title: Impacts of a Large Decentralized Telepathology Network in Canada.
abstract: BACKGROUND
  Telepathology is a fast growing segment of the telemedicine field. As of yet, no prior research has investigated the impacts of large decentralized telepathology projects on patients, clinicians, and healthcare systems. This study aims to fill this gap. We report a benefits evaluation study of a large decentralized telepathology project deployed in Eastern Quebec, Canada whose main objective is to provide continuous coverage of intraoperative consultations in remote hospitals without pathologists on-site. The project involves 18 hospitals, making it one of the largest telepathology networks in the world.
  
  
  METHODS
  We conducted 43 semistructured interviews with several telepathology users and hospital managers. Archival data on the impacts of the telepathology project (e.g., number of service disruptions, average time between initial diagnosis and surgery) were also extracted and analyzed.
  
  
  RESULTS
  Our findings show that no service disruptions were recorded in hospitals without pathologists following the deployment of telepathology. Surgeons noted that the use of intraoperative consultations enabled by telepathology helped avoid second surgeries and improved accessibility to care services. Telepathology was also perceived by our respondents as having positive impacts on the remote hospitals' ability to retain and recruit surgeons.
  
  
  CONCLUSIONS
  The observed benefits should not leave the impression that implementing telepathology is a trivial matter. Indeed, many technical, human, and organizational challenges may be encountered. Telepathology can be highly useful in regional hospitals that do not have a pathologist on-site. More research is needed to investigate the challenges and benefits associated with large decentralized telepathology networks.
authors.affiliation: 1 Information Technology Department, HEC Montreal , Montreal, Quebec, Canada .
authors.forename: Guy
authors.initials: G
authors.lastname: Pare
authors.affiliation: 2 School of Health Services Management, Ryerson University , Toronto, Ontario, Canada .
authors.forename: Julien
authors.initials: J
authors.lastname: Meyer
authors.affiliation: 1 Information Technology Department, HEC Montreal , Montreal, Quebec, Canada .
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Trudel
authors.affiliation: 3 Pathology Department, Laval University Health Center , Quebec, Quebec, Canada .
authors.forename: Bernard
authors.initials: B
authors.lastname: Tetu
mesh_terms: D002170:Canada; D019058:Community Networks / Q000458:organization & administration*; D017046:Cost Savings; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011057:Politics; D015397:Program Evaluation; D011792:Quebec; D019113:Telepathology / Q000458:organization & administration*
keywords: business administration/economics; e-health; telemedicine; telepathology