Whole-slide imaging-based telepathology in geographically dispersed Healthcare Networks. The Eastern Québec Telepathology project

This study reports the first 3-year experience of the Eastern Québec Telepathology Network. Clinical activities started in January 2011 and involved 18 hospitals practicing oncologic surgery in the region. Clinical activities comprised primary diagnosis (including intraoperative consultations (IOC)), expert opinions between two pathologists, continuing education and assistance to macroscopic description. A concordance rate of 98% was found between IOC diagnosis and the final report and the average turnaround time was 20 minutes. Expert opinion reports were completed within 24 hours in 68% of cases. An evaluation of the benefits demonstrates that telepathology prevented interruption of IOC, two-stage surgeries and patient transfers. It also shows that retention and recruitment of surgeons in remote hospitals were facilitated and that professional isolation among pathologists was reduced. Wider adoption of telepathology would require technological improvements and appropriate change management policies. A second phase is underway to expand the service to other regions across the province.