slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology PowerPoint Presentation
Download Presentation
Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology

Loading in 2 Seconds...

play fullscreen
1 / 22

Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology - PowerPoint PPT Presentation


  • 173 Views
  • Uploaded on

Ronald S. Weinstein, M.D. Professor, Pathology Head, Pathology 1990 – 2007 Director, Arizona Telemedicine Program. Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology. Disclosure. DMetrix – Tucson, AZ Medical Director Apollo Telemedicine – Falls Church, VA

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology' - cade


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1
Ronald S. Weinstein, M.D.

Professor, Pathology

Head, Pathology 1990 – 2007

Director, Arizona Telemedicine Program

Surgical Pathology Quality Assurance Program Using Robotic Real-time Telepathology

disclosure
Disclosure
  • DMetrix – Tucson, AZ
    • Medical Director
  • Apollo Telemedicine – Falls Church, VA
    • Shareholder
telepathology
Telepathology
  • The use of telecommunications technology to facilitate the transfer of image-rich pathology data between remote locations for the purposes of diagnosis, education, and research.
slide4
Telepathology systems are divided into three major types: static image-based systems, real-time systems, and virtual slide systems.
  • Static image systems have major benefits of being the most reasonably priced and usable in the widest range of settings, but have the significant drawback in only being able to capture a selected subset of microscopic fields.
  • Real-time systems and virtual slides allow a consultant pathologist the opportunity to evaluate the entire specimen. With real-time systems, the consultant actively operates a microscope located at a distant site -- changing focus, illumination, magnification, and field of view at will.
  • Virtual slide systems utilize an automated scanner that takes a visual image of the entire slide, which can then be forwarded to another location for diagnosis.
slide5

*Hospital housing the telepathology workstation.

The Hospital General del Estado in Hermosillo served as the hub for a network of regional hospitals whose pathologists brought cases to the referring site for transmission to Tucson and teleconsultation.

slide6

a University of Arizona telepathology services, initial 4100 cases, 1993-2008.

b Weinstein Classification of Telepathology Systems [2].

c For special studies, such as immunohistochemistry, or for glass slide review

d Includes some second-opinion cases.

slide7

TELEMEDICINE JOURNALVolume 1, Number 1, 1995Mary Ann Liebert, Inc., Publishers

Case Triage Model for the Practice of Telepathology

A.K. BHATTACHARYYA, M.D., JOHN R. DAVIS, M.D., BRADFORD E. HALLIDAY M.D.,

ANNA R. GRAHAM, M.D., S. ANNE LEAVITT, M.D., RALPH MARTINEZ, Ph.D.,

RICARDO A. RIVAS, and RONALD S. WEINSTEIN, M.D.

case triage model
Case Triage Model

Referring

Pathologist

Triage

Pathologist

Subspecialty

Pathologist

Triage

Pathologist

Case

Sign-out

Case

Sign-out

PATHWAY A

PATHWAY B

afip model
AFIP Model

Referring Pathologist

Triage Clerk

GYN Path

Renal Path

Derm Path

Etc.

GI Path

Case

Sign-out

Case

Sign-out

Case

Sign-out

Case

Sign-out

Case

Sign-out

slide10

a University of Arizona telepathology services, initial 4100 cases, 1993-2008.

b Weinstein Classification of Telepathology System [2].

c For special studies, such as immunohistochemistry, or for glass slide review

slide11

Havasu Regional Medical Center

University Medical Center Tucson, AZ

316 Miles

quality assurance program
Quality Assurance Program
  • HRMC processes approximately 3500 surgical pathology cases annually
  • One pathologist, on-site, between July 2005 and October 2009.
  • All new cancer cases and challenging non-malignant cases were selected by the HRMC pathologist for telepathology re-review.
deferral rate3
Deferral Rate
  • The case deferral rates for individual telepathologists ranged from

4.79% to 21.26%

  • The deferral rates were not significantly changed by exclusion of cases within the individual pathologists’ subspecialty area. These deferral rates ranged from

4.94% to 21.81%

slide18

The triage pathologist completed the telepathology consultation without any assistance of a subspecialty pathologist in 66% of the cases.

  • A review panel examined the original glass slides from 134 cases by light microscopy.
  • Concordance rates of the telepathologists’ provisional diagnosis or review panel’s diagnoses with the referring pathologists’ diagnoses were not statistically different ( P > 0.05).
conclusions
Conclusions:
  • Deferral rates were minimally impacted by pathologist subspecialty.
  • Overall diagnostic discordance rate, comparing on-site light microscopy and telepathology diagnoses, was 5.73%.
  • Deferrals for glass-slide review represented less than 10% of

telepathology QA cases.

conclusions1
Conclusions:
  • Deferral rates were minimally impacted by pathologist subspecialty.
  • Overall diagnostic discordance rate, comparing on-site light microscopy and telepathology diagnoses, was 5.73%.
  • Deferrals for glass-slide review represented less than 10% of

telepathology QA cases.