title: The challenges of implementing a "patient-oriented" telepathology network; the Eastern Québec telepathology project experience.
abstract: BACKGROUND
  The aim of the Eastern Québec telepathology project is to provide uniform diagnostic telepathology services across a huge geographic region with a low population density. This project is intended to provide surgeons and pathologists with frozen section and second opinion services anywhere and at any time across the entire region in order to avoid unnecessary patient transfer.
  
  
  METHODS
  The project has been implemented in 21 sites, each equipped with a whole slide scanner, a macroscopy station, two videoconferencing devices and a viewer/case management and collaboration solution. Of the 21 sites, 6 are devoid of a pathology laboratory. Of the remaining 15 sites, two have no pathologists, 6 have one and 7 have two or more.
  
  
  RESULTS
  The project has been successful and most appreciated by pathologists and surgeons. We report a number of challenges related to change management that we had to take into account in the course of implementation of this network. The challenges underscore the need for regular visits and active support to participating centers by the project team.
  
  
  CONCLUSIONS
  The Eastern Québec telepathology network is successful and improves medical care in this region. In the course of implementation, we encountered a number of challenges which required innovative solutions.
authors.affiliation: RUIS-Laval University telepathology project, Faculty of medicine, Laval University, Québec, Canada. bernard.tetu@fmed.ulaval.ca
authors.forename: Bernard
authors.initials: B
authors.lastname: Têtu
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Fortin
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Gagnon
authors.forename: Said
authors.initials: S
authors.lastname: Louahlia
mesh_terms: D005629:Frozen Sections; D005843:Geography; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D009937:Organizational Objectives; D010340:Pathology, Surgical / Q000379:methods* / Q000458:organization & administration; D011792:Quebec; D019113:Telepathology / Q000379:methods* / Q000458:organization & administration