1. Curing Cancer with Alfresco and the
American Society for Clinical
Pathologists
Ron Swan
CTO
Ray Wijangco
Alfresco Practice Manager

2. Agenda
• About ASCP
• Solution Overview
• Roadmap
• Architecture Overview

3. What is Pathology?
• pa·thol·o·gy
noun: the study of diseases and of the
changes that they cause
: changes in a person, an animal, or a plant
that are caused by disease
• 18,000 Practicing Pathologists in US
• Average age is 50 years and increasing
• Representing 70-80% of the world’s total
• Roughly 70-80% of disease diagnosis comes
from a laboratory

4. Problems facing Pathology
• Medical errors
• Missed 1st opinions
• Misclassification of diagnoses
• Wait times for diagnosis are increasing in some cases
• Market Forces
• Greater access to healthcare
• Decreasing number of laboratory healthcare providers

5. Solution Overview

6. ASCP Alfresco Applications
Asset Warehouse
Alfresco Share
Vault Web
Indexing Interface
ASCPedia
Consumer Search
Managed by Asset
Administrator to start
workflows / upload
assets
Experts index content by
discipline, including
workflow review by
peers and admin.
Consumer search
interface to access
images

7. Our history with Alfresco
• 2008 - Initial development of Asset Library using
Alfresco Community
• 2012 - Rewrite of the Asset Library using
Alfresco Enterprise
• 2014 – Development of ASCPedia

8. Asset Warehouse
• Librarian / Admin Tool
• OOTB Alfresco Share
• Manage
Contributions
• Prepare / Organize
Unindexed Assets
• Apply / Admin
Metadata
• Start Indexing
Workflows

9. Vault Web
• Asset Indexing Tool
• Bulk Indexing
• Annotations
• Pathology Terms / Tagging
• Workflow
• Peer Review Process
• Final Admin Approval
• Based on Expertise

10. ASCPedia

11. Challenges of working in a lab
• Workflow issues
• Glass slides break or are lost
• Comparisons to previous
patient specimens are
challenging
• Hoarding of reference slides
• Remote Diagnosis
• Slides often need to be
shipped to an expert
• Lack of real time collaboration

12. Opportunities in Pathology
• Pathology is becoming digital
• Full Slide Scans ~3gb an image
• Crowdsourcing & sharing have become
mainstream
• Virtual Training
• Shared Viewing
• Image Annotations
• Machine Learning
• Image comparison
• Clinical Decision Support

13. Interesting Features

14. Crowdsourcing

15. Annotations

16. Curated Collections

17. Google Glass
Integration Prototype

18. Roadmap

19. Image Analysis
•Cross referencing images
• Pathology to Radiology
• Time lapse
• To known abnormalities

20. Image Recognition
Applying facial recognition software to your
biopsy

21. "Clinical Decision Support systems link health observations
with health knowledge to influence health choices by
clinicians for improved health care” - Robert Hayward of the
Centre for Health Evidence

22. Other possibilities
• Case management tool
• Provide medical knowledge and diagnosis to
countries in need.
• Collaborative Viewing
• Allow experienced Pathologists to virtually
train others

23. Architecture Overview

24. MS SQL Server
Alfresco Server
NAS
External Solr
Asset Warehouse
Vault Web
ASCPedia
Annotation Server
(OpenSlide)
PathTerms
Amazon Web Services – S3
ASCPedia User
High Level Architecture

25. Vault Web Architecture
• Custom Java Spring MVC
• Activiti / Workflow Driven
• TSG OpenAnnotate for Asset Annotations
• Integration with PathTerms for Medical
Keywords
• Authentication with ASCP’s CRM

26. ASCPedia Architecture
• Single Page App / Backbone.js
• External Solr for Search / Metadata
• Published metadata from Alfresco Repository
• Access content via Alfresco WebScripts
• Integration with CRM

27. Demo

28. Question & Answers

29. Thank You!