An image repository for decision support O. Eichhorn * * Aperio, Vista, USA Objective: Pathology is a visual field, and pathologists make decisions based on visual information. An online repository of easily searched, well-categorized pathology images can be of immense use to pathologists, scientists, educators, and students. Method: Individuals and institutions all over the world have accumulated collections with thousands of slides representing a huge variety of pathologies. Some collections are digitized and available online, while others remain libraries of glass slides, with a variety of formats for case information and other metadata. Working with collectors to publish their slides and aggregating them together can yield an amazing decision support resource. Results: Long-term archival storage is a key issue for organizations adopting ePathology. A cloud-based repository can provide an inexpensive and scalable solution. ePathology is increasingly used for remote consultations. Cases managed by online consultation networks can be de-identified and contributed to a common repository, increasing the value of the decision support tool while providing a long-term archive. Conclusion: This talk will present concepts for an Image Repository for Decision Support, and discuss technical and business considerations for making it a reality, including ways to curate image metadata, organizational principles and search tools, relationships with users and contributors, access methods, and security and privacy considerations.