Siemens' Pursuit of an Integrated Diagnostics Portfolio

Of interest to me in the recent articles describing the purchase of Bayer Diagnostics by Siemens (see my notes here and here) have been the references by company executives and analysts to Siemens' pursuit of an integrated diagnostics portfolio. Here is a link to one such article that describes this goal in the following way:

As an integrated diagnostics company, Siemens can offer a more complete range of diagnostics services, including imaging diagnostics, laboratory diagnostics, and clinical IT.

These three disciplines (imaging diagnostics, laboratory diagnostics, and clinical IT) can be referred to as the diagnostic holy grail. I will take the reference to clinical IT to mean, in part, the use of computerized diagnostic algorithms. Each of these diagnostics disciplines, on its own, is a powerful tool. Combined, however, they become even more powerful.

As I have suggested before (links here and here), molecular diagnostics will usher in an era of broad and complex lab testing with standard wellness and hospital admission test panels consisting of hundreds of biomarkers each. The detection of tumor and disease signatures will involve the computer analysis of multiple biomarkers (link here) or a patient's immune response to tumor progression (link here). In the first of these references, the multiple biomarkers that together signal the presence of a tumor is referred to as a multiplex, which is a term that I have not encountered before in this context.

If the private sector understands and pursues the goal of an integrated diagnostics portfolio, the question needs to be asked why there is not more collaboration between the medical specialties of pathology and radiology in order to take advantage of this very same synergy. I believe that the goal of merging these two disciplines to create a unified department of diagnostic medicine would be unattainable. However, it would not be unreasonable for the two groups of specialists to cross-reference the reports of each other.

I believe that it is common practice for surgical pathologists to routinely review the reports of prior imaging studies, particularly for patients with tumor biopsies and/or resections. However, to what extent do radiologists routinely review the downstream diagnoses rendered by pathologists when imaging studies reveal pre-operative space-occupying lesions? It is my understanding that radiology lacks a coding system analogous to SNOMED so that codes cannot be assigned to the diagnoses or impressions contained in their reports. If such a system were in place, it would be easy to cross-reference the reports from radiology with the subsequent pathology diagnoses when the suspect tissues are removed.