telepathology

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Title and Authors

• Title: Telepathology: An update on applications, latest advances, and current status in Indian scenario

• Authors: Ajeesha Feroz, T. P. Mohammed Feroz, T. S. Bastian, M. Selvamani

• Affiliation: Departments of Oral Pathology and Microbiology, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India.

Correspondence

• Contact: Dr. Ajeesha Feroz, Mahe Institute of Dental Sciences and Hospital, P. O. Palloor, Chalakkara, Mahe - 673 310, Puducherry, India.

• Email: ajiferoz@gmail.com

Abstract

• Telepathology enables pathologists to diagnose from a distance, replacing traditional microscopes with video monitor-based image viewing.

• This article reviews telepathology: applications, advances, limitations, and current status in India, emphasizing technological impacts on healthcare delivery.

Key Terms

• Telepathology, diagnostic pathology, microscope, teledentistry, virtual pathology.

Introduction

• Historical Context: Pathologists have utilized microscopes since the 17th century. The diagnosis in pathology is now notably specific and sensitive compared to other medical disciplines.

• Technological Advances: Innovations in molecular biology and digital communication have dramatically transformed diagnostic pathology. These improvements enhance disease diagnosis, especially in cancer and infectious diseases.

Definition and Background of Telepathology

• Definition: Coined by Ronald Weinstein, telepathology allows pathology practice over distances using telecommunication technologies.

• Evolution: Originated in the 1960s with NASA's trials, with significant developments leading up to the first telepathology international congress in 1992.

Modes of Telepathology

• Static Telepathology: Images preselected and sent via email or the internet. It is low-cost but has limitations such as potentially missing crucial diagnostic areas.

• Dynamic Telepathology: Real-time, live transmission of images, allowing remote pathologists to control the examination. High concordance rates praise its efficiency.

• Hybrid Telepathology: Combines static and dynamic elements, improving consultation and patient care through automated image management.

Applications of Telepathology

• Healthcare Delivery: Allows for timely diagnostics, especially in underserved areas where pathologists are scarce.

• Medical Education: Facilitates learning through digital image sharing, enhancing the quality of education compared to traditional methods.

• Intraoperative Analysis: Enables pathologists to assess tumor margins during surgeries remotely.

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Technological Requirements for Telepathology

• Data and Server Needs: Includes data storage, IT support, and high-resolution monitors. Necessary components are digital imaging systems, archiving systems, and patient information interfaces.

• Implementation Components: Digital image capture, transfer, display, and storage systems maintain efficiency and enhance workflow in pathology.

Disadvantages of Telepathology

• Cost: High initial setup and maintenance costs can hinder adoption, particularly in smaller labs.

• Acceptance: Resistance from pathologists and surgical teams can slow the implementation process due to trust issues around remote diagnoses.

• Slide Selection Challenges: Dynamic telepathology poses difficulties in slide manipulation, risking diagnostic errors.

• Legal and Security Issues: Concerns about data protection, physician licensing, and contracts may impede telepathology's integration into standard practices.

Implementation Challenges

• Individual Barriers: Trust issues with unfamiliar remote diagnoses among clinicians.

• Organizational Barriers: Financial constraints and the need for workflow reengineering complicate implementation within healthcare systems.

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Advances in Telepathology

• Virtual Slides: High-quality, multi-magnification images that provide detailed diagnostics without multiple image captures.

• Digital Imaging: Transition from traditional photography to digital captures allows efficient archiving and dissemination.

• Miniature Microscope Arrays: Emerging technology that can simultaneously capture multiple images for rapid slide production.

• Whole-slide Imaging: Digitized full slide imaging enabling easy access and high-resolution viewing from any device.

Telepathology in India

• Current Status: India is in the early stages of telepathology application, primarily using static telepathology due to resource limitations.

• Pioneering Work: The first telepathology experiences began from national conferences and the establishment of e-learning platforms.

• Challenges Faced: Issues include suboptimal slide preparation, lack of rapport between pathologists, and resistance from experienced practitioners.

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Future Prospects

• Integration: Advancements in telepathology and digital pathology are crucial for transforming pathology practices and improving diagnosis speed and accuracy.

• Obstacles to Progress: Continued focus on overcoming technological, financial, and acceptance hurdles for successful integration into healthcare.

Conclusion

• Significant global advancements in telepathology underscore its potential as a transformative tool in pathology.

Conflicts of Interest and Financial Support

• Financial Support: None.

• Conflicts of Interest: None reported.

References

• Includes studies and articles that support the research and findings presented in this review.