Telepathology between Richmond and Beckley Veterans Affairs Hospitals: Report on the First 1000 Cases

Weisz-Carrington, Paul; Blount, Melissa; Kipreos, Barbara; Mohanty, Laxmi B.; Lippman, Robert; Todd, William M.; Trent, B

doi:10.1089/107830299311934

Cited by 30 publications

(17 citation statements)

References 5 publications

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“…Similar results using Apollo TP equipment have been reported at the Beckley (WV) VAMC by pathologists located at the Richmond (VA) VAMC [7]. The occasional discordances we have observed have not significantly affected patient care adversely because the corrected results have typically been available to the clinician within several days after the diagnosis was rendered by TP.…”

Section: Discussionsupporting

confidence: 85%

“…Other TP services are active in the United States, including those at the Armed Forces Institutes of Pathology [9,10], the University of Arizona [11], Beckley-Richmond VAMCs [7], at least one Veterans outpatient clinic [12], and the US military [13]. Kaplan et al [13], using a MedMicroscopy robotic TP system (Trestle Corporation, Newport Beach, CA), reported 100% concordance between TP and LM diagnoses for 120 consecutive frozen section cases taken from a wide variety of specimens.…”

Section: Discussionmentioning

confidence: 99%

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Robotic surgical telepathology between the Iron Mountain and Milwaukee Department of Veterans Affairs Medical Centers: a 12-year experience

et al. 2009

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Since mid-1996, we have operated a diagnostic robotic telepathology (TP) system at the Iron Mountain, MI, Department of Veterans Affairs Medical Center (VAMC) from the Milwaukee, WI, VAMC, located some 220 miles away. No on-site pathologist is present in Iron Mountain. Instead, an experienced, well-trained pathologist assistant, under direction of pathologists located in Milwaukee, is responsible for tissue grossing and sectioning. The pathologist assistant places slides onto the stage of the robotic microscope, which is then controlled by pathologists in Milwaukee. Each case read by TP is subsequently read by light microscopy (LM) by the same pathologist. Three distinct phases of TP have been recognized. Our experience during phase I (mid-1996 to early 1999) has been published previously. During phase II (early 1999 to mid-2004), 1 of the 2 senior telepathologists in phase I retired, and 3 junior pathologists were hired. During phase III (mid-2004 to June 2008), 2 new junior pathologists were hired, and ASAP Imaging (Apollo Telemedicine, Inc., Falls Church, VA) was implemented. The number of TP case opportunities in phases I, II, and III was 2200, 5841, and 3512, respectively, resulting in a total of 11 553. A total of 1834 cases were deferred to LM for a variety of reasons. The number of TP diagnoses rendered in phases I, II, and III was 2144, 4636, and 2939, respectively, resulting in a total of 9719. The major discordance rates in phases I, II, and III were 0.33%, 0.45%, and 0.20%, respectively, with an overall rate of 0.35%. Pathologist-specific discordance rates were not significantly different and ranged from a low of 0.12% to a high of 0.77%, whereas case deferral rates were significantly different (P < .0001) and ranged from 2.5% to 28.7%. In general, no relationship between deferral rate and discordance rate was noted. Iron Mountain clinicians have expressed great satisfaction with the services provided by their off-site pathologist colleagues.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Robotic surgical telepathology between the Iron Mountain and Milwaukee Department of Veterans Affairs Medical Centers: a 12-year experience

et al. 2009

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“…Telepathology is already integrated into histopathology services in other countries, despite similar initial reservations. [14][15][16][17][18][19][20] The ultimate role for telepathology in UK histopathology service delivery remains unclear. More evaluation and education are essential before significant resources are directed towards this technology.…”

Section: Discussionmentioning

confidence: 99%

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

Dennis

Start²,

Cross³

2005

J Clin Pathol

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Aims:To undertake a large scale survey of histopathologists in the UK to determine the current infrastructure, training, and attitudes to digital pathology.Methods:A postal questionnaire was sent to 500 consultant histopathologists randomly selected from the membership of the Royal College of Pathologists in the UK.Results:There was a response rate of 47%. Sixty four per cent of respondents had a digital camera mounted on their microscope, but only 12% had any sort of telepathology equipment. Thirty per cent used digital images in electronic presentations at meetings at least once a year and only 24% had ever used telepathology in a diagnostic situation. Fifty nine per cent had received no training in digital imaging. Fifty eight per cent felt that the medicolegal implications of duty of care were a barrier to its use. A large proportion of pathologists (69%) were interested in using video conferencing for remote attendance at multidisciplinary team meetings.Conclusions:There is a reasonable level of equipment and communications infrastructure among histopathologists in the UK but a very low level of training. There is resistance to the use of telepathology in the diagnostic context but enthusiasm for the use of video conferencing in multidisciplinary team meetings.

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“…Although the real-time approach represents a reasonable substitute for in-person consultation and has the advantage of enhancing interaction, it is more time-consuming and expensive. Nonetheless, dynamic telepathology using fully motorized robotic systems has revolutionized the field, and a concordance rate of 99-100% has been reported between telepathology and light microscopy diagnosis (Dunn et al, 1999;Weiss-Carrington et al, 1999). Much progress has been made in the past couple of years in the field of digital imaging and virtual microscopy making the hybrid systems a lot more convenient than ever before such that 'virtual slides' can now be made where the entire slide is scanned at a very high resolution and then viewed by multiple pathologists (Leong & McGee, 2001) and without any loss of resolution.…”

Section: Telepathology In Perspectivesmentioning

confidence: 99%

Recent Advances in Telepathology in the Developing World

Malami¹

2011

Advances in Telemedicine: Applications in Various Medical Disciplines and Geographical Regions

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Telepathology between Richmond and Beckley Veterans Affairs Hospitals: Report on the First 1000 Cases

Abstract: This study demonstrates that telepathology is a reliable and cost-effective alternative to on-site pathology services and reviews advantages and disadvantages of the system.

Cited by 30 publications

References 5 publications

Robotic surgical telepathology between the Iron Mountain and Milwaukee Department of Veterans Affairs Medical Centers: a 12-year experience

Robotic surgical telepathology between the Iron Mountain and Milwaukee Department of Veterans Affairs Medical Centers: a 12-year experience

The use of digital imaging, video conferencing, and telepathology in histopathology: a national survey

Recent Advances in Telepathology in the Developing World

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