Patients are clamoringfor convenience and theArizona TelemedicineProgram is answeringthe call. What will therepercussions be for thehealthcare industry?

The S-Curve Framework:Predicting the Future in Anatomic Pathology

Ronald S. Weinstein, M.D., F.C.A.P.Professor and Head

Department of PathologyDirector

Arizona Telemedicine Program

University of ArizonaCollege of Medicine

Tucson, AZ

Disclosures: UltraClinics®, DMetrix, Apollo

S-Curve of InnovationPe

rfor

man

ce

Effort (funds)

S-CURVE

Thomas W. Lawson 19021 2

3

4

5

6

7

1 2 3 4 5 6 7

Perf

orm

ance

Effort (funds)

S-Curve of InnovationS-CURVE

Over-optimistic

Under-optimistic

One tends to be over-optimistic in the short run and

under-optimistic in the long run,

because we can only extrapolate linearly

and progress is always an

exponential curve.

- Arthur C. Clarke

One tends to be over-optimistic in the short run and

under-optimistic in the long run,

because we can only extrapolate linearly

and progress is always an

exponential curve.

- Arthur C. Clarke

NATIONAL BLADDER CANCER PROGRAMCentral Pathology Laboratory

4540

643

3530252015105

521 7 8

Major Discrepancy

Minor Discrepancy

186 118

75

154 185

58

7070

INTER-INSTITUTIONAL QA

1983

College of American PathologistsFoundation Conference IVPathology Practice in a World ofChanging TechnologyJanuary 16-18, 1987 - Hawaii

First use of the word“telepathology” in a

scientific paper.

No.

Site

s/N

o. C

ases

Years

S-Curve of InnovationTelepathology/Digital Pathology

2007

S-Curves of Innovation

Robotic Microscopy Virtual Microscopy

Telepathology/Digital Pathology

Site #3Internet

Virtual Slide Processor

ClientSite #2

Site #1

Virtual slide network1999

Whole slide digital imaging

Virtual Slide Image Acquisition

Raster scanning

Single optical axis light microscope

Virtual Slide Telepathology

TelepathologyReport

Fully Digitized Slide Server

workstation

Aperio virtual slide scanner

Aperio virtual slide scanner

Lab Services Education

What’s next?

• 1987 to 2007• 2007 to 2027

2001

Arizona College of Optical SciencesUltra-Rapid Virtual Slide Processor Program

Working Group: Michael R. Descour, Ph.D, Peter Bartels, Ph.D. Chen Liang, René Slack, Ph.D., Ronald S. Weinstein, M.D.

Aim: Increase the field-of-view of the light microscopeDeliverable: Miniaturized microscope array digital imaging engine

Miniaturized microscope

• Miniaturization• Array microscope• Parallel processing

ArizonaProgram

Conventional Optics vs. Array Microscope OpticsConventional Optics vs. Array Microscope Optics

ArizonaProgram

9 mm

Weinstein et al, Human Pathology, 2001

Miniaturized Microscope ArrayConcept rendering

field-of-view

FOV 1 to 25 FOV 1 to 7

tissue

glass slide

MiniaturizedOptical Bench

Lenslet Array U.S. Quarter Coin

Invention of the lenslet array ensemble

ArizonaProgram

3 stacked lenslet arrays = 1 lenslet array ensemble

Patient Name

S-14926-06

University Physicians HospitalTucson, Arizona

Virtual Slide Breast core biopsy

Scan time - ~ 1 minute

Virtual Slide

S-Curves of Innovation

Single axis LM Array microscopy

Virtual Microscopy

College of MedicineUniversity of Arizona

Tucson, Arizona

University of Arizona Virtual Slide Applications

Virtual Slides in Diagnostic Pathologyat the University of Arizona

DMetrix Virtual Slides

U of A Pathology Quality Assurance Program

DMetrix Virtual Slides

®

SameSame--day Breast Care Servicesday Breast Care Services

•• ““One stop shoppingOne stop shopping””

•• TelemedicineTelemedicine--enabledenabled

•• UltraUltra--rapid labs and radiology servicesrapid labs and radiology services

•• OnOn--line second opinions line second opinions

IBM SYSTEMS JOURNAL 46: 69-84, 2007

®

NBC Tucson, AZ UltraClinics®

Susan G. Komen Race for the Cure - Tucson, Arizona – April 15, 2007

Tucson CitizenApril 16, 2007

Susan G. Komen Race for the Cure - Tucson, Arizona – April 15, 2007

“Patients Vote With Their Feet”

Perf

orm

ance

Effort

Robotic Telepathology Virtual Microscopy

Digital Pathology Laboratories

Discontinuity

? Retail Clinics

Thank you!

Ronald S. Weinstein, M.D.

ronaldw@u.arizona.edu