Patent Publication Number: US-11657370-B2

Title: Medical image based collaboration

Description:
RELATED APPLICATION 
     The present application is a continuation of U.S. patent application Ser. No. 14/432,178, filed on Mar. 27, 2015, which is a national stage entry of International Patent Application No. PCT/US2013/032583, filed on Mar. 15, 2013, which claims priority to U.S. Provisional Patent Application No. 61/706,466, filed on Sep. 27, 2012, which are all hereby incorporated herein by reference as if set forth in full. 
    
    
     BACKGROUND 
     Field of the Invention 
     The present invention generally relates to collaboration surrounding medical images and more specifically relates to primary diagnoses, secondary opinions, and collaboration between professionals facilitated by medical images. 
     Related Art 
     In conventional medical image based cases, an individual medical professional may feel uncomfortable rendering a final diagnosis on a difficult case and/or a case outside his or her area of expertise. Such a medical professional may want to consult with a peer or a recognized expert in the particular subject matter of the medical image based case. Similarly, a medical practice group or hospital or health care company may desire to consolidate its diagnoses for medical image based cases. Such consolidation may be within the medical group or hospital or health care company or may be external to the medical group or hospital or health care company. Conventional systems based upon glass microscope slides or proprietary medical imaging systems fail to allow easy, scalable and reliable collaboration on medical image based cases. Digital imaging for medical image based cases holds the promise of allowing some level of collaboration but has not been able to overcome the significant technical and administrative challenges associated with medical image based collaboration. Therefore, what is needed is a system and method that provides for easy, scalable and reliable medical based image collaboration to meet the needs of individual medical professionals while also meeting the needs of medical groups and hospitals and health care companies and the like. 
     SUMMARY 
     Accordingly, a medical image based collaboration system is described herein that provides easy, scalable and reliable solutions to the problems described above. The system includes a collaboration server that creates a medical image based case and establishes a set of minimum required information to complete the case. The collaboration server creates the medical image based case in response to a request from a requesting system and the collaboration server cooperates with the requesting system to populate the medical image based case with at least a digital medical image and a case number to complete the case. The collaboration server provides the medical image based case to a consulting system and receives analysis information in response. The collaboration server stores the analysis information in association with the medical image based case and provides the analysis information to the consulting system to complete the medical image based collaboration. 
     Other features and advantages of the present invention will become more readily apparent to those of ordinary skill in the art after reviewing the following detailed description and accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The structure and operation of the present invention will be understood from a review of the following detailed description and the accompanying drawings in which like reference numerals refer to like parts and in which: 
         FIG.  1    is a network diagram illustrating an example system for medical image based collaboration according to an embodiment of the invention; 
         FIG.  2    is a block diagram illustrating an example smart medical image capture device in a system for medical image based collaboration according to an embodiment of the invention; 
         FIG.  3    is a block diagram illustrating an example server in a system for medical image based collaboration according to an embodiment of the invention; 
         FIG.  4    is a flow diagram illustrating an example process for initiating medical image based collaboration by a requesting system according to an embodiment of the invention; 
         FIG.  5    is a flow diagram illustrating an example process for automatically initiating medical image based collaboration by a smart medical image capture device according to an embodiment of the invention; 
         FIG.  6    is a flow diagram illustrating an example process for creating a complete medical image based case according to an embodiment of the invention; 
         FIG.  7    is a flow diagram illustrating an example process for configuring a smart medical image capture device in accordance with medical image based case parameters according to an embodiment of the invention; 
         FIG.  8    is a flow diagram illustrating an example process for searching a directory of consulting systems according to an embodiment of the invention; 
         FIG.  9    is a block diagram illustrating an example workflow in a system for medical image based collaboration according to an embodiment of the invention; and 
         FIG.  10    is a block diagram illustrating an example wired or wireless processor enabled device that may be used in connection with various embodiments described herein. 
     
    
    
     DETAILED DESCRIPTION 
     Certain embodiments disclosed herein provide for medical imaging based collaboration. For example, one method disclosed herein allows for a requesting system to cooperate with a collaboration server system to create a medical image based case on the server, establish a minimum data set required to complete the case, provide the completed case to a consulting system, update the case with analysis information from the consulting system and receive the updated case from the server system. After reading this description it will become apparent to one skilled in the art how to implement the invention in various alternative embodiments and alternative applications. However, although various embodiments of the present invention will be described herein, it is understood that these embodiments are presented by way of example only, and not limitation. As such, this detailed description of various alternative embodiments should not be construed to limit the scope or breadth of the present invention as set forth in the appended claims. 
       FIG.  1    is a network diagram illustrating an example system  100  for medical image based collaboration according to an embodiment of the invention. In the illustrated embodiment, the system  100  comprises a network  90  that communicatively couples a plurality of entities. It should be noted that an entity may be an organization such as a company or a medical practice group or it may be one or more computer server device or one or more medical image capture devices or the like. Throughout this description, entities may be alternatively referred to as systems or institutions or the like. 
     In the illustrated embodiment, the network  90  communicatively couples one or more requesting systems  10  and  20 , one or more consulting systems  30 , one or more collaboration servers  40 , one or more smart medical image capture systems  50 , one or more medical image capture systems  60  and one or more repository systems  70 . As shown in  FIG.  1   , each of these systems has one or more data storage areas  15 ,  24 ,  27 ,  28 ,  35 ,  45 ,  55 ,  65  and  75 , which may include both persistent and volatile storage. The network  90  can be a public or private network, a wired or wireless network or any combination including public and private and wired and wireless. Network  90  can include a personal area network (“PAN”), a local area network (“LAN”), a wide area network (“WAN”), or a distributed combination of networks collectively comprising a global communications network such as the Internet. Network  90  can be an ad hoc network or a persistent network and can be fixed in location, be mobile, or network  90  may comprise a combination of fixed and mobile components. Additionally, network  90  may carry communications corresponding to a single network protocol or corresponding to multiple network protocols. 
     Requesting system  10  is configured to interface with the server  40  to initiate the creation of one or more medical image based cases and facilitate the completion of such cases. Requesting system  10  may include one or more computer devices capable of autonomous operation to accomplish the above described creation and completion of medical image based cases. In one embodiment, the requesting system  10  is a hospital or medical practice group with one or more professionals tasked with rendering diagnoses based in part on medical images. The requesting system  10  may or may not include one or more smart medical image capture devices (“SMICD”) and other medical image capture devices. 
     For example, in one embodiment, a medical practice group  20  comprises a requesting system  22  and one or more smart medical image capture devices  26  and one or more other medical image capture devices  25 . In such an embodiment, the group  20  may also include a laboratory information system (“LIS”)—not separately illustrated in  FIG.  1   —and other systems—also not shown in  FIG.  1   —that store information related to a medical image based case. 
     In an alternative embodiment, requesting system  10  operates over network  90  in cooperation with one or more smart medical image capture devices  50  and/or one or more other medical image capture devices  60 . In one embodiment, the difference between a smart medical image capture device  50  and a medical image capture device  60  is that the smart medical image capture device  50  is configured to interface with the one or more collaboration servers  40  to initiate the creation of one or more medical image based cases and facilitate the completion of such cases. Both the smart medical image capture device  50  and the medical image capture device  60  are capable of storing the digital medical images they capture. Otherwise, the one or more smart medical image capture devices  50  and the one or more medical image capture devices  60  are devices that are capable of capturing and storing medical images. Some examples of such devices include digital pathology systems, magnetic resonance imaging (“MRI”) systems, computed axial tomography (“CAT”) systems, and X-ray systems just to name a few. Other medical imaging systems may also be employed in the system  100  as will be understood by those skilled in the art. 
     In one embodiment, the repository  70  is configured to store medical image based cases and provide decision support to professionals as requested for medical image based diagnoses. The repository  70  can also advantageously store important collections of medical images for training and educational purposes. 
     Collaboration server  40  is configured to interface with requesting systems  10  and  20 , consulting systems  30 , smart medical image capture devices  50 , medical image capture devices  60 , and repositories  70  to implement and facilitate medical image based collaboration. The collaboration server  40  creates and manages medical image based cases and manages the workflow between a requesting system  10  (and any related systems such as the aforementioned LIS) and a consulting system  30  and any smart medical image capture devices  50  and the repository  70 . It should be noted that a medical image based case is an electronically stored data set that comprises at least a medical image and an identifier referred to herein as a case number. 
     In operation, the system  100  is configured such that the requesting system  10  initially requests that a medical image based case be created by the collaboration server  40 . This can be accomplished by an operator at the requesting system  10  logging into the collaboration server  40  and submitting the request. This can also be accomplished by a smart medical image capture device  50  sending an electronic request communication to the collaboration server  40  over the network  90 . The collaboration server  40  cooperates with the requesting system  10  (operator or SMICD) to create the case and define the minimum data set required for the case to be complete. The collaboration server  40  and/or the requesting system  10  then cooperate to provide the collaboration server  40  with the necessary information for the case to be complete and the collaboration server  40  stores the case in a local or remote data storage area accessible by the collaboration server  40 . 
     Once the case is completed, the collaboration server  40  provides notice to the consulting system  30  (e.g., by sending an electronic notice communication to the consulting system  30  over the network  90 ) and the consulting system  30  is allowed to access the medical image based case on the server  40 . In one embodiment, the collaboration server  40  provides the medical image based case information to the consulting system  30  via the network  90  in response to one or more requests for the information and none of the medical image based case information is persistently stored in a data storage area the consulting system  30 . 
     The consulting system  30  is configured to provide the collaboration server  40  with analysis information based on the provided medical image based case information and the collaboration server  40  is configured to receive that information and store that information in association with or as part of the medical image based case. The collaboration server  40  can then send a notice to the requesting system  10  and provide the analysis information to the requesting system  10 , for example via the network  90  in response to one or more requests for the analysis information from the requesting system  10 . 
     For example, in one embodiment, the collaboration server  40  creates a medical image based case and receives first medical image based case information comprising a digital medical image from the requesting system  10 . The collaboration server  40  assigns a case number and with the case number and the digital medical image, the medical image based case is considered complete. The collaboration server  40  notifies the consulting system  30  and provides the medical image based case information to the consulting system  30  and receives analysis information in response. The collaboration server  40  stores the analysis information as part of or in association with the medical image based case and notifies the requesting system  10  that the analysis information is available for review. The collaboration server  40  provides the analysis information to the requesting system  30  to complete the medical image based collaboration. The collaboration server  40  may also transmit the medical image based case to the repository  70  if the medical image based case meets certain predetermined criteria for inclusion in the repository  70 . 
       FIG.  2    is a block diagram illustrating an example smart medical image capture device  50  in a system for medical image based collaboration according to an embodiment of the invention. In the illustrated embodiment, the SMICD  50  comprises a configuration module  200 , an image capture module  210  and an upload module  220 . The SMICD  50  also has a data storage area  55 , which may include both persistent and volatile storage as described above. 
     The configuration module  200  is configured to establish the parameters under which the SMICD  50  will capture medical image data. For example, in a microscope based imaging system, the configuration module  200  may set a parameter that determines the magnification at which the system will capture image data. Alternatively, in an MRI system, the configuration module  200  may set a parameter that determines the frequency of image slices captured. A variety of image capture parameters can be established by the configuration module  200  as will be understood by those skilled in the art. Advantageously, the one embodiment, the configuration module  200  is configures to cooperate with the collaboration server  40  to establish these parameters. This allows the collaboration server  40  to ensure that appropriate medical image data is made part of the medical image based case. For example, for certain tissue types or for certain disease types, image data may need to be captured as a certain magnification. The configuration module  200  operates to cooperate with the collaboration server  40  to set a parameter on the SMICD  50  that will cause the digital medical image data to be captured at the desired magnification. 
     The image capture module  210  is configured to capture and store digital medical image data as appropriate for the particular type of SMICD  50 , e.g., digital pathology system, MRI system, CT system, X-ray system, etc. 
     The upload module  220  is configured to cooperate with the collaboration server  40  to securely upload digital medical image data to the collaboration server  40 . For example, the upload module  220  may encrypt the medical image data prior to sending the medical image data to the collaboration server  40 . Additionally, the upload module  220  may use a secure data communication protocol to send the encrypted medical image data to the collaboration server  40 . 
     In addition to sending the digital medical image data to the collaboration server  40 , the upload module  220  may also send metadata and other information to the collaboration server  40 . For example, the upload module  220  may also provide the collaboration server  40  with information from multiple sources such as an LIS, other imaging systems (e.g., a digital camera that captures a gross image), reports such as radiology reports, pharmacy reports, patient information, patient prescription information, patient insurance information, requesting system billing information, ancillary test results (e.g, immunohistochemistry, flow cytometry, special stains information, genetics information, etc.), LIS information, requesting system  10  case identification information, requesting system  10  preferred consulting system information, and any other information maintained by the requesting system  10 . 
     In an alternative embodiment, such additional information is provided to the collaboration server  40  by another device that is part of the requesting system  10  and not by the SMICD  50 , which may for example be a specialized medical imaging device that is unable to host and execute the upload module  220 . 
       FIG.  3    is a block diagram illustrating an example collaboration server  40  in a system for medical image based collaboration according to an embodiment of the invention. In the illustrated embodiment, the server  40  comprises SMICD command module  300 , a case module  310 , a directory module  320 , an image viewing module  330 , an image analysis module  340 , a user interface module  350 , a data mining module  360 , a repository module  370  and an admin/billing module  380 . The collaboration server  40  also has a data storage area  45 , which may include both persistent and volatile storage as described above. 
     SMICD command module  300  is configured to interface via network  90  with the configuration module  200  and the upload module  220  of the SMICD  50 . The SMICD command module  300  is configured to provide information and instructions to the SMICD  50  and to receive requests and information from the SMICD  50 . In one embodiment, the SMICD command module  300  coordinates the workflow for medical image based collaboration in cooperation the various other modules on the collaboration server  40 . For example, the command module  300  may cooperate with the case module  310  to create and complete a medical image based case, may cooperate with the directory module  320  to allow a requesting system to search the directory of available consulting systems (individuals and groups), may cooperate with the image viewing module  330  to provide medical image based case information to a consulting system, cooperate with the image analysis module  340  and the case module  310  to update a medical image based case with image analysis information, cooperate with the user interface module  350  to provide information on the display of a user device or a viewing device, cooperate with the data mining module  360  to analyze medical image based information to identify trends in data and provide other analytical information based on such analyses, cooperate with the repository module  370  to archive medical image based case information for later use, and cooperate with the admin/billing module  380  to effect payment for medical image based collaboration and provide reports to both consulting systems and requesting systems. 
     In one embodiment, the SMICD command module  300  receives an electronic request from a requesting system  10  to create a medical image based case. The request may be received from an operator of a computer device at the requesting system  10  or it may be received directly from a SMICD  50 . In response, the command module  300  creates a medical image based case and establishes a minimum data set required to complete the case. In one embodiment, the minimum data set is a digital medical image and a case number. The command module  300  is configured to assign a case number to the medical image based case. In one embodiment the case number may include a portion that is associated with an LIS system employed by the requesting system. The command module  300  can request additional information that is to be made part of the medical image based case, for example by querying the requesting system or by directly querying the LIS system employed by the requesting system. Once the medical image based case is complete, the command module  300  notifies the consulting system and then cooperates with the image viewing module  330  to allow the consulting system to view the medical image based case information, for example via a browser running on a computer system associated with the consulting system. 
     The command module  300  is also configured to receive medical image based case analysis information from the consulting system and store that information in association with the medical image based case and then to cooperate with the user interface module  350  to provide the medical image based information, including the medical image based case analysis information to the requesting system. 
     The command module  300  is also configured to receive uploaded medical image data, either in cooperation with an upload module  220  or otherwise. For example, in an embodiment where the requesting system does not use a smart medical image capture device, an operator at the requesting system may login to the collaboration server  40  and interact with the SMICD command module  300  via the user interface module  350  and provide digital medical image data. This may be accomplished by the command module  300  presenting the operator with a file upload window to allow the operator to select a digital medical image file located in a data storage area at the requesting system. Additional and alternative information may also be provided from the requesting system in this fashion and accordingly various reports, gross images, LIS information, ancillary test results and the like can be incorporated into the medical image based case in this fashion. 
     Case module  310  is configured to create and store medical image based cases and cooperate with the command module  300  to establish a set of minimum required data to complete a medical image based case. For example, in Table 1 below, the case module  300  maintains a set of minimum required information for a plurality of medical conditions and tracks the status of any new medical image based case until the various required elements are included in the case information to allow the medical image based case to be determined to be complete. 
     
       
         
           
               
               
             
               
                   
               
               
                 MEDICAL 
                   
               
               
                 CONDITION 
                 MINIMUM REQUIRED INFORMATION 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
               
               
               
            
               
                 CONDITION_1 
                 X 
                   
                   
                 X 
                   
                 X 
               
               
                 CONDITION_2 
                   
                 X 
                 X 
                   
                 X 
                   
               
               
                 CONDITION_3 
                   
                 X 
                   
                 X 
                   
                 X 
               
               
                   
               
            
           
         
       
     
     Case module  310  may also cooperate with image analysis module  340  to update the medical image based case information to include image analysis information provided by the image analysis module  340 . The case module  310  may also maintain a current status of the medical image based case in order to facilitate tracking and management of the workflow associated with the medical image based case. In one embodiment, the current status of the case may include whether the case is pending or complete, whether the consulting system has requested additional information (and if so, who is responsible to provide the additional information). Advantageously, the case module  310  may cooperate with the directory module  320  to maintain a set of preferences for consulting systems that are individuals or groups and then apply those preferences to individual medical image based cases that are associated with the particular consulting systems that are those individuals or groups. 
     Directory module  320  is configured to maintain in a data storage area a list of consulting systems and their respective availabilities that can be searched by requesting systems in need of a consulting system. As discussed above, the directory module  320  may also maintain preferences of each consulting system so that medical image based cases assigned to a particular consulting system are properly seeded with the information desired by the particular consulting system. This capability advantageously reduces the turn-around-time (“TAT”) associated with providing a consultation analyses. 
     In one embodiment, the directory module  320  may include additional information for each consulting system. For example, in Table 2 below the directory module  320  maintains subspecialty information for each consulting system in addition to a price per case that is charged by the respective consulting system for the particular subspecialty, a turn-around-time and an availability that is expressed as the volume of cases per month that the consulting system can process. 
     
       
         
           
               
               
               
               
               
             
               
                   
               
               
                   
                   
                 PRICE 
                   
                   
               
               
                 CONSULTING 
                 SUB- 
                 PER 
                   
                   
               
               
                 SYSTEM 
                 SPECIALTY 
                 CASE 
                 TAT 
                 VOLUME 
               
               
                   
               
             
            
               
                 CONSULTING_1 
                 BREAST 
                 $210 
                 4D 
                  40/MO 
               
               
                 CONSULTING_2 
                 LUNG 
                 $225 
                 2D 
                  25/MO 
               
               
                 CONSULTING_3 
                 PROSTATE 
                 $275 
                 3D 
                 200/MO 
               
               
                   
               
            
           
         
       
     
     Image viewing module  330  is configured to provide a consulting system or a requesting system with medical image based case information including metadata and digital medical image data. The image viewing module  330  is advantageously capable of presenting such data in a browser window of a consulting system&#39;s computer. The image viewing module  330  is also capable of providing this same information to another party such as the requesting party or some other third party with the appropriate access credentials. 
     Image analysis module  340  is configured to store and execute image analysis algorithms on the medical image based case information in order to provide more robust information and data to the requesting system and the consulting system alike. The image analysis module  340  is also configured to cooperate with the case module  310  to store such image analysis information in association with each medical image based case so analyzed. 
     The image analysis module  340  may also be employed to analyze digital medical image data that is part of a medical image based case and determine if the digital medical image data is appropriate for the medical image based case. For example, if the particular condition or tissue type that is the subject of the medical image based case requires a digital medical image at a particular resolution, the image analysis module  340  is configured to analyze the digital medical image data and determine if the digital medical image data meets the required parameters for the medical image based case. As discussed above, such parameters may be established in advance of capturing the digital medical image by the SMICD command module  300  in cooperation with the configuration module  200  at the requesting system. 
     User interface module  350  is configured to present information on a display at the requesting system or the consulting system and receive input and instructions from an operator and provide such input and instructions to, for example, the SMICD command module  300 . 
     Data mining module  360  is configured to analyze medical image based case information stored in the data storage area and identify trends and events to facilitate improved medical image based collaboration by requesting systems and consulting systems. For example, the data mining module  360  can identify major and minor discrepancies based on an analysis of all of the medical image based collaborations for a requesting system. Specifically, the data mining module  360  may compare the analysis information provided to the requesting system by a consulting system for a particular medical condition against the initial diagnosis information that is stored as part of the medical image based case. The data mining module  360  may make this comparison across all medical image based cases for a particular requesting system and calculate a major and minor discrepancy rate. 
     Advantageously, if the major discrepancy rate for the requesting system is sufficiently low, then the requesting system may be able to reduce future costs by eliminating consultations for the particular medical condition. Similarly, if the major discrepancy rate for the requesting system is sufficiently high then the requesting system may be able to improve accuracy of future diagnoses by requiring consultations in all instances of the particular medical condition. 
     The data mining module  360  is also configured to identify areas where training could be beneficial for a requesting system or a consulting system and to conduct companion diagnostics image analysis. The data mining module  360  is also configured to analyze information related to rejected image data and provide quality assessments of at least medical imaging services or specimen preparation laboratories. 
     Repository module  370  is configured to send identified medical image based cases to a repository server for archival and storage and analysis for decision support and educational purposes. The repository module  370  may also interface with an operator via the user interface module  350  to facilitate searching of the repository and facilitate the use of the decision support capabilities of the repository  70  by the operator. Advantageously, the repository module  370  may assist an operator in using certain sophisticated visual search capabilities offered by the repository  70 . 
     Admin/billing module  380  is configured to bill requesting systems for services provided by the collaboration server and/or the consulting system. The admin/billing module  380  is also configured to pay consulting systems for services provided by the consulting systems to the collaboration server  40  and/or the requesting system. The admin/billing module  380  is also configured to provide a robust report generating capability for requesting systems and consulting systems. In one embodiment, the admin/billing module  380  works in cooperation with the data mining module  360  to provide reports and other information including data mining module  360  analysis regarding a requesting system&#39;s major and minor discrepancies and/or a consulting system&#39;s areas of strength. The admin/billing module  380  can therefore assist a requesting system with identifying areas where its medical professionals may need some future training and assist a consulting system with identifying areas where its medical professionals can market expanded consulting services or training services. 
       FIG.  4    is a flow diagram illustrating an example process for initiating medical image based collaboration by a requesting system according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . Initially, in step  400  an operator at a requesting system logs into the collaboration server and requests that a case be created in step  405 . In response to this request, the collaboration server creates a data structure that resides in a memory of the collaboration server and stores the medical image based case information. The collaboration server assigns a case number to the newly created case and the operator at the requesting system receives the case number in step  410 . Next, the operator at the requesting system obtains the digital medical image in step  415 , for example, by instructing a digital medical imaging device to capture a digital medical image. Alternatively, if the digital medical image already exists, the operator may simply browse a hierarchical file system (or other type) and select the desired digital medical image. Once the digital medical image has been obtained (by real time image capture or by selecting from a file system), in step  420  the requesting system uploads the digital medical image in association with the case number previously received in step  410 . 
     In this fashion, an operator at a requesting system can effectively create and complete a number of medical image based cases on the collaboration server. In an embodiment where additional information is required to meet the minimum required data to complete a medical image based case, the operator can either upload the additional required information in step  420  or allow the collaboration server to interface with an LIS system or other data source at the requesting system or elsewhere to obtain any additional information needed to complete the medical image based case. 
       FIG.  5    is a flow diagram illustrating an example process for automatically initiating medical image based collaboration by a smart medical image capture device according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . Initially, in step  430  the SMICD receives a first slide. In this example embodiment, the SMICD is a digital pathology system that is configured with an autoloader having a one hundred and twenty (120) physical glass microscope slide capacity. Accordingly, the SMICD receives a first slide by way of the autoloader and then in step  435  the SMICD scans or reads one or more barcodes that are affixed to the glass microscope slide. As will be understood by those skilled in the art, the one or more barcodes, when decoded, provide access to certain information about the specimen on the glass microscope slide and the patient to which the specimen belongs. For example, the information about the specimen may include what stains the specimen was treated with and the information about the patient may include demographic information, medical record information, LIS information and the like. 
     Next, in step  440  the SMICD sends an image of the barcode(s), the decoded barcode, or the information corresponding to the barcode to the collaboration server. In turn, the collaboration server creates a medical image based case in step  440  and sends a case number back to the SMICD, as shown in step  445 . Next, the SMICD obtains the digital medical image in step  450 . In this particular example embodiment, the digital pathology system digitally scans the glass microscope slide to create a whole slide image. Alternatively, the digital pathology system may only digitally scan a portion of the specimen on the slide. Advantageously, any type of digital pathology system that creates a digital image of a specimen on a glass microscope slide may be employed. 
     Once the digital medical image has been obtained, the image is uploaded to the collaboration server in association with the case number as shown in step  455 . In one embodiment, this completes the medical image based case on the collaboration server. If additional information is required to meet the minimum required data for the medical image based case, such data can be provide to or obtained by the collaboration server as previously described. 
     Continuing with the present example of the digital pathology system SMICD, if the autoloader has additional unscanned slides, as determined in step  460 , the SMICD loops back to step  430  and receives another glass microscope slide and the process of creating another medical image based case proceeds. Alternatively, if all 120 glass microscope slides from the autoloader have been scanned and medical image based cases created for each glass microscope slide, then the process ends in step  465 . 
       FIG.  6    is a flow diagram illustrating an example process for creating a complete medical image based case according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . Initially, in step  470  the collaboration server receives a request to create a new medical image based case and then in step  475  the collaboration server creates the medical image based case. Next in step  480  the collaboration server determines the minimum data required to complete the case. 
     The minimum data required to complete a case may be predicated upon the subject matter of the case. For example, if the medical image based case is of a certain tissue type or a certain pathological condition or the like, then the minimum data required may be established by a predetermined list of requirements that are associated with the particular tissue type, certain pathological condition or the like. The collaboration server may obtain information about the tissue type or pathological condition from LIS information or other metadata information that was provided to the collaboration server in association with the case number. Additionally, the collaboration server may request information including tissue type, pathological condition or the like from one or more data sources at the requesting system or from one or more data sources elsewhere that are not affiliated with the requesting system. For example, industry groups or medical professional groups may establish minimum standards that can be used by the collaboration server as minimum data requirements. In one embodiment, the collaboration server maintains a table of minimum data requirements for a plurality of types of medical image based cases. 
     Once the minimum data required has been determined and associated with the medical image based case, the collaboration server proceeds to receive data and store the received data as part of, or in association with, the medical image based case as shown in step  485 . The collaboration server continues to evaluate whether all of the minimum data required has been received and stored for the medical image based case as indicated by step  490  and the continuing loop between evaluating if the case is complete in step  490  and receiving data in step  485 . Once the collaboration server has determined that the medical image based case is complete in step  490 , the collaboration server sends a notice to one or more consulting systems that are associated with the medical image based case. Advantageously, the notice indicates that the medical image based case is available for analysis by the one or more consulting systems. 
       FIG.  7    is a flow diagram illustrating an example process for configuring a smart medical image capture device in accordance with medical image based case parameters according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . Initially, in step  500  the collaboration server receives a request to create a case from an SMICD at a requesting system. Alternatively, the collaboration server may receive the request from an operator at the requesting system where the operator is using a communication device that is not an SMICD. Next, in step  505  the collaboration server obtains certain information for the medical image based case, for example, the collaboration server may receive barcode or LIS or other information directly from the SMICD device or from other data sources. Alternatively, the operator may upload or otherwise provide such information to the collaboration server. Next, in step  510  the collaboration server creates the case and as part of creating the case the collaboration server assigns a case number to the medical image based case. In one embodiment, the case number may be a combination of a requesting system case number and a consulting system case number. Alternatively, the case number may be a combination of a requesting system case number and a collaboration server case number or the case number may be a combination of a requesting entity case number and a consulting system case number and a collaboration server case number. A variety of options for case numbers may be employed, with workflow advantages realized from repurposing the requesting system case number and the consulting system case number. 
     After the case has been created, the collaboration server configures the SMICD. This configuration of the SMICD can be accomplished by the collaboration server by sending a single command or a series of commands to the SMICD to cause the SMICD to execute the commands and thereby establish the desired parameters for the medical image capture process. In one embodiment, configuring the SMICD establishes the parameters under which the medical imaging process takes place. For example, illumination characteristics, magnification, resolution, speed, frequency, area and other general and/or specific medical imaging characteristics for the particular type of SMICD can be established through the configuration process. Once the SMICD has been configured, the collaboration server receives image data and metadata in step  520  and analyzes the image data and metadata to confirm that the image data corroborates that the digital medical image was captured using the parameters that were established when the SMICD was configured with respect to step  515 . If the analysis of the image data confirms that the correct parameters were used, the collaboration server updates the case file with the image data and the metadata received in step  520 . Alternatively, if the analysis of the image data confirms or suggests that the correct parameters were not used, the collaboration server can discard the image data and the metadata received in step  520 . 
     In one embodiment, analysis of the image data includes determining the resolution of the digital medical image, determining the magnification of the digital medical image, determining the image quality of the digital medical image, determining the illumination characteristics of the digital medical image, determining if the digital medical image was captured under fluorescent imaging conditions, determining the tissue type of the specimen, determining the color space of the digital medical image and the like. 
       FIG.  8    is a flow diagram illustrating an example process for searching a directory of consulting systems according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . Initially, in step  600  the collaboration server obtains medical image based case information, e.g., from a data storage area, and analyzes the medical image based case information in step  605 . Based on the analysis, in step  610  the collaboration server searches a directory of consulting systems. As previously discussed, a consulting system may be an individual consultant or a group of consultants. Based on the search results, the collaboration server compiles an initial list of possible consulting systems in step  615 . In one embodiment, the initial list may be compiled based on a match of the medical image based case type and a consulting system&#39;s subspecialty. 
     Once an initial list has been compiled by the collaboration server, in step  620  the sever obtains additional parameters from the requesting system and filters the compiled list of consulting systems based on the additional parameters, as shown in step  625 . Next, in step  630  the collaboration system provides the filtered list of consulting systems to the requesting system. Optionally, the collaboration server may loop back and obtain additional or alternative parameters from the requesting system and then apply the additional or alternative parameters to further filter the initial list of possible consulting systems. This process of reviewing and filtering may continue through multiple iterations until such time as the requesting system is satisfied with the list of available consulting systems. 
     In one embodiment, the initial compiled list or the filtered list (or both) may be compiled or filtered based on the availability of the consulting system. Accordingly, if a particular consulting system is currently too busy or is currently on vacation, then that particular consulting system may advantageously be excluded from both the initial compiled list and the filtered list. 
       FIG.  9    is a block diagram illustrating an example workflow in a system for medical image based collaboration according to an embodiment of the invention. The illustrated process may be carried out by a system such as previously described with respect to  FIGS.  1 - 3   . In the illustrated embodiment, the system comprises a requesting system  10  communicatively coupled with a consulting system  30  via a collaboration server  40  and a network  90 . Initially, in step  650  a medical image is digitized at the requesting system  10  and then uploaded in step  660  to a data storage area at the collaboration server  40 . As shown, LIS case information and/or additional information  655  may be provided to the collaboration server  40  at the time of the image upload  660  or during case review  665  or consult request  670 . 
     Once the digital medical image has been uploaded to the server and the medical image based case has been created, the next steps in the workflow are performed at the server  40  in cooperation with the requesting system  10  and/or the consulting system  40 . For example, in step  665  the collaboration server  40  facilitates a review of the medical image based case by the requesting system  10  to allow the requesting system  10  to ensure that the medical image based case is complete. At this step, additional information such as LIS information  655  may be uploaded to the collaboration server  40  and included with the medical image based case. In one embodiment, this review can be conducted by an operator at the requesting system  10 . 
     Similarly, the collaboration server  40  next receives a consult request in step  670  from the requesting system  10  and solely or interactively with the requesting system  10  searches a directory of consulting systems to identify one or more consulting systems appropriate for the particular medical image based case. Note that at this step during the workflow, additional information such as LIS information  655  may be added to the medical image base case. 
     In step  675  the collaboration server  40  assigns a consulting system  30  to the medical image based case and in one embodiment the medical image based case information is exported to an LIS system managed and maintained by the consulting system  30 . Next in step  680 , the consulting system  30  analyzes the medical image based case information received from the collaboration server  40  and prepares a consultant analysis and sends the consultant analysis to the collaboration server  40  for storage with the medical image based case. In one embodiment, a companion LIS report or other reports from the consulting system  30  may be included with the consultant analysis and ultimately made part of the medical image based case. The collaboration server  40  then provides the consultant analysis to the requesting system  10  to complete the collaboration workflow. Advantageously, additional digital medical images may be digitized and uploaded simultaneously or serially to provide larger scale collaboration between one or more requesting systems  10  and one or more consulting systems  30 . 
     Additionally, in one embodiment, during the consulting system  30  review, the consulting system  30  may request that additional information be included with the medical image based case. In response, the collaboration server  40  may update the status of the medical image based case and send a notice to the requesting system  10  regarding the request for additional information. Once the requesting system  10  has provided the additional information, the collaboration server  40  may again update the status of the medical image based case and notify the consulting system  30  that the updated medical image based case is ready for review by the consulting system  30 . Multiple iterations of requests for additional information may be employed in order to ensure that the medical image based case is complete. 
       FIG.  10    is a block diagram illustrating an example wired or wireless system  550  that may be used in connection with various embodiments described herein. For example the system  550  may be used as or in conjunction with a requesting system, consulting system, medical image capture device, smart medical image capture device, server or repository as previously described with respect to  FIGS.  1 - 3   . The system  550  can be a personal computer, computer server, personal digital assistant, smart phone, tablet computer or the like, a medical image capture system such as a digital slide scanning system, radiology imaging system, magnetic resonance imaging system, computed axial tomography system, X-ray system or the like or any other processor enabled device that is capable of wired or wireless data communication. Other computer systems and/or architectures may be also used, as will be clear to those skilled in the art. Specialty components needed for specific purposes such as medical imaging can be integrated into the system  550  as will be understood by those skilled in the art and will therefore not be described here in detail. One example of a digital slide scanning system is described in U.S. Pat. No. 6,711,283, which is incorporated herein by reference in its entirety. 
     The system  550  preferably includes one or more processors, such as processor  560 . Additional processors may be provided, such as an auxiliary processor to manage input/output, an auxiliary processor to perform floating point mathematical operations, a special-purpose microprocessor having an architecture suitable for fast execution of signal processing algorithms (e.g., digital signal processor), a slave processor subordinate to the main processing system (e.g., back-end processor), an additional microprocessor or controller for dual or multiple processor systems, or a coprocessor. Such auxiliary processors may be discrete processors or may be integrated with the processor  560 . 
     The processor  560  is preferably connected to a communication bus  555 . The communication bus  555  may include a data channel for facilitating information transfer between storage and other peripheral components of the system  550 . The communication bus  555  further may provide a set of signals used for communication with the processor  560 , including a data bus, address bus, and control bus (not shown). The communication bus  555  may comprise any standard or non-standard bus architecture such as, for example, bus architectures compliant with industry standard architecture (“ISA”), extended industry standard architecture (“EISA”), Micro Channel Architecture (“MCA”), peripheral component interconnect (“PCI”) local bus, or standards promulgated by the Institute of Electrical and Electronics Engineers (“IEEE”) including IEEE 488 general-purpose interface bus (“GPIB”), IEEE 696/S-100, and the like. 
     System  550  preferably includes a main memory  565  and may also include a secondary memory  570 . The main memory  565  provides storage of instructions and data for programs executing on the processor  560 . The main memory  565  is typically semiconductor-based memory such as dynamic random access memory (“DRAM”) and/or static random access memory (“SRAM”). Other semiconductor-based memory types include, for example, synchronous dynamic random access memory (“SDRAM”), Rambus dynamic random access memory (“RDRAM”), ferroelectric random access memory (“FRAM”), and the like, including read only memory (“ROM”). 
     The secondary memory  570  may optionally include a internal memory  575  and/or a removable medium  580 , for example a floppy disk drive, a magnetic tape drive, a compact disc (“CD”) drive, a digital versatile disc (“DVD”) drive, etc. The removable medium  580  is read from and/or written to in a well-known manner. Removable storage medium  580  may be, for example, a floppy disk, magnetic tape, CD, DVD, SD card, etc. 
     The removable storage medium  580  is a non-transitory computer readable medium having stored thereon computer executable code (i.e., software) and/or data. The computer software or data stored on the removable storage medium  580  is read into the system  550  for execution by the processor  560 . 
     In alternative embodiments, secondary memory  570  may include other similar means for allowing computer programs or other data or instructions to be loaded into the system  550 . Such means may include, for example, an external storage medium  595  and an interface  570 . Examples of external storage medium  595  may include an external hard disk drive or an external optical drive, or and external magneto-optical drive. 
     Other examples of secondary memory  570  may include semiconductor-based memory such as programmable read-only memory (“PROM”), erasable programmable read-only memory (“EPROM”), electrically erasable read-only memory (“EEPROM”), or flash memory (block oriented memory similar to EEPROM). Also included are any other removable storage media  580  and communication interface  590 , which allow software and data to be transferred from an external medium  595  to the system  550 . 
     System  550  may also include an input/output (“I/O”) interface  585 . The I/O interface  585  facilitates input from and output to external devices. For example the I/O interface  585  may receive input from a keyboard or mouse and may provide output to a display. The I/O interface  585  is capable of facilitating input from and output to various alternative types of human interface and machine interface devices alike. 
     System  550  may also include a communication interface  590 . The communication interface  590  allows software and data to be transferred between system  550  and external devices (e.g. printers), networks, or information sources. For example, computer software or executable code may be transferred to system  550  from a network server via communication interface  590 . Examples of communication interface  590  include a modem, a network interface card (“NIC”), a wireless data card, a communications port, a PCMCIA slot and card, an infrared interface, and an IEEE 1394 fire-wire, just to name a few. 
     Communication interface  590  preferably implements industry promulgated protocol standards, such as Ethernet IEEE 802 standards, Fiber Channel, digital subscriber line (“DSL”), asynchronous digital subscriber line (“ADSL”), frame relay, asynchronous transfer mode (“ATM”), integrated digital services network (“ISDN”), personal communications services (“PCS”), transmission control protocol/Internet protocol (“TCP/IP”), serial line Internet protocol/point to point protocol (“SLIP/PPP”), and so on, but may also implement customized or non-standard interface protocols as well. 
     Software and data transferred via communication interface  590  are generally in the form of electrical communication signals  605 . These signals  605  are preferably provided to communication interface  590  via a communication channel  600 . In one embodiment, the communication channel  600  may be a wired or wireless network, or any variety of other communication links. Communication channel  600  carries signals  605  and can be implemented using a variety of wired or wireless communication means including wire or cable, fiber optics, conventional phone line, cellular phone link, wireless data communication link, radio frequency (“RF”) link, or infrared link, just to name a few. 
     Computer executable code (i.e., computer programs or software) is stored in the main memory  565  and/or the secondary memory  570 . Computer programs can also be received via communication interface  590  and stored in the main memory  565  and/or the secondary memory  570 . Such computer programs, when executed, enable the system  550  to perform the various functions of the present invention as previously described. 
     In this description, the term “computer readable medium” is used to refer to any non-transitory computer readable storage media used to provide computer executable code (e.g., software and computer programs) to the system  550 . Examples of these media include main memory  565 , secondary memory  570  (including internal memory  575 , removable medium  580 , and external storage medium  595 ), and any peripheral device communicatively coupled with communication interface  590  (including a network information server or other network device). These non-transitory computer readable mediums are means for providing executable code, programming instructions, and software to the system  550 . 
     In an embodiment that is implemented using software, the software may be stored on a computer readable medium and loaded into the system  550  by way of removable medium  580 , I/O interface  585 , or communication interface  590 . In such an embodiment, the software is loaded into the system  550  in the form of electrical communication signals  605 . The software, when executed by the processor  560 , preferably causes the processor  560  to perform the inventive features and functions previously described herein. 
     The system  550  also includes optional wireless communication components that facilitate wireless communication over a voice and over a data network. The wireless communication components comprise an antenna system  610 , a radio system  615  and a baseband system  620 . In the system  550 , radio frequency (“RF”) signals are transmitted and received over the air by the antenna system  610  under the management of the radio system  615 . 
     In one embodiment, the antenna system  610  may comprise one or more antennae and one or more multiplexors (not shown) that perform a switching function to provide the antenna system  610  with transmit and receive signal paths. In the receive path, received RF signals can be coupled from a multiplexor to a low noise amplifier (not shown) that amplifies the received RF signal and sends the amplified signal to the radio system  615 . 
     In alternative embodiments, the radio system  615  may comprise one or more radios that are configured to communicate over various frequencies. In one embodiment, the radio system  615  may combine a demodulator (not shown) and modulator (not shown) in one integrated circuit (“IC”). The demodulator and modulator can also be separate components. In the incoming path, the demodulator strips away the RF carrier signal leaving a baseband receive audio signal, which is sent from the radio system  615  to the baseband system  620 . 
     If the received signal contains audio information, then baseband system  620  decodes the signal and converts it to an analog signal. Then the signal is amplified and sent to a speaker. The baseband system  620  also receives analog audio signals from a microphone. These analog audio signals are converted to digital signals and encoded by the baseband system  620 . The baseband system  620  also codes the digital signals for transmission and generates a baseband transmit audio signal that is routed to the modulator portion of the radio system  615 . The modulator mixes the baseband transmit audio signal with an RF carrier signal generating an RF transmit signal that is routed to the antenna system and may pass through a power amplifier (not shown). The power amplifier amplifies the RF transmit signal and routes it to the antenna system  610  where the signal is switched to the antenna port for transmission. 
     The baseband system  620  is also communicatively coupled with the processor  560 . The central processing unit  560  has access to data storage areas  565  and  570 . The central processing unit  560  is preferably configured to execute instructions (i.e., computer programs or software) that can be stored in the memory  565  or the secondary memory  570 . Computer programs can also be received from the baseband processor  610  and stored in the data storage area  565  or in secondary memory  570 , or executed upon receipt. Such computer programs, when executed, enable the system  550  to perform the various functions of the present invention as previously described. For example, data storage areas  565  may include various software modules (not shown) that are executable by processor  560 . 
     Various embodiments may also be implemented primarily in hardware using, for example, components such as application specific integrated circuits (“ASICs”), or field programmable gate arrays (“FPGAs”). Implementation of a hardware state machine capable of performing the functions described herein will also be apparent to those skilled in the relevant art. Various embodiments may also be implemented using a combination of both hardware and software. 
     Furthermore, those of skill in the art will appreciate that the various illustrative logical blocks, modules, circuits, and method steps described in connection with the above described figures and the embodiments disclosed herein can often be implemented as electronic hardware, computer software, or combinations of both. To clearly illustrate this interchangeability of hardware and software, various illustrative components, blocks, modules, circuits, and steps have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the overall system. Skilled persons can implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the invention. In addition, the grouping of functions within a module, block, circuit or step is for ease of description. Specific functions or steps can be moved from one module, block or circuit to another without departing from the invention. 
     Moreover, the various illustrative logical blocks, modules, and methods described in connection with the embodiments disclosed herein can be implemented or performed with a general purpose processor, a digital signal processor (“DSP”), an ASIC, FPGA or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. A general-purpose processor can be a microprocessor, but in the alternative, the processor can be any processor, controller, microcontroller, or state machine. A processor can also be implemented as a combination of computing devices, for example, a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. 
     Additionally, the steps of a method or algorithm described in connection with the embodiments disclosed herein can be embodied directly in hardware, in a software module executed by a processor, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD-ROM, or any other form of storage medium including a network storage medium. An exemplary storage medium can be coupled to the processor such the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium can be integral to the processor. The processor and the storage medium can also reside in an ASIC. 
     The above description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles described herein can be applied to other embodiments without departing from the spirit or scope of the invention. Thus, it is to be understood that the description and drawings presented herein represent a presently preferred embodiment of the invention and are therefore representative of the subject matter which is broadly contemplated by the present invention. It is further understood that the scope of the present invention fully encompasses other embodiments that may become obvious to those skilled in the art and that the scope of the present invention is accordingly not limited.