Evaluation of a Web-Based Telepathology Consultation Service Platform
Ioan C Cucoranu, Samuel A Yousem, Gonzalo Romero Lauro, William Cable, Jeff McHugh, Anil V Parwani, Liron Pantanowitz. UPMC, Pittsburgh, PA
Background: Telepathology facilitates distribution of professional expertise over broad geographic areas. Various modes of telepathology have been adopted at our institution for over a decade to support pathology services at local, national and international sites. These telepathology initiatives have evolved to begin leveraging whole slide imaging (WSI) technology and the Internet. We recently developed web-based telepathology consultation portals that facilitate WSI sharing by local and international clients for second opionion, in a secure environment. Our aim was to evaluate our experience with these portals.
Design: A general portal was developed for all clients to securely upload WSI and pertinent clinical information, for transmission to our pathology specialty consultants. It employs a vendor neutral viewer, allowing use of multiple WSI file types. Clients can login securely to check the status of their cases and to view or print reports. Workflow is handled by managers who triage requests, monitor cases, and maintain personnel data. A client-specific portal required customization for individual clients (Table 1). This setup allows consultants to view WSI hosted on remote servers at the client's location, via Internet streaming. Image files are organized by scanner's software and no storage or transmission of personal health information is encountered.
Results: Streamlined workflow and users training has ensured prompt turn-around time and buy-in by pathologists. Post-launch feedback has resulted in customization to incorporate transcription services, peer-to-peer review for consultants, provision for issuing addenda or amendments, and improved WSI viewing experience. During a 10-months period, 75 teleconsultation cases were signed out by our subspecialty pathologists on the client's specific portal. The average case turnaround time was 3.86 days. Delayed cases have been attributed mainly to network outage problems.
Conclusions: Both client and consultant users' satisfaction with the telepathology consultation portal is positive. This technology provides faster and more convenient access to subspecialty pathology consultants.
|General Portal||Client-Specific Portal|
|Simple and cheaper||Configurable|
|Image transfer required||No need for image transfers|
|Supports multiple WSI vendor formats||Customized to run only the client's WSI format|
|WSI files organized by folders||Files organized by scanner software|
|Customers enter PHI into the portal tool||No transmission or storage of PHI|
|Built-in billing component||No billing tool (contractual)|