[Histonet] Histology Workflow Solutions

Mon Feb 28 12:12:21 CST 2011

I agree he should have left it off.  However; we looked at Vantage and the cost for the interfaces and upgrades to be able to use it fully were very significant for us.  Pam

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Rathborne, Toni
Sent: Monday, February 28, 2011 12:03 PM
To: Mahoney,Janice A; Jesus Ellin; Michael Mihalik; CHRISTIE GOWAN; dana.spencer <@t> pcmh.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Histology Workflow Solutions

I can say that I appreciated Michael's comments, but also think that he should have left his contact information and the company he represents off of the email. If anyone would have been interested in replying to him privately, they still could have done so.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu]On Behalf Of Mahoney,Janice A
Sent: Monday, February 28, 2011 12:56 PM
To: 'Jesus Ellin'; Michael Mihalik; CHRISTIE GOWAN; dana.spencer <@t> pcmh.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Histology Workflow Solutions

Histonet Users.
Please help me understand something.  I may be opening a big can of worms here but I'm confused.
Why is it that Michael Mihalik is allowed to expound on the subject of workflow solutions when he is a competitor in that market?  I'm not saying that some of his comments are not helpful but I thought this was a users forum?  People usually freak out when a vendor tries to put comment on a competitors products, what is the difference here? I personally do not want to hear what he has to say here because he obviously has another agenda regardless of how it is disguised.
I openly admit that I am a Ventana Vantage user and will stand by that system because I know it so well and know it's capabilities. The BIG difference is, I am a user, not a Vendor.
Jan
Omaha

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jesus Ellin
Sent: Monday, February 28, 2011 11:40 AM
To: Michael Mihalik; CHRISTIE GOWAN; dana.spencer <@t> pcmh.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Histology Workflow Solutions

Well put Michael!!

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Michael Mihalik
Sent: Monday, February 28, 2011 10:35 AM
To: 'CHRISTIE GOWAN'; dana.spencer <@t> pcmh.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Histology Workflow Solutions

As many as you know this is a topic that is near and dear to my heart so I'd like to expound on this subject if you'll permit me.  For those of you who already have solutions, or perhaps have more favored topics, please feel to move on to the next subject.

First off, while I have some knowledge of both products, I am a user of neither.  In fact I am a competitor of both, to some degree.  Both products offer advantages and disadvantages.  You really need to think about how they fit in your lab.  When I say 'in your lab', I mean not only the histology area, but everyone, including the accessioning clerks, secretaries, pathologists, and even cytotechnologists.

To me, one of the items that is more relevant to your situation is whether you want an integrated solution (IMPAC) or a standalone/interfaced solution.
For instance,

1.  How will information get into Vantage?  Will it have to be manually accessioned/entered or will there be an interface?  In the IMPAC solution this is a non issue.  Also, keep in mind that there may be an interface cost from BOTH vendors should you decide an interface is in order.

2.  How will information get OUT of Vantage or put another way, does the pathologist or secretary need to see information gathered/stored by Vantage?
This may be resolved by another interface, but it may also be resolved by putting Vantage on more and more PCs.

3.  Who is going to configure, manage and maintain Vantage?  This is going to be a whole other computer system in your lab.  Will your IT department support it, maintain it, administer it, etc.  Who will understand and set up the files, etc.?  You have the same issue with IMPAC, but I bet someone is already handling all these issues.

4.  Can you use barcodes generated from Ventana on IMPAC?  I don't know the answer to this question.  It's not that each system can't read the barcode.
It's a matter of whether IMPAC calls their slide, slide X and Vantage calls it 'y'.  For instance, maybe IMPAC calls it case#.spnid.blockid.slideid and maybe Vantage calls it slideidNN.  That means whenever the pathologist scans the slide at his IMPAC workstation, IMPAC won't recognize it.  Perhaps this is not an issue, but I thought I would bring it up.

5.  Management Reports:  I know IMPAC supports Crystal Reports and at least theoretically you can build your own management reports.  I don't what the situation with Vantage is.  Are they canned reports or can you add more?
Does this matter to you?  I don't know enough about the details of either reporting module.  Perhaps, the Vantage report subsystem generates everything you could possibly need and therefore why deal with Crystal Reports to generate unneeded reports.  On the other hand, I note that in a response, Christie mentioned that Vantage tracked quality issues 'anywhere in the process'.  I would wonder how Vantage could track quality issues at specimen receipt or at the pathologists PC if Vantage was not installed at those two areas.  Perhaps as long as it's tracked somewhere, who cares what system contains the data.

These are some serious issues to consider and as you might conclude, the analysis leans towards an integrated solution.  However, that's not the whole story.

There is really no magic to printing and scanning barcodes.  The real science/magic lies in how those barcoded identifiers are used.  You want them to make misidentification errors go away and you want them to constantly provide who/what/where information for any and all material.
...but again, HOW do the two sets of software do that?

You might want to consider the following questions:

1.  Do you HAVE to use PCs for each grossing, embedding, cutting station?
This is important because more PCs cost money and more PCs take up precious space.  On the other hand, more PCs allow more ease of data entry.
2.  At grossing do you need to see the requisition?  Are the requisitions
scanned into IMPAC?   That would make it difficult for IMPAC to display
those images.  What about patient history?  Do you need to see that at grossing?
3.  Do ALL slides print automatically when a block is scanned or do they have to be selected?  You may have a preference here, but notice that I said 'slides for a block'.  I can see both answers being 'correct'.
4.  If you already have a Benchmark or Ultra, you have a built in motivation to use Vantage.  With Vantage, you can use only ONE slide label to label slides going to those instruments.  With IMPAC, you have to hand write or double label.  This is because those 2 instruments require the use of
Ventana's own label.   Also, once the order for the benchmark or Ultra is in
Vantage, I 'imagine' that this data would be sent to those instruments automatically.  Please confirm this as I do not know if this is an additional cost.
5.  Again, if you use either the Ultra or Benchmark, the anticipated slide completion date is available.  This date/time is not available via an interface to IMPAC or any other vendor.
6.  At grossing do you need to see the requisition?  Are the requisitions
scanned into IMPAC?   That would make it difficult for Vantage to display
those images.  What about patient history?  Do you need to see that at grossing?

There are certainly other issues, and please don't get me wrong.  I think that Vantage is a very sexy product.  It looks very nice and it provides the positive ID everyone should really have.  As you read the literature and get responses from others keep in mind that you have a choice a lot of people don't have.  You can choose a system that is supported by your current vendor.  A LOT of other people don't have that choice.  It's either Vantage, a competitor to Vantage or a new LIS.  You can get a lot of 'bang for the buck' with just Vantage.

...but if you're looking for a new LIS, well that's where my company comes in.... but that's a subject for a private email.

P.S.  The purpose of this email is to neither endorse one or the other product.  My intention was to simply get people thinking about the issues involved, especially as tracking solutions and LIS's have evolved over the last few years.

Michael Mihalik
PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of CHRISTIE GOWAN
Sent: Monday, February 28, 2011 7:05 AM
To: dana.spencer <@t> pcmh.com; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Histology Workflow Solutions

Hi Dana,
I can't speak to the Elekta module but I have used the Vantage system for over a year now. We generate a bar code at accessioning that is used throughout the entire process to make cassettes, gross, embed, section, stain and turn out. We do not batch during any of the process other than the 20 slides we put in our staining tray. We scan each block at microtomy as we section which prints a label that we affix to the slide when we pick up the section. We have virtually eliminated errors at all stations. We were able to see quite an improvement in turn around times as well as tracking our specimens. This system also allows us to track quality issues anywhere in the process. Please feel free to contact me if you have further questions.
Christie Gowan
University of Alabama at Birmingham
Surgical Pathology
205 934 4991

> Date: Mon, 28 Feb 2011 09:41:02 -0500
> From: Dana.Spencer <@t> PCMH.COM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] Histology Workflow Solutions
>
> I am currently investigating workflow solutions for our Histology Lab
incorporating bar code labeling. We use the PowerPath/ Elekta AP System. I am looking into Elekta's AMP Module vs Ventana's Vantage system. I would welcome any comments on these systems and how they work in your lab or if you use something else. I would also welcome any suggestions or comments on how you label slides...Do you batch print and scan barcodes of the blocks and slides at the microtome? Do you scan blocks at the microtome and print labels there for the slides? Do you scan blocks at the microtome and print slides at the microtome? You may email directly if you prefer. Please share!
Thanks in advance for your help and feedback!
>
> Dana
>
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