Pathtracker, a software program which uses commercial digital cameras to track the movement of biospecimens and which has reminder capabilities William H. Yong MD; Philippe Taieb; Victoria C. DeGuzman; Steven S. Silver B.Sc. Brain Tumor Translational Resource, UCLA Neuro-Oncology Program and Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA

The Problem We are a UCLA Brain Tumor Bank and Core We are a UCLA Brain Tumor Bank and Core Many inhouse and many outside samples Many inhouse and many outside samples with diverse labeling with diverse labeling Many with no bar-code Many with no bar-code Materials transit to and from many UCLA sites Materials transit to and from many UCLA sites (Tissue microarray core, immunolab, WSDI etc) (Tissue microarray core, immunolab, WSDI etc) Final transit to outside site Final transit to outside site Not appropriate to track in Dept clinical LIS as research Not appropriate to track in Dept clinical LIS as research

The Basic Concepts More efficient to photo than to manually enter many cases More efficient to photo than to manually enter many cases “Picture is worth a thousand words” “Picture is worth a thousand words” When materials (slides, blocks) arrive or leave, photograph them When materials (slides, blocks) arrive or leave, photograph them This image is linked to a manually entered case number, name or study name (e.g. Dr.Jones Study #1). Bar code entry soon. RFID? This image is linked to a manually entered case number, name or study name (e.g. Dr.Jones Study #1). Bar code entry soon. RFID? If materials move out of the lab, a due date is assigned and an reminder sent when due If materials move out of the lab, a due date is assigned and an reminder sent when due E.g. If a block is loaned to the immunolab, a due date is set for 3 days after start of loan E.g. If a block is loaned to the immunolab, a due date is set for 3 days after start of loan

-Pathtracker written in Visual Basic 6 -Image and Specimen Data stored in Access Inexpensive retail digital cameras, a Canon Powershot S2 S2IS or SX100IS -A set camera distance is maintained with self- assembled camera stand. TECHNOLOGY

STEP 1 -Enter case ID# and patient name -Or enter Study Name (Jones 08-5)

STEP 2 -Put tray of slides under camera (Standard 20 slide tray) or box of cassettes

STEP 3: Snap Photo -Captures alphanumeric labels -Image twenty slides/tray or ninety blocks -Image zoom (Detail) function -Hardcopy report printable

Hardcopy reports containing all information including images regarding a case or group of cases can also be created.

STEP 4: Select Preset Processes: Common processes (stains, loans of material) and their duration can be pre-specified. On the due date, an notification will be sent. E.g. Slide loan 15 days, FISH 7 days New processes can be specified on the fly

Pop-up calendar Interface: 1.Clicking on a date in the calendar can modify preset date. 2.The number of days in which a task is due can be set as working days (excluding weekends etc) or as calendar days including weekends etc.

STEP 5: Automated Reports: Automated reminders are sent when tasks are due. Click check box to select recipient. Check boxes for addresses are easily added. The contains a summary of due items.

STEP 6: Search Function 1. Find cases using specified parameters including name, destination, and date range and display results as a report. 2. List Due cases

STEP 7 Option: Notes with Date/Time Stamps: When notations are made, a time stamp can be issued with the note to document the time by clicking watch icon.

How has Pathtracker fared in real life? Technicians like the ease and speed of use over extensive manual entry Technicians like the ease and speed of use over extensive manual entry Photo at initial entry/final exit only Photo at initial entry/final exit only Resolved several “lost” cases Resolved several “lost” cases (documented not in BTTR) (documented not in BTTR) Photo corrected one incorrectly (LIS) Photo corrected one incorrectly (LIS) documented case documented case Needs better integration with LIS Needs better integration with LIS

Autopsy Report Tracker Version No specimen/image tracking No specimen/image tracking Autopsy Due Dates set (e.g. 60 days) Autopsy Due Dates set (e.g. 60 days) After 50% time (e.g. 30 days) expires an is sent to remind pathologist After 50% time (e.g. 30 days) expires an is sent to remind pathologist Sequential reminder mails are sent every 10 days till case is finalled in Path tracker Sequential reminder mails are sent every 10 days till case is finalled in Path tracker Specific Autopsy Format Template is used Specific Autopsy Format Template is used

Sample Autopsy Report Reminder A CAP Reminder Dear Dr. J. Hippocrates This is a reminder that A09-178’s [60]-working-day due date [11/13/09] is approaching. In order to comply with CAP’s regulations, the case should be signed out prior to the date listed above. As a reference, current CAP accreditation requirements state that the final autopsy report “must be submitted within 60 working days for routine cases and within 3 months for complicated cases” (p. 326 of CAP’s Autopsy Performance & Reporting, 2nd edition). If you feel that the case is complicated one and will exceed the due date, please respond in writing so that all exceptions to the rule may be documented appropriately. Please let me know if there is any way in which I may assist you. Thank you for your time and understanding, Jenny Jones UCLA Autopsy Reporting Office X99999

Summary User friendly User friendly The point and shoot camera costs are low The point and shoot camera costs are low Computer and software preexisting Computer and software preexisting Useful where bar coding not available Useful where bar coding not available reminder system flexible reminder system flexible A community of users may potentially build on this? Talk to me! A community of users may potentially build on this? Talk to me! Future will bring bar-code and RFID based data entry in combination with image based tracking Future will bring bar-code and RFID based data entry in combination with image based tracking (e.g. misapplied bar code labels or RFID tags can be misleading- a picture is still powerful) (e.g. misapplied bar code labels or RFID tags can be misleading- a picture is still powerful)