Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol
Objective/Background Telepathology has been widely adopted to allow intraoperative pathology examinations to be performed remotely and for obtaining second opinion teleconsultation. In the Italian northern region of South Tyrol, the widespread geographical distances and consequent cost for the healt...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-07-01
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| Series: | Digital Health |
| Online Access: | https://doi.org/10.1177/20552076221116776 |
| _version_ | 1828190961889443840 |
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| author | Ilaria Girolami Stefania Neri Albino Eccher Matteo Brunelli Mattew Hanna Liron Pantanowitz Esther Hanspeter Guido Mazzoleni |
| author_facet | Ilaria Girolami Stefania Neri Albino Eccher Matteo Brunelli Mattew Hanna Liron Pantanowitz Esther Hanspeter Guido Mazzoleni |
| author_sort | Ilaria Girolami |
| collection | DOAJ |
| description | Objective/Background Telepathology has been widely adopted to allow intraoperative pathology examinations to be performed remotely and for obtaining second opinion teleconsultation. In the Italian northern region of South Tyrol, the widespread geographical distances and consequent cost for the health system of having a travelling pathologist cover intraoperative consultations in peripheral hospitals was a key driver for the implementation of a telepathology system. Methods In 2010, four Menarini D-Sight whole slide scanners to digitize entire pathology slides were placed in the peripheral hospitals of Merano, Bressanone, Brunico, and in the hub hospital of Bolzano. Digital workstations were also installed to allow pathologists to remotely perform intraoperative consultations with digital slides. This study reviews the outcome after 12 years of telepathology for this intended clinical use. Results After an initial validation phase with 100 cases which yielded a sensitivity of 65% (CI 43–84%) and specificity of 100% (CI 95–100%), there were 2058 intraoperative consultations handled by telepathology. The cases evaluated were mainly breast sentinel lymph nodes, followed by urological, gynecological and general surgical pathology frozen section specimens. There were no false-positive cases and 165 (8%) false-negative cases, yielding an overall sensitivity and specificity of 65% (CI 61–69%) and 100% (CI 99–100%), respectively. Conclusion Telepathology is reliable for remote intraoperative diagnosis and, despite technical issues and initial acquaintance issues, proved beneficial for patient care in satellite hospitals, improved standardization, promoted innovation, and resulted in cost savings for the health system. |
| first_indexed | 2024-04-12T08:29:53Z |
| format | Article |
| id | doaj.art-b65974e21eb14140b2967f831c25ab59 |
| institution | Directory Open Access Journal |
| issn | 2055-2076 |
| language | English |
| last_indexed | 2024-04-12T08:29:53Z |
| publishDate | 2022-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Digital Health |
| spelling | doaj.art-b65974e21eb14140b2967f831c25ab592022-12-22T03:40:14ZengSAGE PublishingDigital Health2055-20762022-07-01810.1177/20552076221116776Frozen section telepathology service: Efficiency and benefits of an e-health policy in South TyrolIlaria Girolami0Stefania Neri1Albino Eccher2Matteo Brunelli3Mattew Hanna4Liron Pantanowitz5Esther Hanspeter6Guido Mazzoleni7 Department of Pathology, Provincial Hospital of Bolzano , Bolzano-Bozen, Italy Department of Pathology, Provincial Hospital of Bolzano , Bolzano-Bozen, Italy Department of Pathology and Diagnostics, , Verona, Italy Department of Diagnostics and Public Health, , Verona, Italy Department of Pathology, , New York, NY, USA Department of Pathology & Clinical Labs, , Ann Arbor, MI, USA Department of Pathology, Provincial Hospital of Bolzano , Bolzano-Bozen, Italy Department of Pathology, Provincial Hospital of Bolzano , Bolzano-Bozen, ItalyObjective/Background Telepathology has been widely adopted to allow intraoperative pathology examinations to be performed remotely and for obtaining second opinion teleconsultation. In the Italian northern region of South Tyrol, the widespread geographical distances and consequent cost for the health system of having a travelling pathologist cover intraoperative consultations in peripheral hospitals was a key driver for the implementation of a telepathology system. Methods In 2010, four Menarini D-Sight whole slide scanners to digitize entire pathology slides were placed in the peripheral hospitals of Merano, Bressanone, Brunico, and in the hub hospital of Bolzano. Digital workstations were also installed to allow pathologists to remotely perform intraoperative consultations with digital slides. This study reviews the outcome after 12 years of telepathology for this intended clinical use. Results After an initial validation phase with 100 cases which yielded a sensitivity of 65% (CI 43–84%) and specificity of 100% (CI 95–100%), there were 2058 intraoperative consultations handled by telepathology. The cases evaluated were mainly breast sentinel lymph nodes, followed by urological, gynecological and general surgical pathology frozen section specimens. There were no false-positive cases and 165 (8%) false-negative cases, yielding an overall sensitivity and specificity of 65% (CI 61–69%) and 100% (CI 99–100%), respectively. Conclusion Telepathology is reliable for remote intraoperative diagnosis and, despite technical issues and initial acquaintance issues, proved beneficial for patient care in satellite hospitals, improved standardization, promoted innovation, and resulted in cost savings for the health system.https://doi.org/10.1177/20552076221116776 |
| spellingShingle | Ilaria Girolami Stefania Neri Albino Eccher Matteo Brunelli Mattew Hanna Liron Pantanowitz Esther Hanspeter Guido Mazzoleni Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol Digital Health |
| title | Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol |
| title_full | Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol |
| title_fullStr | Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol |
| title_full_unstemmed | Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol |
| title_short | Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol |
| title_sort | frozen section telepathology service efficiency and benefits of an e health policy in south tyrol |
| url | https://doi.org/10.1177/20552076221116776 |
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