Charite, University of Berlin, Germany.
Anal Cell Pathol (Amst). 2012;35(1):3-10. doi: 10.3233/ACP-2011-0044.
Virtual microscopy which is the diagnostic work with digitized microscopic images in tissue - based diagnosis is in its childhood in being implemented in routine diagnosis. Until today, only a few pathology institutions take use of this new technology, although it is available since several years. Why?
Virtual microscopy requires a new workflow organisation in the pathologist's diagnostic procedure. At a first view, the laboratory workflow seems to remain untouched to a high degree. However, the used laboratory information system (LIS), which is commonly built in a hierarchic order, has to be adjusted at its highest levels, i.e., diagnosis statement, quality evaluation, submission to the clinician (hospital information system), and feedback to the laboratory. Therefore, the laboratory's workflow is involved at all levels too, and the LIS has to be changed or adjusted to the requirements of VM. VM systems are usually equipped with a viewer that mimics the viewing of a conventional microscope, and do not offer access to sensitive nodes of the LIS. Similar, LIS are usually closed and fixed systems because of data security and certification demands. Thus, VM systems have to possess communication access at different LIS levels together with steering commands for the LIS in close association with the diagnostic quality and efficiency (for example demands for additional stains, immunohistochemical or quantitative image methods, etc.), as well as expert consultation, or panel discussion.
An implementation of an open and active LIS - VM management system could significantly promote the introduction of VM into routine diagnostic surgical pathology. The management system has to coordinate and translate the demands of VM to LIS (and vice versa), and to assure the communication with HIS. Mandatory features include streaming of the laboratory workflow, feedback commands to LIS, as well as regulation of temporary priority levels.
A successful implementation of VM systems in routine tissue-based diagnosis requires communicative management systems as long as VM is considered to be a "stand alone system" that just mimics a conventional microscope.
虚拟显微镜是在组织学诊断中使用数字化显微镜图像进行诊断的工作，它在常规诊断中的应用还处于起步阶段。尽管这项新技术已经问世多年，但目前只有少数几家病理机构在使用它。为什么呢？
虚拟显微镜需要对病理学家的诊断程序进行新的工作流程组织。乍一看，实验室工作流程似乎在很大程度上保持不变。然而，常用的实验室信息系统（LIS）通常是按层次结构构建的，必须在最高级别进行调整，即诊断陈述、质量评估、提交给临床医生（医院信息系统）以及反馈给实验室。因此，实验室的工作流程也涉及到各个层面，LIS 必须根据 VM 的要求进行更改或调整。VM 系统通常配备一个类似于传统显微镜的查看器，但无法访问 LIS 的敏感节点。类似地，由于数据安全和认证需求，LIS 通常是封闭的、固定的系统。因此，VM 系统必须具有与诊断质量和效率密切相关的不同 LIS 级别上的通信访问权限，以及对 LIS 的控制命令（例如，对额外染色、免疫组织化学或定量图像方法等的需求），以及专家咨询或小组讨论。
实现开放和主动的 LIS-VM 管理系统可以显著促进 VM 在常规外科病理学诊断中的引入。该管理系统必须协调和翻译 VM 对 LIS 的需求（反之亦然），并确保与 HIS 的通信。强制性特征包括实验室工作流程的流、对 LIS 的反馈命令以及临时优先级级别的调节。
在常规组织学诊断中成功实施 VM 系统需要有通信管理系统，只要 VM 被视为只是模仿传统显微镜的“独立系统”。
