Use of Telemedicine in Postgraduate Pathology Education

Asaranti Kar, Tushar Kar, Priyadarshini Biswal, Kaumudee Pattanaik, Pallavi Bhuyan, Rajashree Mallick, B. N. Mohanty

Department of Pathology, Shriramachandra Bhanj Medical College, Cuttack, Odisha, Pin-753007, India..

DOI: 10.4236/ijcm.2013.46053                

Abstract

Objective: Telemedicine is the use of telecommunication for medical diagnosis, treatment, health education and research. Telepathology is diagnostic pathology at a distance. It functions with images viewed on a video monitor rather than directly through a microscope. Many years have passed since the evolution of telepathology. But no study has yet been done to evaluate the benefits postgraduates got through this. Therefore this study is undertaken to analyse the different impacts of telepathology on the postgraduate learning. Material and Methods: The study was done in Telemedicine Center of S. C. B. Medical College, Cuttack over a period of 9 years. The telepathology service was carried out by store and forward method using a CCD, a large computer server and a huge bandwidth network service (VSAT). The sessions with SGPGI, Lucknow were analysed and the benefits of postgraduates were studied. Results: The number of sessions held was 95. Out of which 92 sessions were with SGPGI. It included 202 cases transmitted from Lucknow and 186 cases from S. C. B. Medical College, Cuttack. The postgraduates had a chance to exposure to rare cases in renal pathology, dermatopathology and hepatopathology. The overall concordance rate with glass slide diagnosis was 87%. Conclusion: The diagnostic expertise through light microscopy and tele-images are not the same. But the telepathology system increased the ability of image analysis, histopathologic diagnosis of our postgraduates and also exposed them to many rare and interesting cases.

Keywords

Histopathologic Diagnosis; Postgraduates; Telepathology

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. S. Weinstein, A. M. Graham, L. C. Richter, G. P. Barker, E. A. Krupinski, A. M. Lopez, Y. Yagi, J. R. Gilbertson, et al., “Overview of Telepathology, Virtual Microscopy and Whole Slide Imagining: Prospects for the Future,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1057-1069. doi:10.1016/j.humpath.2009.04.006
[2]	S. Kumar, S. Kumar and B. E. Dunn, Eds., “Telepathology: An Audit,” In: Telepathology, Springer-Verlag, Berlin Heidelberg, 2009, pp. 225-229. doi:10.1007/978-3-540-85786-0_16
[3]	R. S. Weinstein, “Prospects for Telepatholgy (Editorial),” Human Pathology, Vol. 17, 1986, pp. 443-434. doi:10.1016/S0046-8177(86)80028-4
[4]	K. Kayser, B. Molnar and R. S. Weinstein, “Digital Pathology Virtual Slide Technology in Tissue-Based Diagnosis, Research and Education,” VSV Interdisciplinary Medical Publishing, Berlin, 2006, pp. 1-193.
[5]	T. Dennis, R. D. Start and S. S. Cross, “The Use of Digital Imaging, Video Conferencing and Telepathology in Histopathology: A National Survey,” Journal of Clinical Pathology, Vol. 58, No. 3, 2005, pp. 254-258. doi:10.1136/jcp.2004.022012
[6]	B. Stanberry, “Tele-mediicne: Barriers and Opportunities in the 21st Century,” Journal of Internal Medicine, Vol. 247, No. 6, 2000, pp. 615-628. doi:10.1046/j.1365-2796.2000.00699.x
[7]	S. A. Wells and C. Sowter, “Telepathology: A Diagnostic Tool for the Millennium?” Journal of Pathology, Vol. 191, No. 1, 2000, pp. 1-7. doi:10.1002/(SICI)1096-9896(200005)191:1<1::AID-PATH624>3.0.CO;2-S
[8]	Y. Shimosato, Y. Yagi, K. Yamagishi, et al., “Experience and Present Status in National Cancer Center Hospital, Tokyo,” Zentralblatt fur Pathologie, Vol. 138, No. 6, 1992, pp. 413-417.
[9]	D. S. Winberg, F.-A. Allaert, P. Dusserre, et al., “Telepathology Diagnosis by Means of Still Digital Images: An International Validation Study,” Human Pathology, Vol. 27, No. 2, 1996, pp. 111-118. doi:10.1016/S0046-8177(96)90363-9
[10]	B. E. Halliday, A. K. Bhatacharya, A. R. Graham, et al., “Diagnostic Accuracy of an International Static-Imaging Telepathology Consultation Service,” Human Pathology, Vol. 28, No. 1, 1997, pp. 17-21. doi:10.1016/S0046-8177(97)90273-2
[11]	A. J. Evans, R. Chetty, B. A. Clarke, S. Croul, D. M. Ghazarian; T. R. Kiehl, B. P. Ordonez, S. Ilaalagan, et al., “Primary Frozen Section Diagnosis by Robotic Microscopy and Virtual Slide Telepathology: The University Health Network Experience,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1069-1081. doi:10.1016/j.humpath.2009.04.012
[12]	B. E. Dunn, H. Choi, D. L. Recla, S. E. Kerr and B. L. Wagenman, “Robotic Surgical Telepathology between the Iron Mountain and Milwaukee Department of Veterans Affairs Medical Centers: A 12-Year Experience,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1092-1099. doi:10.1016/j.humpath.2009.04.007
[13]	A. R. Graham, A. K. Bhattacharyya, K. M. Scott, F. Lian, L. L. Grasso, L. C. Richter, J. T. Henderson, J. B. Carpenter, et al., “Virtual Slide Telepatholgoy for an Academic Teaching Hospital Surgical Patholgoy Quality Assurance Program,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1129-1136. doi:10.1016/j.humpath.2009.04.008
[14]	C. Massone, H. P. Soyer, G. P. Lozzi, A. DiStefani, B. Leinweber, G. Gabler, et al., “Feasibility and Diagnostic Agreement in Teledermatology Using a Virtual Slide System,” Human Pathology, Vol. 38, No. 4, 2007, pp. 546-554. doi:10.1016/j.humpath.2006.10.006
[15]	F. R. Dee, “Virtual Microscopy in Pathology Education,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1112-1121. doi:10.1016/j.humpath.2009.04.010
[16]	L. A. Bruch, B. R. De Young, C. D. Kreiter, T. H. Haugen, T. C. Leaven and F. R. Dee, “Competency Assessment of Residents in Surgical Pathology Using Virtual Microscopy,” Human Pathology, Vol. 40, No. 8, 2009, pp. 1122-1128. doi:10.1016/j.humpath.2009.04.009
[17]	R. Piece, “Cybermedicine,” New England Journal of Medicine, Vol. 339, No. 9, 1998, pp. 638-639. doi:10.1056/NEJM199808273390920