Telepathology Network for the New York-New Jersey VA Integrated Health System



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Telepathology Network for the New York-New Jersey VA Integrated Health System Charles Ladoulis MD1,2; Rosemary Wieczorek MD1,2; Nicholas Cassai HT2; Shahida Ahmed MD2; Rakhee Saxena MD2; Gary Clarke MD2; Paul Endres MD 2 ; Matthew Pincus MD1,2; Cathy CruiseMD2; Telepathology Working Group of VA NY/NJ Integrated Health System [1]State University of New York at Brooklyn; [2]Department of Veterans Affairs, Veterans Integrated System Network 3;

Telepathology Network for the New York-New Jersey VA Integrated Health System Charles Ladoulis MD1,2; Rosemary Wieczorek MD1,2; Nicholas Cassai HT2; Shahida Ahmed MD2; Rakhee Saxena MD2; Gary Clarke MD2; Paul Endres MD 2 ; Matthew Pincus MD1,2; Cathy CruiseMD2; Telepathology Working Group of VA NY/NJ Integrated Health System [1]State University of New York at Brooklyn; [2]Department of Veterans Affairs, Veterans Integrated System Network 3; This is to affirm that the authors have no financial interest in any of the commercial interests pertaining to this presentation, in compliance with ASCP and API requirements for disclosure of conflicts of interest. Charles T. Ladoulis MD VA New York Harbor Healthcare System 800 Poly Place Brooklyn NY 11209 Clin. Assoc. Professor of Pathology State University of New York at Brooklyn Department of Pathology 750 Clarkson Brooklyn NY 2

National VA Network 3

Current Status of National VA Telepathology Networks National VA Network Richmond VA Server Apollo Enterprise Management Application Regional VA Telepathology Installations Eight VISN Networks within 22 Regions incl. VISN 12 North Chicago IL Milwaukee WI VISN 8 - Tampa Bay FL San Juan PR VISN 3 New York / New Jersey 4

Milwaukee- Madison N. Chicago VISN 12 Network 5

VISN 8 Tampa Bay Puerto Rico 6

NY NJ VA Telepathology Funding Initiative National Telehealth Funding for VISN3 Telepathology Initiative by Telehealth Service All six VAMC Pathology Departments Budget Deadline for FY 2014 Total Budget allocation 1.5 million for VISN 3 Distribution to each Pathology sites equivalent 7

VISN 3 NY/NJ Telepathology Network Overview 8

VISN 3 NY/NJ Telepathology Network Overview Telepathology Network Strategy Robotic Microscopy Workstations Whole Slide Imaging Gross Specimen Imaging Integration with National VA Server Long-term goal The Present Situation Development up to present 9

Telepathology Strategy for Implementation Robotic microscopy Apollo Microscopes (6) Whole slide imaging MikroScan D2 (6) Gross specimen imaging MacroPath (6) Electron Microscopy Digital Imaging (1) Existing Digital Photomicrographic equipment Olympus, Nikon, Leica, etc.o 10

Telepathology Network Sites VISN 3 - NY / NJ Manhattan VA New York Harbor Healthcare Brooklyn VA - New York Harbor Healthcare New Jersey VA East Orange, New Jersey Bronx VA, New York Hudson Valley VA New York Northport, Long Island, New York 11

Telepathology Patient Care Project Aims and Objectives Malignancy Confirmations Second Opinion Consultation Pathologists Within VA Site Pathologists at Other VA Site Pathologists at Joint Pathology Commission Frozen Section Diagnosis online Tumor Board Conferences within network 12

Telepathology Working Group Project Management Team FACILITY TELEHEALTH CHAIR PATHOLOGIST CHAIR PROJECT MANAGEMENT LEADER Pathologists at each site Full-time, parttime Technology Supervisors at each site Biomedical Engineering at each site Information Technologist at each site NY NJ VA Network Information Officer 13

Telepathology Working Group Project Milestones Weekly online Team Meetings 2014 2015 Installation of Robotic Microscopy in 2014 Network Implementation with Richmond 2014 Installation of WSI in 2014 Installation of Gross Specimen Imaging Integration with EHR in 2015 (CPRS, ViSTA) Implementation of Training Protocols 2014-15 14

VA NY/NJ Telepathology Network Current Progress March 2015 Implemented Robotic Microscopy Interfaced with National Network Installation of Whole Slide Imaging Initiated WSI Validation, Six Sites Adaptation of Protocol for All Sites Training of Pathologist, and Staff Pathologists at All Sites Supervising Technologists at All Sites Biomedical Engineering Staff IT Network Staff 15

VA NY/NJ Telepathology Network Intermediate Goals 2015 Intermediate Goals Standardize policies and procedures Validation across six hospitals Implementation of Specimen Imaging SUNY Pathology Informatics Elective Curriculum Design 16

VA NY NJ Hospitals Academic Affiliations 17

NY NJ VA Academic Pathology Affiliations Manhattan VA - New York University Brooklyn VA - SUNY at Brooklyn Bronx VA - Mt. Sinai Northport VA - SUNY Stony Brook New Jersey VA - Univ Med Dent NJ? Hudson Valey NY VA none Opportunities for Integration Pathology Informatics Programs None Joint Pathology Commission Consultation 18

Robotic Microscopy System Apollo PACS Microscope Remote Control Display Local Server National VA Server Interface 19

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Whole Slide Imaging MikroScan D2 5x, 10x, 20x, 40x Objectives Dual Slide Holder Z-Axis Remote Online Access National VA Server Interface 21

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Gross Specimen Imaging Milestone MacroPath System Laboratory Hood Mounted Integral Illumination Workstation and Keyboard Annotation Software Workstation Apollo Local Server Network Remote Online Access National VA Server Interface 24

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