old-fashioned telepathology with courier transport: a case ......objectives...
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OBJECTIVESIn this case study, we will report apractical example faced by ourcompany and discuss how simpleand low-cost options may makeviable an interstate histopathologylab operation without qualitycompromise, maintainingprofitability.
INTRODUCTIONThe strict requirements of laboratory structure and specializedpersonnel may impose itself as barriers to the development ofLaboratory Medicine, as globally known. Undernourished areas facestronger embargoes, although this phenomenon does not sparedeveloped areas as well. Clinical Pathology and Histopathology,high demand areas, are not spared, leaving unassisted populationsand setting a pent-up demand, while creating a potential unexploredmarket share.
Old-fashioned Telepathology with courier transport: a case study in Laboratory Medicine through 3000 km in Brazil with positive results
Laboratory ManagementGiuliano Ferreira Morgantetti, MD1, Guilherme Alencar de Medeiros, MD1, Marcelo Balancin, MD2
1Managing Partner, Singular Patologia, Northeast Division2Consultant Pathologist, Singular Patologia, São Paulo Division
CONCLUSIONSimple low-cost options, as courier and common informatic tools may be employed to bypass barriers tohistopathology implementation, when Digital Pathology is not economically viable, allowing access toModern Medicine and market development anywhere in the world, bypassing geographical barriers andmaintaining acceptable revenues.
Corresponding author: Dr. Marcelo Balancin, [email protected] مامتھالا ىلع كل اركش
CASE STUDYWe are a small-sizedhistopathology and cytopathologymedical laboratory serving threebranches in two distinct states inNorthern Brazil (Ceará andMaranhão states, Map). Whiletechnical operations, as grosssections, histopathology slideconfection andimmunohistochemistry are run inthe northern states, slides areassessed by pathologists innorthern and southern Brazil.Around 30% of the cases (around4000 slides / month) aretransported through a courierservice, delivered in a 48-hourschedule, to a southern (SãoPaulo state) branch and analyzedby local specialists andconsultants. A minimal-setapparatus has adjoined theefficacy of this process, as basicmicrophotography and simpleinformatic tools, as a web-basedlaboratory informatics service andvideoconferencing for controversialand difficult cases. During a yearan adequate turn-around time hasbeen maintained, complying withadequate quality control methods.
LACK OF ACESS TO DIAGNOSIS: A GLOBAL PROBLEM.
“We have employed a two day courier
service and connected three cities from three
states. Maranhãostate has less than
20 pathologists registered at the medical council, while São Paulo
has more than 100 at the capital”
SIMPLE SOLUTIONS FOR A COMPLEX PROBLEM
Next day Courier transport system;Skype meetings for case discussion;
Whatsapp and cell phone slide photos;Simple slide scanning systems and software.
Fig 1. Smartphone photography for case discussion; Fig 2. Manual Scanning System (Microvisioneer, Germany); Fig 3. Stored slides received through courier service.