Telepathology links rural Iowa hospital laboratories to references laboratories
"Telepathology equipment allows us to review material such as abnormal peripheral blood smears on a semi-urgent basis," claims Dr. Goetz. The telepathology system installed at St. Joseph Community Hospital in New Hampton was purchased from Autocyte (formerly Roche Image Analysis Systems), and allows transmission of static microscopic images to a similar system in Mason City for review. The resolution has been sufficient to distinguish blasts from reactive lymphocytes, for example, and to examine red blood cell morphologic abnormalities.
Recently, telemedicine video equipment was used in conjunction with microscopic images to manage a surgical consultation. An enlarged lymph node from a young patient was sectioned by Sharon Steege, laboratory supervisor in New Hampton, on the video document camera (usually used to send radiographic images or documents). The gross images were clear enough to discern the classic nodular texture of follicular lymphoid hyperplasia, a common reactive condition in children. Subsequent wright stained touch prep slides were sent by telepathology to our laboratory, and these correlated with the gross impression.
Our lab is also involved in a telepathology pilot project with the Mayo Clinic. In selected cases, images of difficult surgical pathology cases are captured and sent to Mayo Clinic consultants before the glass slides are forwarded for the final consult. This allows for an immediate preliminary diagnosis. So far, the preliminary impression has matched the final diagnosis in every case.
Future applications may include forming a pathologist network to review and share interesting cases for quality assurance and teaching purposes. Images can also be stored on disk and transported to other applications such as Internet webpages. The websites can be an large educational database for pathologists or may be used by other health professionals such as cytotechnologists.
Dr. Goetz can be reached at: 515/424-7487 or e-mail him at: