Pathology

Materials received

Laboratory receipt: simple number assignment and transparent documentation management

Laboratory receipt is a crucial step in checking specimens into the laboratory. The assignment of a sequential laboratory number per order involves a range of numbers, the year and a sequential number. This is used for case identification and supports billing and statistical evaluation. The subsequent document scan not only facilitates recording but also guarantees complete electronic case documentation.

 

Secure specimen receipt

The careful comparison of the receptacles/swab preparations sent in with the accompanying requisition slip is not only essential within the context of quality management but also from a legal perspective.

The NEXUS Label label printing solution prints barcode labels, which are then applied to the receptacles/swab preparations and delivery notes. The labeled delivery notes are scanned at the scanning workstation and assigned to the respective order. The order can then be opened at any workstation with the barcode reader.

 

Document scanning

All documents relating to an order can be scanned as a batch. Freely definable scanning profiles are used to define which file format and which type of billing are to be assigned to the scanned documents. Clearly arranged classification of the documents is also guaranteed. The scanning process is supported by automated OCR, 1D and 2D recognition.

 

Macroscopy and cutting

At a glance

The cutting workstation provides quick access to previous findings, laboratory services and patient diagnoses. The process of tissue cutting and the reprocessing of biopsies is practiced at purpose-built single- or dual-monitor workstations. Macroscopy can be documented by means of digital dictation and, if desired, speech recognition.  

 

Photo documentation

The digital camera can be used to photographically document the incoming material for the case. The zoom and trigger are operated using a foot switch. Once the camera has been calibrated, precise measurements of the preparation can be taken. The images are then stored for enhanced documentation, added to the diagnosis or marked for presentation at the next clinic conference.

 

Capsule printing with cutting

If capsule printing for the large cut is not used until macroscopy or if capsules need to be reprinted, these can be electronically requested by means of a touchscreen function or a click of the mouse. This function can also be used to request further stainings.

 

Specimen collection

Specimen collection and capsule printing: individually configurable with clearly defined structures

Specimen collection with NEXUS / PATHOLOGY enables patient specimens to be collected efficiently and based on orders. At the same time, you have full control over the progress of laboratory orders. Statuses and responsibilities are visible at a glance.

 

Laboratory protocols

Institute-specific laboratory protocols define the structure of a laboratory order. The number of capsules and stainings, including empty cuts, is defined for each type of tissue/material in the NEXUS / PATHOLOGY master data. Recording the incoming receptacles means that the number of capsules and slides defined in the master data is output.

 

Capsule and slide printers

Specimen collection enables various capsule and slide printers to be used. Depending on the way of working, the capsules can either be printed upon entry of the incoming receptacles or at a later time, for example within the scope of macroscopy. The same applies to the printing of laboratory labels and glass slides.

 

Follow-up requests

Manual paper processes are being superseded by digital follow-up requests for stainings. By scanning the slide barcode, the doctor opens the case history and block and then creates a panel with the follow-up requests with just one or two clicks of the mouse. The shipment of material based on consultation requests can also be saved with time stamp and user.

 

Microtome workstation

After scanning the 2D barcode on the cassette, an overview of the cuts to be made is presented on the screen at the microtome workstation. While the paraffin block is being cut, NEXUS / PATHOLOGY prints the desired number of glass slides or labels. The "Cut on microtome" status is logged in the background with the date and time.

If further cuts that are not included in the laboratory protocol need to be made or if printing needs to be repeated, this can be carried out in seconds by means of touchscreen control.

 

Laboratory management

Clearly defined structures – including in the laboratory

NEXUS / PATHOLOGY enables you to document and manage your laboratory processes electronically. This includes laboratory lists, the tracking of work steps and the traceability of the laboratory status. NEXUS / CYTOLOGY also enables laboratory automation, such as HPV typing equipment, to be used.

Laboratory management provides practical support for quality management. What's more, the work of the institute is not only standardized and simplified but also clearly structured. Numerous evaluation options are also available.

 

Laboratory exit point

Stained preparations that leave the laboratory go through the laboratory exit point. A new time stamp is added to the work lists and the laboratory status is set to "complete".

 

Work lists

Work lists provide various options for displaying and reviewing processes that are not yet completed. These can be displayed in the form of assigned tasks or a detailed overview. The work lists can be individually configured and adapted to the tasks of the respective employee.

 

Laboratory list / laboratory tracking

The laboratory order list is an overview of all requested laboratory orders. Various parameters and filters can be configured here, too, which display the status of the laboratory order and the requesting doctor, for example.

Laboratory tracking is an extension of the laboratory list. Various laboratory activities can be scanned by means of a barcode. The laboratory employees carrying out the work are automatically logged within the scope of quality management requirements. This means that the completion time and processor of each task is shown.

 

Information management at the doctor’s workstation

Doctor's workstation module

The doctor's workstation module provides access to all important information (images, preliminary examinations, previous findings, laboratory data, documents) relating to the patient. This means that research can be carried out quickly and multiple cases can readily be presented during tumor conferences using a tablet PC.

Diagnostic reports are created during the material examination by means of digital dictation or speech recognition. This makes notepads and other accessories obsolete. The software enables the user to focus fully on the material in question. Measurements can be taken in the image with a calibrated camera setup. The images taken are transferred directly to the diagnostic report and can be saved and transferred for use in presentations at clinical conferences. The report text is created using the integrated MS Word word processing tool.

This makes the processes involved faster, simpler and more focused.

 

Displaying documents

The case to be diagnosed can be opened quickly and easily using the barcode reader or filtered work lists at the microscope. The patient and case data, a list of previous findings with the available cuts and diagnoses, and the document directory are all opened.

All associated documents, such as the examination request, laboratory-internal notes, Cave information or consultant diagnoses are displayed.

 

Image acquisition and image management systems

In the field of microscopy, the integration of standard microscope cameras and image acquisition solutions from various manufacturers is a matter of course. Furthermore, virtual microscopy systems from various manufacturers can be connected via HL7 or proprietary interfaces. If desired, all image data can be stored in native or DICOM format in a Vendor Neutral Archive (VNA).

In clinic information systems, laboratory data, X-ray images or digital documents from the medical record archive can be accessed from the case history, provided the corresponding interfaces are available in the clinic system.

 

Workflow optimization and data export

Microscopic images need to be available to various users at different workstations. This applies to a wide range of use cases, such as consultant and second-opinion examinations, frozen section telepathology and study projects.

The windows can be shown individually on multiple monitors or larger TFT displays for an optimum view of the case history.

With the introduction of virtual pathology, new opportunities for providing decentralized access to the digital cuts have opened up. This enables information to be shared securely and quickly with cooperation partners, combined with maximum convenience for users and partners.

Following a data export, the case histories can be presented in clinical conferences using a browser or iPad.

 

Microscopy & creation of diagnostic reports

Documentation of diagnoses and digital dictation

A smooth process for creating diagnostic reports is an important criterion when it comes to communication with the sender. The report is also the calling card of the institute. Professional digital dictation and documentation of diagnoses must be possible in just a few steps.

 

Fast, efficient and effortless creation of diagnostic reports

Diagnostic reports are created quickly and easily. With NEXUS / PATHOLOGY, it is possible to carry out digital dictation in Word and to subsequently edit medical service codes for claims at the same workstation. Previous findings as well as documents and image material can also be conveniently accessed.

Digital dictation makes it easy to process all reports that need to be created, and these can also be classified according to urgency. Individually designed templates and text modules are selected according to the person ordering the report or the type of examination.

 

Interface for communicating diagnoses

Diagnoses can be sent to the systems of cooperation partners via HL7, LDT, KV-Connect, fax and as encrypted e-mails.

Within the scope of increasing digitalization in the laboratory, electronic orders are transferred from the senders via HL7, LDT 3.0 or L2L interfaces. Media discontinuities and the delayed creation of orders or the delayed distribution of diagnoses are reduced, making order throughput faster and more convenient.

 

Speech recognition

Fully integrated Nuance software solutions are recommended in order to use foreground and background speech recognition. The doctor or the MTA can decide on a case-by-case basis which speech recognition method to use, depending on the situation. If necessary, the voice-recognized texts can be reviewed by a typist or the doctor can create the diagnostic report themselves using direct speech recognition. The report text can be dictated as continuous text or as a text module. If necessary, fee codes can also be recorded by voice.

 

Digital pathology

In the field of microscopy, the control of standard microscope cameras is a matter of course. It is also possible to connect slide scanners and image management database systems from various manufacturers, which are controlled via HL7, DICOM or proprietary interfaces.

With the introduction of virtual pathology, NEXUS / PATHOLOGY is supporting new processes. Among other things, it provides decentralized access to digital cut information and enables image analysis methods to be extended. This results in an efficient, work-list-based workflow from any location and enables information to be shared quickly with cooperation partners, combined with maximum convenience for users and partners.

 

Case recording

Quick and easy order creation including recording of all data relevant to billing

Every incoming item of material has to be recorded, diagnosed and archived in accordance with certification-relevant criteria. NEXUS / PATHOLOGY and NEXUS / CYTOLOGY is the software that fulfills these criteria and many more.

Thanks to the optical barcode recognition on the letters of referral, these are read in with virtually no mistakes and an order is created. Letters of referral that cannot be automatically read in are quickly and easily corrected with just a few manual inputs. Inpatient clinic requests are also electronically imported via an HL7 interface.

 

Collecting, linking and further processing

Case recording is used to record all contractually relevant information that is required for correct order processing. This can be carried out manually or following a scan with OCR or PDF417 barcode data transfer (KBV) as well as 1D/2D barcode recognition. It is also possible to import electronic inpatient orders from clinics via an HL7 interface, and these are automatically assigned to the respective patient.

The increasing importance of digital processes in pathology requires a modern, powerful and sustainable software solution. For a paperless workflow, the corresponding letter of referral and the list of scanned documents are also displayed in addition to the collection of patient data. The NEXUS software also enables the current order to be linked to previous findings.

 

Recording orders

The type of billing can be preset when scanning the documents.

Depending on the type of delivery note, optical character recognition can be used to detect patient data, which must then be checked for correctness. An even greater degree of efficiency can be achieved by using previously defined order templates for stainings, medical service codes for claims and types of material.

Important additional information can also be stored during case recording, which is then displayed when the case is opened at the doctor's, clerical staff or laboratory workstation.

 

Documentation of diagnoses

Fast, efficient and effortless creation of diagnostic reports

Diagnostic reports are created quickly and easily. The digital dictation feature is opened at the NEXUS / PATHOLOGY clerical staff workstation and transferred to a pre-populated report template in Word. It is also possible to subsequently edit the medical service codes for claims at the same workstation. Previous findings as well as documents and image material can also be conveniently accessed and automatically transferred to the report.

Digital dictation makes it easy to process all reports that need to be created, and clerical staff can view the classification according to their urgency at any time. Individually designed templates and text modules are selected according to the person ordering the report or the type of examination.

Once it has been completed and released, the report can be sent by post, by fax or electronically (e.g. LDT, HL7, e-mail). In order to ensure the secure transfer of the report, it is sent in the form of a protected PDF document. A PDF file is also generated and archived for every non-electronic transfer. This enables a report to be sent again at a later date or sent via a different method.

Secure archiving is possible as an option.

 

Billing

Simple invoicing

NEXUS supports all standard billing types: private, collective or KV billing. Billing periods can be defined individually for each type of billing. The invoices that are created are stored in the form of a PDF document with the order. Outstanding items can also be transferred to an accounting system.

Reminders can be sent for outstanding invoices using individually defined reminder sentences and templates.

 

Finance interfaces

Various financial accounting, OPOS and DATEV interfaces are available to optimize the flow of data between accounting and accountants.

External service providers for healthcare billing (PVS) receive the billing data via XML-based interfaces. If you carry out private billing yourself, NEXUS takes care of posting for you by importing incoming payments in MT940 data format with support from the respective electronic banking software.

 

Evaluations

Statistics and lists – with individual configuration and filtering

Reliable statistics are an essential tool in making quick and informed decisions. The status quo must be ascertained quickly and clearly. The NEXUS solution can help with this in a variety of ways.

 

Key figures at a glance

Evaluations and key figures are critical tools in measuring the performance of institutes and practices from a business management perspective. Regular analyses of sender behavior, monitoring the billing status and evaluations of diagnostic information are key variables in measuring economic success.

All relevant evaluations and statistics are stored in the NEXUS software, which simplifies control and planning for owners and managers. The ready-made SQL reports can be adapted to individual requirements with very little effort.

 

Controlling with NEXUS / CUBE

NEXUS / CUBE enables detailed controlling and provides a new perspective on your pool of data. Various database views can be dynamically linked using MS Excel. A range of different features can be selected from your pool of data, e.g. on examinations, diagnoses and billable services, and displayed in relation to one another.

Flexibility and different perspectives are built in, meaning that values can be displayed as both absolute and relative values. Furthermore, columns and rows can be displayed and filtered depending on the analysis.

To analyze your data, the data from your live database is transferred to a second SQL Server database instance. This safeguards the ongoing performance of your live system.

 

Quality management

Quality management system

Certification or accreditation requires a professional quality management system. NEXUS / CURATOR manages your specifications in accordance with DIN ISO. This means you benefit from clearly defined read receipts, a multi-stage approval workflow and reminders for your procedural instructions, forms or documents, for example. Be ready for accreditation and certification with DIN-ISO-compliant document control.

 

Documentation and control

As well as logging all relevant processes in NEXUS / PATHOLOGY or NEXUS / CYTOLOGY, NEXUS / CURATOR provides a tool for a professional quality management system. This fulfills the requirements of the competent certification and accreditation bodies in terms of documentation and document control.

The portal serves to improve organizational communication. Content for quality, personnel or risk management, current news or central project lists can be edited as part of a team. A simple search and find function creates a shared, living knowledge base. Important and relevant information in documents, contracts, the risk atlas or catalogs of measures can be found quickly and easily.

NEXUS / CURATOR, the web-based knowledge database and basis for the intranet, is tailored to the requirements of healthcare quality management. All organizational data can be accessed quickly and shown on a web interface.

NEXUS / CURATOR also automatically reminds you to update important documents, contracts that are about to expire and about notice periods or maintenance cycles for your laboratory equipment.  

 

Data protection management

The EU General Data Protection Regulation (GDPR) sets out extended duties and responsibilities for all companies that collect and process personal data. Patient data is often particularly sensitive and therefore requires special protection.

In order to satisfy these more stringent requirements, it is advisable to implement a data protection management system. Four core actions can be derived from the GDPR, which can be easily mastered with NEXUS / GDPR.

• DISCOVER: Support for the identification of processes and procedures that collect and process personal data
• MANAGE: Form-based recording and structuring of all information relating to the collected personal data (e.g. purpose for which the data was recorded, groups of people involved, processor, etc.)
• PROTECT: Implementation, management and monitoring of data protection measures that have been initiated
• REPORT: Quick and easy generation of reports from the database

The data protection toolbox can be fully integrated into the NEXUS / CURATOR quality management system and can be optionally expanded with the data protection risk management, data protection audits and data protection training management components.

Image management / PACS

Connection to external image acquisition and image management systems

In the field of microscopy, the control of standard microscope cameras is a matter of course. These can be integrated into NEXUS. It is also possible to connect image management systems from various manufacturers, which are controlled via HL7, DICOM or proprietary interfaces.

NEXUS / PATHOLOGY also provides interfaces to standard digital slide scanners as well as an image archive (PACS) according to the DICOM standard for digitized slides. Functions such as the streaming of image data or a "prefetching function" for slides that have already been archived when a new material is received for the same patient are also integrated.

 

Archive

Secure archiving

The NEXUS archive kernel is based on the established PEGASOS archive, document and process management system from NEXUS / MARABU GmbH.

All data formats from NEXUS / PATHOLOGY can be securely archived in the NEXUS archive system. All diagnoses and invoices as well as scanned documents are stored using the recognized PDF/A archive format, which means they can be viewed with standard viewers. Photos and letters of referral are archived in the standard JPG format. It is also possible to encrypt the data when it is archived so that it can only be accessed via the archive kernel.

For the archiving of data and documents, we support storage solutions from various manufacturers that can only be written to once or which guarantee the immutability of the archived data by some other means. Hierarchical storage management enables the distributed storage and migration of objects in different storage locations. The NEXUS archive kernel also offers the option of automatically adding a time stamp to your data. This makes secure archiving possible with low-cost hardware.

 

Security

The security of archiving is always dependent on the entire archiving solution and can only be ensured with the correct interaction between technical components, workflow management and process documentation. We would be delighted to provide implementation advice and support.

 

Individual connection

If you are already using an archive solution, the case history can also be transferred from NEXUS / PATHOLOGY via an archive data export interface. We would be happy to tell you which archive systems can be connected.

Do you have questions?

We will be happy to help! Whether you're already a customer or are interested in our solutions, our NEXUS / LAB experts have years of experience and expertise in all laboratories as well as pathology, cytology and genetics and will be happy to share their knowledge with you: