Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging

Abstract

The use of telepathology for clinical applications in Canada has steadily become more attractive over the last 10 years, driven largely by its potential to provide rapid pathology consulting services throughout the country regardless of the location of a particular institution. Based on this trend, the president of the Canadian Association of Pathologists asked a working group consisting of pathologists, technologists, and healthcare administrators from across Canada to oversee the development of guidelines to provide Canadian pathologists with basic information on how to implement and use this technology. The guidelines were systematically developed, based on available medical literature and the clinical experience of early adopters of telepathology in Canada. While there are many different modalities and applications of telepathology, this document focuses specifically on whole-slide imaging as applied to intraoperative pathology consultation (frozen section), primary diagnosis, expert or second opinions and quality assurance activities. Applications such as hematopathology, microbiology, tumour boards, education, research and technical and/or standard-related issues are not covered.

International Clinical Guidelines for the Adoption of Digital Pathology: A Review of Technical Aspects

“…The Canadian Association of Pathologists clinical guidelines on telepathology focuse only on WSI for intraoperative consultation/frozen-section primary diagnosis, expert or second opinions, and quality assurance practices [7,9,10]. This document includes the CAP recommendation for validation of digital pathology systems [10].…”

“…The pathology imaging system should be integrated in other clinical systems, such as LIS via accepted standards such as HL7, as recommended by ATA [3], Canadian [10] and European guidelines [25,37]. …”

“…This software can also be configured to reflect the appropriate workflows [10]. Data transmission, integration, security and software performance should comply with existing CAP checklists, CLIA [2,20] and Part 11 regulations for electronic records in the United States [23].…”

“…This document includes the CAP recommendation for validation of digital pathology systems [10]. Since 2013, several WSI systems have received their Class II Medical Device License from Health Canada [30].…”

“…Networks used for WSI should transmit images within the required timelines without resulting in image distortion and/or degradation [10]. …”