ABSTRACT
The objective of this study is to analyze the deferrals in static telepathology consultation service. A store and forward approach is used to transmit cases from two remotely located rural centers to Tata Memorial Hospital. A total of 346 tele-surgical pathology cases were accessioned for second opinion and were reported from January 2002 to August 2005. The glass slides and paraffin blocks were reviewed at a later date and the telepathology diagnosis was compared with the final diagnosis rendered on light microscopy. Of all 251 teleconsults referred from one of the referring centers, a telepathology diagnosis was rendered in 205 cases and 46 cases were deferred. The reasons for deferral were as follows: the requirement for ancillary studies (40 cases), clinical details (5 cases) and poor quality sections and images (1 case). In all these deferred cases, a probable diagnosis was rendered by the telepathologist and was compared with the final diagnosis after paraffin block evaluation. In 47% of the cases, the "probable" diagnosis on telepathology matched the final diagnosis.
Subject(s)
Adolescent , Adult , Aged , Child , Delivery of Health Care , Health Services Research , Humans , Middle Aged , Remote Consultation/statistics & numerical data , Telepathology/statistics & numerical dataABSTRACT
Telepathology is the practice of pathology at a distance. Static telepathology is employed to achieve teleconsultation between a tertiary cancer referral centre, Tata Memorial Centre and a sister concern in rural area viz. Nargis Dutt Memorial Cancer Hospital, Barshi, Solapur. This is an analysis of the first 102 cases. Two transcontinental consultations have not been included in statistical analysis. A diagnosis was offered in 99 (99%) cases; whereas it was deferred in only I (1%) case. Clinically important or relevant diagnosis were achieved in 93/ 99 (93.93%) of cases. Major discrepancies were encountered in 6/99 (6.06%) of cases. A total of 79% of cases were reported within 3 days, of which 32% were reported within 8 hours (a single working day) and 47% within 1-3 days. Telemedicine can be used effectively to bridge the gap between medically underprivileged, geographically distant rural areas and advanced centers with technical expertise using cheaper static store and forward methodology.
Subject(s)
Cancer Care Facilities , Costs and Cost Analysis , Diagnostic Errors , Female , Humans , India , Male , Neoplasms/diagnosis , Remote Consultation/economics , Rural Health Services , Telepathology/economicsABSTRACT
BACKGROUND: Telepathology allows quick and timely access to an expert opinion, no matter where the patient is located. We analysed the experience with the use of telepathology between a tertiary cancer centre and a rural cancer hospital. METHODS: Ninety-three cases were analysed in which static telepathology was used to obtain a consultation between Tata Memorial Centre and Nargis Dutt Memorial Cancer Hospital at Barshi, a rural area. RESULTS: Successful teleconsultation was achieved in all cases. A diagnosis was offered in 92 cases (98.9%) and was deferred in 1 case (1.1%). Complete concordance, clinically unimportant minor discrepancy and hedged diagnosis were obtained in 83 cases (90.2%). Major discrepancies were encountered in 9 cases (9.7%). The number of images per case ranged from 3 to 27 (average: 7 images). Images were of diagnosable quality in 89.2% of cases. Most of the cases (77.4%) were reported within 3 days; 32.2% were reported within 8 hours (a single working day) and 45.1% within 1-3 days. CONCLUSION: Telemedicine can be effectively used to bridge the gap between medically underprivileged, geographically distant rural areas and advanced centres using the static store and forward methodology.