System requirements, the use of telepathology in diagnostic pathology and its application to quality assurance programmes

Abstract

The concept of using video microscopy to provide diagnostic services to remote locations was first described in the USA in 1968, when monochrome images were transmitted in real time. The communication protocol was a dedicated point-to-point microwave link. Eighteen years later, in 1986, a prototype commercial system using colour images, computer controlled microscopy, highdefinition television and satellite communication was described. It was not, however, until 1990 that a commercial telepathology system became available. I Since 1990, the development of telepathology has led to its routine use in some countries. There are no technological problems to be solved. The high-speed communication costs needed for remote diagnosis and remote consultation are, however, very expensive. These costs are a major obstacle to the routine application of telepathology within the UK. The multimedia computers now available at very low prices can be used as the basis of telepathology systems. Such systems can be used for remote consultation of experts or consensus diagnosis using microscope teleconferencing. Both require real-time performance. Other applications such as quality assurance, continuing medical education (CME) and teaching do not need a realtime capability and the lower purchase and running costs of such telepathology systems should make them cost effective. Telepathology should help to streamline quality assurance and improve diagnostic accuracy. Although the exact specification of a telepathology