Name of Presentation Added in Header Box Digital Pathology: The Role of APLIS Integration in Supporting the Pathologists’ Workflow Curtis Stratman Partha Boocha Andrew Kotov Vanja Kvarnstrom These are the notes typed into the notes area of the presentation in Normal view. The Notes Pages can be viewed through File/Preview, and choose preview Notes pages. Print the notes pages through the print dialog. Note pages can be printed for all slides, or a custom range of slides. Notes can be printed in color or grayscale. When printing handouts, you may want to check the frame slides checkbox to give slides with a white background a frame on the note page. Omnyx, LLC, Pittsburgh, PA

Name of Presentation Added in Header Box DISCLOSURES Employee of Omnyx, LLC

BACKGROUND: This Question is Often Asked Name of Presentation Added in Header Box BACKGROUND: This Question is Often Asked How do APLIS and digital pathology systems work together to enable an efficient all digital workflow for high-volume routine use? Interfaces exist today, but one has yet achieved this goal.

BACKGROUND: Values Cannot Be Achieved Without Solution Name of Presentation Added in Header Box BACKGROUND: Values Cannot Be Achieved Without Solution Save pathologist time: eliminate sorting of and searching for slides immediate access to prior cases Optimize utilization of pathologists: distribute workload across locations route cases to knowledge experts Provide additional tools: precision measurement document interpretation with tissue region And more…

DESIGN: Workflow Informs Interface Requirements Name of Presentation Added in Header Box DESIGN: Workflow Informs Interface Requirements Methodology to define integration needs: Model the current state workflow Identify when data is created 2. Design the future state workflow - Identify when data is used Define the data interface specification - Provide the right information at the right time for the user - Balance technical trade-offs

RESULT: Leverage Tools from Service Modeling Name of Presentation Added in Header Box RESULT: Leverage Tools from Service Modeling

RESULT: Triggers Drive Workflow Actions Name of Presentation Added in Header Box RESULT: Triggers Drive Workflow Actions

RESULT: Pathologists’ Workflow is Slide-driven Name of Presentation Added in Header Box RESULT: Pathologists’ Workflow is Slide-driven

RESULT: Pathologists’ Workflow is Slide-driven United States United Kingdom France

RESULT: Images Alone Do Not Fill the Hole Name of Presentation Added in Header Box RESULT: Images Alone Do Not Fill the Hole PathologistWorkflow Slides Images What tells pathologists a case is ready for review? How do pathologists manage their workload?

RESULT: Digital Workflow Requires Tight Integration Name of Presentation Added in Header Box RESULT: Digital Workflow Requires Tight Integration Key Insights: Imaging workflow inserts activity of Scanning between Histology and Case Review Case review is triggered by imaging activity of scanning Case Review is where data from APLIS and imaging system come together for use Data from many points in workflow is leveraged by pathologist at time of Case Review

CONCLUSION: Neither System Can Deliver Alone Name of Presentation Added in Header Box CONCLUSION: Neither System Can Deliver Alone APLIS has data: Patient and case records Case details and documentation Tissue and processing details Slide identification and tracking Digital imaging system has data: Slides images Additional slide tracking details Image archival management Documentation of image analysis Workflow needs data from both to do: Assemble and present digital cases Alert to pathologist of ready work Organize and manage workload

CONCLUSION: Summary and Next Steps Name of Presentation Added in Header Box CONCLUSION: Summary and Next Steps Existing APLIS digital pathology interfaces focus on minimizing data transfer to: Attach images into the current slide-driven APLIS workflow Provide metadata to display around an image viewer However, a slide-driven workflow will not function when images replace slides and images alone do not provide a workflow Therefore, a new image-driven workflow module is needed to deliver an efficient value-add all digital workflow And as neither an APLIS nor a digital pathology system can deliver this module without the supporting data from the other We conclude that even though the interface specification to provide workflow integration across systems is more technical effort, doing so is necessary to enable the adoption of digital pathology for routine use.