The California Telepathology Service: UCLA's Experience in Deploying a Regional Digital Pathology Subspecialty Consultation Network.

Autor:	Chong T; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Palma-Diaz MF; Kaiser Permanente Los Angeles Medical Center, Department of Pathology, Los Angeles, CA, USA., Fisher C; UCSD Medical Center Pathology, San Diego, CA, USA., Gui D; Department of Pathology and Laboratory Medicine, University of California, Sacramento, CA, USA., Ostrzega NL; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Sempa G; Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Irvine, CA, USA., Sisk AE; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Valasek M; UCSD Medical Center Pathology, San Diego, CA, USA., Wang BY; Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Irvine, CA, USA., Zuckerman J; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Khacherian C; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Binder S; Affiliated Pathologists Medical Group, Inc., Rancho Dominguez, CA, USA., Wallace WD; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of pathology informatics [J Pathol Inform] 2019 Sep 27; Vol. 10, pp. 31. Date of Electronic Publication: 2019 Sep 27 (Print Publication: 2019).
DOI:	10.4103/jpi.jpi_22_19
Abstrakt:	Background: The need for extending pathology diagnostic expertise to more areas is now being met by the maturation of technology that can effectively deliver this level of care. The experience and lessons learned from our successfully deployed International Telepathology Service (ITS) to a hospital system in China guided us in starting a domestic telepathology network, the California Telepathology Service (CTS). Many of the lessons learned from the ITS project informed our decision-making for the CTS. New challenges were recognized and overcome, such as addressing the complexity and cost-benefit tradeoffs involved in setting up a digital consultation system that competes with an established conventional glass slide delivery system. Methods: The CTS is based on a hub-and-spoke telepathology network using Leica Biosystems whole-slide image scanners and the eSlide Manager (eSM Version 12.3.3.7055, Leica Biosystems) digital image management software solution. The service currently comprises six spoke sites (UC San Diego [UCSD], UC Irvine [UCI], UC Davis, Northridge Hospital Medical Center [NHMC], Olive View Medical Center [OVMC], and Children's Hospital Los Angeles) and one central hub site (UCLA Medical Center). So far, five sites have been validated for telepathology case consultations following established practice guidelines, and four sites (UCI, UCSD, NHMC, and OVMC) have activated the service. Results: For the active spoke sites, we reviewed the volume, turnaround time (TAT), and case types and evaluated for utility and value. From May 2017 to July 2018, a total of 165 cases were submitted. Of note, digital consultations were particularly advantageous for preliminary kidney biopsy diagnoses (avg TAT 0.7 day). Conclusion: For spoke sites, telepathology provided shortened TAT and significant financial savings over hiring faculty with expertise to support a potentially low-volume service. For the hub site, the value includes exposure to educationally valuable cases, additional caseload volume to support specialized services, and improved communication with referring facilities over traditional carrier mail. The creation of a hub-and-spoke telepathology network is an expensive undertaking, and careful consideration needs to be given to support the needs of the clinical services, acquisition and effective deployment of the appropriate equipment, network requirements, and laboratory workflows to ensure a successful and cost-effective system. Competing Interests: There are no conflicts of interest. (Copyright: © 2019 Journal of Pathology Informatics.)
Databáze:	MEDLINE
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