologists in this new era is how to best optimize the pathology workstation, the reading environment and the new and varied types of information available in order to ensure efficient and accurate processing of this information. Although workstations can be stand-alone units with images imported via external storage devices, this scenario is becoming less common as pathology departments connect to information highways within their hospitals and to external sites. Picture Archiving and Communications systems are no longer confined to radiology departments but are serving the entire integrated healthcare enterprise, including pathology. In radiology, the workstation is often referred to as the "cockpit" with a "digital dashboard" and the reading room as the "control room." Although pathology has yet to "go digital" to the extent that radiology has, lessons derived from radiology reading "cockpits" can be quite valuable in setting up the digital pathology reading room. In this article, we describe the concept of the digital dashboard and provide some recent examples of informatics-based applications that have been shown to improve the workflow and quality in digital reading environments. |
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Editorial: Computerized provider order entry systems - Research imperatives and organizational challenges facing pathology services  |
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Andrew Georgiou, Johanna Westbrook, Jeffrey Braithwaite J Pathol Inform 2010, 1:11 (13 July 2010) DOI:10.4103/2153-3539.65431 PMID:20805962Information and communication technologies (ICT) are contributing to major changes taking place in pathology and within health services more generally. In this article, we draw on our research experience for over 7 years investigating the implementation and diffusion of computerized provider order entry (CPOE) systems to articulate some of the key informatics challenges confronting pathology laboratories. The implementation of these systems, with their improved information management and decision support structures, provides the potential for enhancing the role that pathology services play in patient care pathways. Beyond eliminating legibility problems, CPOE systems can also contribute to the efficiency and safety of healthcare, reducing the duplication of test orders and diminishing the risk of misidentification of patient samples and orders. However, despite the enthusiasm for CPOE systems, their diffusion across healthcare settings remains variable and is often beset by implementation problems. Information systems like CPOE may have the ability to integrate work, departments and organizations, but unfortunately, health professionals, departments and organizations do not always want to be integrated in ways that information systems allow. A persistent theme that emerges from the research evidence is that one size does not fit all, and system success or otherwise is reliant on the conditions and circumstances in which they are located. These conditions and circumstances are part of what is negotiated in the complex, messy and challenging area of ICT implementation. The solution is not likely to be simple and easy, but current evidence suggests that a combination of concerted efforts, better research designs, more sophisticated theories and hypotheses as well as more skilled, multidisciplinary research teams, tackling this area of study will bring substantial benefits, improving the effectiveness of pathology services, and, as a direct corollary, the quality of patient care. |
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Editorial: HIMSS10 - Perspectives from a newcomer pathologist and a seasoned attendee pathologist: Pathologists should attend!  |
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Alexis B Carter, Raymond Aller J Pathol Inform 2010, 1:6 (13 July 2010) DOI:10.4103/2153-3539.65340 PMID:20805957 |
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Editorial: Introducing the Journal of Pathology Informatics  |
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Liron Pantanowitz, Anil V Parwani J Pathol Inform 2010, 1:1 (26 May 2010) DOI:10.4103/2153-3539.63821 PMID:20805964 |
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