Telepathology

[KeratinPearls]

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So whats the update on telepathology. One Gynpath expert showed me his slide scanner and he said he feels more comfortable signing out cases using this software where he is able to zoom in and out using his mouse than a traditional scope. Are there any programs out there using it or do you know of any pathologists who send consults to their colleagues using the slide scanner? Pretty neat stuff.

 

[sirenomelia]

Its coming but not primetime.
Too much bandwidth needed to do live/ interact with others
Ok for stills and main app is online specials/IHC/FISH reads for reference studies to see before glass is mailed back.
In Sweden and some places they have been doing remote frozens for a while.

 

[coroner]

Our program has been using telepath for remote frozens the last couple of years. That way the attending can just look at a live feed of the slide without leaving home. I've also heard these automatic pap slide screening machines have also improved efficiency allowing hospitals/groups to keep revenue in house instead of shipping off to Quest/LabCorp type places.

 

[Torsed]

Slides still have to be signed out in a CLIA approved lab is that not correct (America...who really cares what Sweden does)? I don't see the advantage of scanning slides for routine histology work unless you are in outer Mongolia. The whole scanning system still relies on the production of a glass slide. FedEx can get my slides to any expert in less that 24 hours so I really don't think timely analysis for consults would be that advantageous.

 

[WEBB PINKERTON]

I thought the FDA kind of slowed people's interest in slide scanners.

http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt%7BactionForm.contentReference%7D=cap_today%2F0112%2F0112a_regulators.html&_state=maximized&_pageLabel=cntvwr

Automatic pap screening devices seem like a waste of money. Leave those for labcorp/quest.

 

[sirenomelia]

Slides still have to be signed out in a CLIA approved lab is that not correct (America...who really cares what Sweden does)? I don't see the advantage of scanning slides for routine histology work unless you are in outer Mongolia. The whole scanning system still relies on the production of a glass slide. FedEx can get my slides to any expert in less that 24 hours so I really don't think timely analysis for consults would be that advantageous.

Our hospital system has outlying facilities in BF egpyt that have surgeons that want sentinel nodes froze once in a while that a tech could prepare and we could see over the web and do just as good a job without having to treck over there. Some digital IHC things are approved to sign out virtually. And yes, some other places do things better and we can learn from it.

 

[DrBloodmoney]

The FDA is making slide scanners / viewers class III device classification (microscopes are class I, btw). Each individual system will require FDA approval for primary signout. We won't be using them in day-to-day signout in the US for a long time. Just the consultants / second opinion.

 

[KCShaw]

We used live-view for remote frozens in residency -- one outlying orthopedic center that liked to ask for neutrophil hunts, and after hours transplant frozens, as I recall.

I've seen CDs of slide scans go around for 2nd opinion/consult type cases in FP; occasionally we come across slides of such potential importance that the originating office refuses to let the original slide leave the office, so any consultant has to come to them. I believe some offices don't let -any- slides leave them as a matter of procedure, barring a court order (though most seem to review and release recuts, as far as I can tell). So unless it can be scanned or images taken of relevant areas or the cost footed to get the consultant to the other office or a court order arranged -- all of which have their own sets of fairly obvious arguments accompanying them -- then it just wouldn't get reviewed. While hardly any offices can whole slide scan, most have some sort of still image capability.