Telepathology

[KeratinPearls]

Anyone know anyone using telepathology to sign out cases at home or on vacation? I came across the BioImagene software at the previous CAP conference and boy did the images look nice. If I could sign out cases at home in my pjs that would be even better.

Also, how about using telepathology to send cases to experts to view? I remember reading about how telepathology is used to send images of the frozen to surgeons in the OR?

Check out this link of Bioimagene at USCAP.

http://www.youtube.com/watch?v=XR4p5A6cFWU

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[pathstudent]

Anyone know anyone using telepathology to sign out cases at home or on vacation? I came across the BioImagene software at the previous CAP conference and boy did the images look nice. If I could sign out cases at home in my pjs that would be even better.

Also, how about using telepathology to send cases to experts to view? I remember reading about how telepathology is used to send images of the frozen to surgeons in the OR?

Check out this link of Bioimagene at USCAP.

http://www.youtube.com/watch?v=XR4p5A6cFWU

It will probably be huge for reference labs as they could consolidate and eliminate histotechs and pathologists.

I think it would be a huge mistake for hospital based pathologists (community and academic) to be at home signing out cases in PJs. It would be bad for patient care and also a bad professional move that would result in pathologists be marginalized.

For pod labs that bill medicare (which means a lot of GU pod labs) the pathologist has to be in the same facility where the test (i.e. biopsy) is performed.

There could be medicolegal issues in using it in terms of consultation.

But the reference labs and for groups that have huge outpatient biopsy volume, it could be a boon.

 

[Gretl]

Telepathology makes sense in industrialized and rural countries in case a second opinion is needed. In rural countries it makes also sense to use it for first opinions.

Telepathology is also usefull when it offers a module for a live tumor board conference. Doctors at different locations can view the same patient case with all the images and discuss this case write comments and fill out forms online.

Have a look at www.campusmedicus.net/more

 

[KCShaw]

One place I was at used it for middle of the night transplant frozens, and to assist in frozen section analysis for an off-site hospital (as I recall it was an ortho hospital, so all they ever wanted was neutrophil hunts on possibly infected joint tissue). We had a lot of transplant cases, and senior residents were allowed to provide a preliminary report overnight anyway, so having telepath available was a nice safety-net. The quality was generally fine, but it could be slow even with a good connection. More to the point, infinitely slower than pushing glass. Until residency programs are training with it on a daily basis and large volume studies have been published comparing time spent and accuracy vs pushing glass, I would heartily recommend against using it as bread and butter practice.

It's useful in certain situations, as previously described -- when there are limited other options for consultation, to avoid a long middle of the night trip to look at only one or two slides, teaching/tumor boards, etc. But I think it has a long way to go. It just doesn't compare to tele-radiology, much of which has been digital for a long time already, and widely systematically integrated into their residency training.

 

[Autopsy Sweet]

Our department has been trying to set this up for use on frozen sections and urgent consults between the main hospital and our multiple outlying hospitals. We've had groups come to demo their products but when it came down to doing a live test the results were less than spectacular.

We currently have system set up between an outpatient building and the main hospital across the street that just involves a microscope camera with a live feed that can be seen by the supervising pathologist in his/her office. It's really only useful for adequacy. Not good enough resolution for making solid diagnoses.

I don't see this being used as a way for the pathologist to work from home for a long time. Just way too many kinks to iron out at this point.

 

[KCShaw]

I don't doubt that it's in our future at some point, just.. not the near future. Especially with the claims pathologists are skulking in the street saying they'll read your cases for a hand-me-down lunch. But it's got cool factor.

 

[Napoleon1801]

Yeah, it looks cool, but has anyone noticed that scrolling through the images is laggy as $hit? I played with a couple of them at CAP this year and there is no way you could go through a slide as quick as you could with their system even under their "ideal" conditions at a conference no less. The technology will get there eventually of course, but I contend that it is still not there. It's still way too buggy and would probably be career suicide at this point to switch EVERYTHING to digital at a practice.