Why Toronto Is Site of Global Digital Path Center

GE Healthcare and Omnyx aim to demonstrate clinical and cost benefits of digital pathology

CEO SUMMARY: GE Healthcare and Omnyx chose Canada to be the location of their new Global Pathology Innovation Centre of Excellence (PICOE). PICOE’s mission is to demonstrate that digital pathology can improve patient outcomes in a cost-effective manner. GE and Omnyx will use PICOE as a proving ground for the value of digital pathology, while also encouraging researchers to develop useful software algorithms that incorporate digital pathology images to improve diagnosis.

IT WAS NO ACCIDENT that the Canadian city of Toronto was chosen by GE Healthcare (GE) to be the location for the company’s Global Pathology Innovation Centre of Excellence (PICOE).

A unique combination of circumstances makes the Province of Ontario an ideal test bed for new digital scanning technologies and digital pathology systems. Pathologists in the province are world leaders in their use of technologies in support of whole slide imaging (WSI) and digital pathology systems.

It was January when GE announced it would locate PICOE in Toronto, Ontario. Luigi Gentile was named as the Executive Director of PICOE. PICOE will have ample funding. GE and its digital pathology joint venture, Omnyx, LLC, are investing $7.75 million in the venture. Planned collaborative research and development partnerships will bring another $7.2 million.

Added to this funding will be a $2.25 million grant from the Health Technology Commercialization Program created by HTX (Health Technology Exchange)which is funded by the Ontario Ministry of Research and Innovation.

“One challenge with digital pathology today is that it means many different things to different people,” explained Michael Becich, M.D., Ph.D., an expert in digital pathology and Chair, Department of Biomedical Informatics at the University of Pittsburgh Medical Center (UPMC). UPMC is a partner with GE in the Omnyx joint venture. Becich has a sponsored research agreement with Omnyx and sits on its scientific advisory board.

Digital Pathology in the Lab

“A primary goal of the Toronto digital pathology center is to bring clarity to what it means to operate a digital pathology laboratory,” noted Becich. “In that way, the center aims to create a transformative health care IT environment around digital pathology.”

PICOE is located in Canada because of the nation’s ongoing effort to create an integrated healthcare informatics infrastructure. “Canada has a mandate to develop advanced pathology infrastructure,” Becich explained. “This is to be accomplished, in part, through support from the Canada Health Infoway project, which is an independent, nonprofit organization funded by the federal government, the independent provincial regional health authorities, as well as Ontario’s Health Technology Exchange (HTX).

“For years, in several ways, the Canadian healthcare environment has been ahead of that in the United States,” he stated. “In Canada, there has been considerable investment in advanced pathology systems— including digital pathology, telepathology, advanced imaging solutions, and software.

“Establishing PICOE in Toronto allows us to build on years of effort by Canada Health Infoway to develop the integrated health informatics environment that can make it easier for pathologists to use digital pathology systems in their daily practice,” added Becich. “Pathologists across Canada have considerable experience with digital pathology systems. They are working collaboratively to further develop regional applications for digital pathology.”

Rajiv Enand, Omnyx’s Senior Vice President of Business Development, explained that PICOE’s first round goals are to develop practical solutions that specifically advance use of digital pathology in day-to-day clinical settings. “The center wants to answer one big question,” he noted. “What is required to be successful when deploying digital pathology solutions on a broad scale?

“PICOE will be evaluating what types of changes must be made to workflow in the pathology laboratory,” added Enand. “There will likely be changes in histology and pathology workflow, with different job descriptions in histology. Pathologists and lab managers will need to re-assess the process required to deliver the best value from use of digital pathology systems.

PICOE As Global Incubator

“PICOE’s staff will work closely with customers—not only from the technical standpoint, but also from all the other aspects of implementation—to determine what it takes for digital pathology technology to be successful in the real world,” observed Enand. “As a global center, PICOE can function as an incubator within Canada’s health system for the controlled study, deployment and development of digital pathology advances. This can aid in acceptance of these tools internationally.”

“Our location in Toronto provides us two immediate benefits in support of these goals,” he noted. “First, there are a number of pathology laboratories in the Province of Ontario already using digital scanners and digital pathology systems. They not only use this technology daily, but are actively looking for ways to expand its use throughout the department.

Integrated Health Informatics

“Second, Ontario and other provinces in Canada are making steady progress toward an integrated healthcare informatics infrastructure,” continued Enand. “The goal is a universal electronic health record (EHR) and a paperless system. This creates many opportunities for digital pathology to contribute and to become part of the medical record, while reducing overall costs.

“Getting proof that digital pathology contributes value is an issue that must be addressed.” added Enand. “Clearly there is value in digital pathology. But digital pathology differs from digital radiology in one important aspect. Radiologists were able to use digital imaging to replace film. Cost savings and speed to diagnosis were immediate and obvious benefits.

“In the case of digital imaging in pathology, there will continue to be the need to produce glass slides,” Enand stated. “This is one reason why some people think digital pathology adds costs to the health system because it introduces one more step in the process.

“Interestingly, in retrospective studies on the gains from radiology-based PACS systems, the savings from not processing film were not significant,” added Enand. “However, savings from increased efficiencies in a digital workflow were quite significant—upwards of 15% to 30% gains in productivity! We believe the same analogies will be found in pathology and our goal is to gather data to prove this.

“For any IT system, including digital pathology, to succeed, it must show a positive return on investment in the marketplace,” he said. “In healthcare, any new system has to save money as well as improve outcomes and quality.

“That’s why our first goal is to work with those of our customers implementing digital pathology and have our researchers and engineers make these customers successful,” Enand stated. “PICOE is a research and development organization that focused on taking digital pathology from the bench to the bedside, meaning taking what we know about how to be successful from our labs into our customers’ labs.

“Success or failure does not result simply from installing new technology,” Enand counseled. “Success or failure hinges on how that technology is deployed. The same technology can be a failure in one place and successful in another. We all know stories about failures of new technology in other markets and with other products.

“Around the world, you can find a number of digital pathology systems that are sitting in a corner unused,” commented Enand. “You just don’t hear about those failures. As such, PICOE will focus on defining best practices in implementing digital pathology to deliver success for all customers.”

For Digital Pathology, Ontario Offers Wealth of Longitudinal Data, Researchers, Grants

THREE COMPELLING REASONS ENCOURAGED GE Healthcare and its Omnyx joint venture to establish their Global Pathology Imaging Centre of Excellence (PICOE) in Toronto.

“The first reason is the availability of longitudinal data,” explained Rajiv Enand, Omnyx’s Senior Vice President of Business Development. “The Canadian cancer registries have extensive longitudinal data on all patients that start when they were first diagnosed with cancer until death. That data is one result of the single-payer healthcare system in Canada.

“The second reason is the center will take advantage of the vibrant and growing community of researchers in Canada actively working on algorithms to analyze digital images,” stated Enand. “These researchers want to develop software algorithms that can find disease and can analyze and recommend treatment options.

“Conducting this type of research in the United States is much more difficult,” Enand added. “That is because patient data in the United States is so fragmented. In Canada, the single-payer healthcare system means all of that data is maintained within each province.

“Third is the amount of investment that the government is making in the development of software algorithms,” he noted. “The provincial and national governments in Canada are motivated to fund this research because these types of algorithms can be used to improve the quality of patient care while driving down the overall cost per healthcare encounter.

“In fact, one of our partners formed a new company in Ontario and received a grant for $13.5 million to develop algorithms for digital pathology,” stated Enand. “This grant money will be used to hire software developers to work with the pathologists and clinicians to write the software. PICOE is involved in about a half dozen requests for grants with different clinical partners to develop algorithms that will utilize and evaluate digital pathology images.”

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