DYNAMIC-ROBOTIC TELEPATHOLOGY - DEPARTMENT-OF-VETERANS-AFFAIRS FEASIBILITY STUDY

In this retrospective study, we assess the accuracy, confidence levels , and viewing times of two generalist pathologists using both dynamic- robotic telepathology and conventional light microscopy (LM) to render diagnoses on a test set of 100 consecutive routine surgical pathology cases. The objective is to determine whether telepathology will allow a pathology group practice at a diagnostic hub to provide routine dia gnostic services to a remote hospital without an on-site pathologist. For TP, glass slides were placed on the motorized stage of the robotic microscope of a telepathology system by a senior laboratory technolog ist in Iron Mountain, MI. Real-time control of the motorized microscop e was then transferred to a pathologist in Milwaukee, WI, who viewed i mages of the glass slides on a video monitor. The telepathologists def erred rendering a diagnosis In 1.5% of casts. Clinically important con cordance between the individual diagnoses rendered by telepathology an d the ''truth'' diagnosis established by rereview of glass slides was 98.5%. In the telepathology mode, there were five incorrect diagnoses out of a total of 197 diagnoses. In four cases in which the telepathol ogy diagnosis was incorrect, the pathologist's diagnosis by LM was ide ntical to that rendered by telepathology. These represent errors of in terpretation and cannot be ascribed to telepathology. The certainty of the pathologists with respect to their diagnoses was evaluated over t ime. Results for tile first 50 cases served as baseline data. For the second 50 cases, confidence in rendering a diagnosis in the telepathol ogy mode was essentially identical to that of making a diagnosis in th e LM viewing mode. Viewing times in the telepathology mode also improv ed with more experience using the telepathology system. These results support the concept that an off-site pathologist using dynamic-robotic telepathology can substitute for an on-site pathologist as a service provider.