Try the Free D Path V5 software online straight away by clicking this link. Please do not enter any real patient data. There is also a more sophisticated version in development for the NHS in the UK that you can try out.
To download V5
to use on your own PC, Mac, or server click this link. There are instructions for installing and using the software below. You can not download the NHS version yet. We hope to have it available around April 2015.
The Free Diagnostic Pathology Software Project arose from the NHS Improvement’s Lean Histopathology Project in the UK. Histopathology laboratories diagnose diseases, particularly cancers, by examining the appearances of the cells in samples of tissue. Many histopathology laboratories are using antiquated reporting software. Upgrading to a more modern system is expensive. Even the more modern systems often lack the technology needed for pathologists to efficiently report complex cases allowing workflow to be visually managed and supporting the use of customisable templates and proformas. They are often difficult to use across multiple sites. We have developed web based reporting software that overcomes these difficulties. This has been used to report thousands of cases; many complex tumour cases requiring key data element capture. We used Lean principles to enhance work flow and improve accuracy. You can read more about the project in the related QIPP report.
The software is written in FileMaker Pro and is designed for use with Instant Web Publishing and WebDirect from FileMaker Server. FileMaker Pro is a cross-platform relational database application from FileMaker Inc., a subsidiary of Apple Inc., and is compatible with both Windows and Mac OS environments, and also Apple mobile devices using FileMaker Go. While this software is designed specifically for histopathologists, it could easily be adapted for use in other areas of medicine in which text based reporting is used.
Version 1.1 of the software was shared online in April 2012 and Version 2.1 in September 2012. During 2012 we have developed proformas for more tumour types including ones based on the recently published The International Collaboration on Cancer Reporting (ICCR) proformas for endometrial carcinoma and invasive melanoma. Version 3.1 was shared in March 2013. This has improved breast carcinoma and colorectal carcinoma proformas, some new navigation features and some bug-fixes. There is also a new haemato-lymphoid proforma for lymphoma reporting. Version 4.1 was shared in June 2013, with further improvements to the proformas, particularly the breast cancer pro forma, and some multidisciplinary meeting visual process control. Version 5.1 is the current version, shared in November 2013. It includes XML export of key data fields for cancers that is compliant with the COSD XML schema (for the NHS National Cancer Intelligence Network in the UK).
In addition, after hundreds of hours of work, we are now near to completing a more sophisticated version of the software written specifically for Filemaker 13, and exploiting the the improved functionality of the HTML5 based WebDirect browser access, and access via the FileMaker Go app on iPad and iPhone. This version of the software is also being adapted for use in other areas of clinical medicine, including breast surgery. This version works beautifully on Apple mobile devices, together with web browsers, PCs and Macs. However, it is being developed in partnership with the NHS in the UK and is not yet ready for general distribution under a GPL3 license. Sorry, you can not download it yet, but you can try it out.
Installing and using the software. First download the software using this link. To try the software you need to install a 30 day trial version of FileMaker Pro. The bad news is that you then have to buy FileMaker Pro when the trial period ends. The software was written using FileMaker Pro version 11. This has been followed by version 12 and very recently a new version of FileMaker Pro been launched; FileMaker Pro 13. The Free D Path software is still distributed as Filemaker Pro 11 software as this is the version is forward compatible. If you use the software with FileMaker Pro 12 or 13 it will convert the software automatically when it is opened.
Username Password Privileges admin admin Full Access; for administrator only path path Restricted Access; for regular users
You can easily change the password and privileges when logged on as “admin”. Also if you read the instructions page in the software you can find out how to create individual accounts, for greater security.
The FileMaker Pro platform has a license structure that is rather too complicated to explain briefly so the details should be obtained from the FileMaker licence web page. To cut a long story short, it would cost about $3500 to £5000 (excluding VAT) to satisfy the needs of a medium sized histopathology lab with 10 consultant pathologists, and related secretarial staff and cut-up technicians. FileMaker also offer a monthly licence agreement that would equate to about £125 per month (excluding VAT) for a medium sized lab. Of course one would need to buy a server (about £5000) and other equipment, adding to the cost considerable. There are Filemaker Server hosting providers in most countries that would cost about $30 a month for a medium sized lab, but these are unlikely to satisfy the data protection policies that exist in the UK. However, in the UK there are already over 200 NHS organisations that are already using FileMaker Server.
We want the software to be improved and the improvements shared. The software has been distributed under The GNU Affero General Public License version 3 (GPLv3). You can adapt the software for your own environment, improve it and then share the improvements under to inherited General Public License.
The GNU Affero General Public License version 3 is a free, “copyleft” license for software and other kinds of works. The licenses for most software and other practical works are designed to take away your freedom to share and change the works. By contrast, GPLv3 is intended to guarantee your freedom to share and change all versions of a program, to make sure it remains free software for all its users.
Help. Writing software for a FileMaker database is relatively easy compared with most other modern database applications such as MySQL. With a little training a laboratory IT enthusiast can change this software and improve it. However, some types of innovation will be beyond the ability of all but the most experienced users. You may need help. You can find another certified FileMaker developer on the FileMaker website.
Some screen shots (click for a closer look).
The software is implements Lean principles. User defined templates improve the speed and accuracy of reporting.
The process sequence for breast carcinoma reporting using a proforma that captures key data elements and then compiles a free text report that can the edited by the user and finalised. The key data elements are retained for export as a data file. The software includes similar proformas for other tumour types.
The breast carcinoma proforma capture more than 50 data elements. Drop-down menus and auto text are used to improve speed and accuracy.
Visual process control is used to process extra-work requests using to promote “first in first out” workflow. Requests are sorted on-screen according to there date and status.
This website has had thousands of visitors from around the World. About 19 percent of visitors trial the software online and 90 percent of these then go on to download the software. The software has been downloaded over 1250 times as of January 2015.
We have added XML export functionality to comply with the COSD data requirements of the Cancer Intelligence Network in the UK. These XML files are created and exported when a malignant condition is reported. The export function can be turned off if it is not required.
October 2014: The Free Diagnostic Pathology Software Project won the EHI Award for the “Best Use of IT to Support Clinical Treatment and Care.
October 2014: The Free Diagnostic Pathology Software Project won the EHI Award for the “Best Use of IT to Support Clinical Treatment and Care.
Dr Fred Mayall (centre) with Tony Speakman – Regional Director of Apple’s FileMaker subsidiary (second Right), Miles Ayling – Director of Innovation, NHS England (Right), Sir Bruce Keogh – National Medical Director, NHS England (Left) and Kate Silverton – BBC presenter (second left).
In November 2013 The Free Diagnostic Pathology Project was awarded an NHS Innovation Challenge Prize by the Secretary of State for Health in the UK.
freedp.wordpress.com 