Telepathology for intraoperative neuropathologic consultations at an academic medical center: a 5-year report.
Telepathology is an attractive solution for providing neuropathologic intraoperative expertise to geographically diverse hospitals from a center of excellence. To date, few reports specifically address the feasibility of such a system for intraoperative neuropathology specimens. The University of Pittsburgh Medical Center is a 20-hospital system in Southwest Pennsylvania in which the pathology department has adopted a subspecialty "centers of excellence" method of managing cases. The Division of Neuropathology is physically located at 1 hospital but provides neuropathologic expertise to the entire system. Adult neurosurgery is currently limited to 2 hospitals separated by 18 city blocks. We describe our experience in providing remote intraoperative neuropathologic consultations over a 5-year period, from 2002 to 2006. Several approaches are discussed, with emphasis on the current system and the evolution of imaging technology. Diagnostic outcomes are compared among >400 telepathology cases and >1,200 conventional intraoperative cases. Current technology is capable of facilitating teleneuropathologic intraoperative diagnoses in a timely manner, with accuracy rates comparable to those for conventional methods. However, the practice of providing these remote consultations requires a sophisticated and technologically advanced environment along with substantial planning, communication, and training of both pathologists and pathology assistants.
Horbinski
Craig
C
Department of Pathology, Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Fine
Jeffrey L
JL
Medina-Flores
Rafael
R
Yagi
Yukako
Y
Wiley
Clayton A
CA
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D006801:Humans; D007432:Intraoperative Period; D015201:Meta-Analysis as Topic; D009369:Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010340:Pathology, Surgical; D010414:Pennsylvania; D019114:Remote Consultation; D012189:Retrospective Studies; D019113:Telepathology / Q000379:methods*