Title: Advantages and Disadvantages of Robotic Telepathology vs. Routine Microscopic pathology
1Advantages and Disadvantages of Robotic
Telepathology vs. Routine Microscopic pathology
- The Experience Between the Richmond and Beckley
VA Medical Centers - Department of Pathology and Laboratory Medicine ,
Richmond, Virginia
2Introduction
- The VISN 6 Veterans Administration hospitals
comprise eight hospitals. Three of these
hospitals are primary care hospitals where minor
surgery takes place. - The size of the smaller hospitals does not
justify a full time pathologist. Therefore,
robotic telepathology was considered as the
solution for one of the hospitals, located in
Beckley, West Virginia. - Beckley VAMC is supported by the larger
tertiary-care facility located 250 miles away in
Richmond Virginia.
3Common Types of Telepathology
- Dynamic or Robotic Telepathology (image is
transmitted instantly, operator can select fields
render diagnosis immediately. - Digitizing Entire Slide.
- Static or Capture image digitally and Transmit
Forward via electronic lines or other
telecommunication media.
4Dynamic Robotic Telepathology
- Operator can view entire slide from a remote
site. - Operator can select fields for digital image
capture. - Operator can communicate with transmitter
simultaneously to viewing.
5Robotic Image Receiving Station at the Richmond
VAMC
6Transmitting Station at Beckley VAMC
7Close-up of Transmitting Station
8Telepathology Vs Routine Microscopy Telepathology Vs Routine Microscopy Telepathology Vs Routine Microscopy
Setup Time Telepathology Routine
10-15 Minutes NA
AV Time per Slide Telepathology Routine
2.61 /- 2.6 SD Minutes 15/- 11SD Seconds
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10Strategies Adopted in Our System
- Because of the length of time required per slide,
only small biopsies are analyzed by
telepathology. - Viewing large sections of tissue by
telepathology is impractical and, therefore,
performed at the larger facility. - All slides are reviewed the next day upon receipt
of slides by mail. - All major specimens and special stains are
processed and viewed by routine microscopy at the
larger facility
11Costs Associated with Robotic Telepathology
Telepathology Hardware 169,344 Purchase cost
Maintenance 15,000
Yearly ISDN line cost 8,000
Yearly Slide-Mailing Costs 1,400
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14Advantages
- Robotic telepathology is a viable alternative to
an on site pathologist. - It allows acceptable turnaround time for surgical
pathology diagnosis. Meets CAP requirements. - It supplies a small hospital with surgical
pathology consultation from five pathologists,
which would otherwise not be accessible to a
small facility.
15Disadvantages
- The system is 12 fold slower to routine
microscopy. - Screen image is not as optimal as direct view.
- Repeated line and equipment down-time hinders
workflow.
16The End