Tiresias: And some more

“The future is not something to predict. The future is something to build.”

Franco Ongero

My friends,

In the last weeks Tiresias has been rather excited by the application of Optiscan’s confocal laser endomicroscope (CLE) in collaboration with alma mater, the Mayo Clinic, to give vision, at sub-cellular magnifications to surgical robots. He has alluded to other aspects of the Mayo collaboration but has only hinted rather than emphasised or elaborated. As we wait for developments on the Optiscan reified semi-autonomous and autonomous developments in robotic breast surgery at the Mayo Clinic, the oral medicine and surgery FDA approvals, gastrointestinal endoscopic in-vivo GI cancer screening, Tiresias says rather neglected the much bigger picture of digital pathology enabled by machine learning/AI/neural-nets combined and distributed networks applications to digital pathology. Tiresias mentioned, just last week, that the Mayo Clinic is leading the world in digitising their 25 million pathological specimens. Some may have thought this is just for more efficient storage, or some such. No, my friends, this is not “The Mayo Way”. There is but one reason and only one reason – to use the enormous data base to as resource necessary to develop machine reading and reporting of pathology. Then, is this just for in-house Mayo Clinic surgery and pathology. No not at all my friends. What this is about is a race to be a world leader to provide instant digital pathology, in real time, networked, providing instant pathology reporting worldwide.

Tiresias asks his friends to pause for a moment and imagine. Tiresias would like to unpack, just a little of what he has suggested in the rather compacted and perhaps indirect way of his. The possibility, nay the reality, of instant real-time in-vivo digital pathology which can be instantly interpreted, by neural networks, trained on a huge database which the Mayo beckons. Is the Mayo Clinic aiming to be the Amazon of the new world of centralised digital networked real-time pathology. With Optiscan’s laser microscopes deployed in every surgical theatre and centre in the world and not only as eye robotic surgery to be fed back to the computer operating the robotic surgery but providing instant and final pathology reports to all networked centres around the world. If fully developed, as Tiresias foresees, actual tissue cutting, processing, staining, microtoming, and then post-hoc reporting by a pathologist, looking down a microscope one or two weeks later, will be as obsolete as bleeding patients to cure their “fevers”. Optiscan, the “sine qua non”, is a crucial central part of this revolution. By itself, Optiscan could not have done this without all these necessary resources and connections possessed only by the Mayo Clinic. Mayo has been at the leading edge of many original developments in medicine in the last 120 years but most of all it has been a leader in application of technology to provide high quality cost effective and efficient medical care. Tiresias is tempted to elaborate a lot more but is cognizant of not overtaxing his friends’ patience and time in his often-over-long epistles. He will undoubtedly expand on these matters in the future but for now, he will only mention one possibility to tantalize. Think of instant worldwide pathology at the click of a mouse. With each click, the “Optiscanned” picture instantly reported, and charged for. Tiresias is certain that Optiscan’s management understands this and will negotiate a percentage cut, or more likely, long before then, Optiscan’s shareholders will be given an offer they will find hard to refuse.

Until next week