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Briefly, value-adding processes are those for which a customer is willing to pay, and which change the shape, form, or function of a product. Current-state workflow is modeled using a VSM, which defines the start and end points for a product or service and classifies the steps in between as either value adding or nonvalue adding. The next steps are identifying key steps in the current workflow, recognizing areas of improvement or wasteful steps, and testing proposed solutions. Lean principles involve defining value, or the customer's need for a specific product, and mapping the value stream, or all processes involved in delivering a final product from its raw materials. Lean industrial production principles were originally developed by Toyota to eliminate manufacturing inefficiencies, subsequently popularized by Womack and Jones, and shown to be applicable to a variety of fields, including pathology. We aim to describe the defined image quality standards for gross photographs and show how lean techniques such as value stream mapping (VSM) can be used, as a process improvement initiative, in developing a cost-effective solution to streamline gross imaging workflow. Proposed solutions required a combination of software, to address image data integrity and accessibility, and hardware, to address image quality standards and ergonomics. We applied lean principles to our gross specimen photography workflow with the goals of defining acceptable image quality standards, improving image acquisition and case association times, and increasing accessibility of images. The ever-evolving field of digital photography and increasing number of options of consumer digital cameras make it difficult to ascertain what image file characteristics produced by these devices matter most for accurate and timely diagnosis. Finally, there is a lack of available data on quality standards for gross specimen photographs.
Twain vs image capture manual#
A higher volume of photos would require more manual labor to transfer, relabel, and archive image files and thus more opportunities for mislabeling or misplacement of data. Furthermore, scaling up and maintaining the archiving system presents challenges in personnel requirements and data integrity.
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These flaws result in significant amounts of time spent on nonproductive tasks, such as waiting for files to copy, or retrieving mislabeled files during times of high specimen volume. However, transferring hundreds of files from a digital camera to a shared drive is a labor-intensive process, and saving files on a shared drive alone has limited capabilities for image integration with anatomic pathology laboratory information systems (AP-LISs). Image files are manually relabeled to the appropriate case number and stored, in batches, on a shared drive accessible to medical staff and referenced during case finalization. Many of these cameras prove too delicate to be used daily in a busy anatomic pathology laboratory or are ergonomically intrusive to the process of specimen grossing. Consumer-type digital cameras are widely used in pathology laboratories to capture gross images of specimens and document significant findings. Pathology departments use various systems to integrate image acquisition, storage, and retrieval into a deliberately designed and streamlined workflow to expedite gross image review. Thus, acquisition of high-quality images, appropriate metadata, and easy access and retrieval at a multidisciplinary level, is a significant part of patient-centered health care.
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Gross specimen photography is a crucial component of anatomic pathology practice and often essential for accurate interpretation of microscopic images.