Document Detail

Virtual slide telepathology for an academic teaching hospital surgical pathology quality assurance program.
MedLine Citation:
PMID:  19540562     Owner:  NLM     Status:  MEDLINE    
Virtual slide telepathology is an important potential tool for providing re-review of surgical pathology cases as part of a quality assurance program. The University of Arizona pathology faculty has implemented a quality assurance program between 2 university hospitals located 6 miles apart. The flagship hospital, University Medical Center (UMC), in Tucson, AZ, handles approximately 20 000 surgical pathology specimens per year. University Physicians Healthcare Hospital (UPHH) at Kino Campus has one tenth the volume of surgical pathology cases. Whereas UMC is staffed by 10 surgical pathologists, UPHH is staffed daily by a single part-time pathologist on a rotating basis. To provide same-day quality assurance re-reviews of cases, a DMetrix DX-40 ultrarapid virtual slide scanner (DMetrix, Inc, Tucson, AZ) was installed at the UPHH in 2005. Since then, glass slides of new cases of cancer and other difficult cases have been scanned the same day the slides are produced by the UPHH histology laboratory. The pathologist at UPHH generates a provisional written report based on light microscopic examination of the glass slides. At 2:00 pm each day, completed cases from UPHH are re-reviewed by staff pathologists, pathology residents, and medical students at the UMC using the DMetrix Iris virtual slide viewer. The virtual slides are viewed on a 50-in plasma monitor. Results are communicated with the UPHH laboratory by fax. We have analyzed the results of the first 329 consecutive quality assurance cases. There was complete concordance with the original UPHH diagnosis in 302 (91.8%) cases. There were 5 (1.5%) major discrepancies, which would have resulted in different therapy and/or management, and 10 (3.0%) minor discrepancies. In 6 cases (1.8%), the diagnosis was deferred for examination of the glass slides by the reviewing pathologists at UMC, and the diagnosis of another 6 (1.8%) cases were deferred pending additional testing, usually immunohistochemistry. Thus, the quality assurance program found a small number of significant diagnostic discrepancies. We also found that implementation of a virtual slide telepathology quality assurance service improved the job satisfaction of academic subspecialty pathologists assigned to cover on-site surgical pathology services at a small, affiliated university hospital on a rotating part-time basis. These findings should be applicable to some community hospital group practices as well.
Anna R Graham; Achyut K Bhattacharyya; Katherine M Scott; Fangru Lian; Lauren L Grasso; Lynne C Richter; John B Carpenter; Sarah Chiang; Jeffrey T Henderson; Ana Maria Lopez; Gail P Barker; Ronald S Weinstein
Publication Detail:
Type:  Journal Article     Date:  2009-06-21
Journal Detail:
Title:  Human pathology     Volume:  40     ISSN:  1532-8392     ISO Abbreviation:  Hum. Pathol.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1129-36     Citation Subset:  IM    
Department of Pathology, University of Arizona College of Medicine, Tucson, AZ 85724, USA.
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MeSH Terms
Diagnostic Errors / statistics & numerical data
Hospitals, Teaching*
Image Processing, Computer-Assisted*
Microscopy / methods*
Observer Variation
Pathology, Surgical / education*,  standards
Quality Assurance, Health Care*
Reproducibility of Results
Telepathology / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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