History and structures of telecommunication in pathology, focusing on open access platforms

Abstract

Background: Telecommunication has matured to a broadly applied tool in diagnostic pathology.

Technology and systems: Contemporary with the development of fast electronic communication lines (Integrated digital network services (ISDN), broad band connections, and fibre optics, as well as the digital imaging technology (digital camera), telecommunication in tissue--based diagnosis (telepathology) has matured. Open access (internet) and server--based communication have induced the development of specific medical information platforms, such as iPATH, UICC-TPCC (telepathology consultation centre of the Union International against Cancer), or the Armed Forces Institute of Pathology (AFIP) teleconsultation system. They have been closed, and are subject to be replaced by specific open access forums (Medical Electronic Expert Communication System (MECES) with embedded virtual slide (VS) technology). MECES uses php language, data base driven mySqL architecture, X/L-AMPP infrastructure, and browser friendly W3C conform standards.

Experiences: The server--based medical communication systems (AFIP, iPATH, UICC-TPCC) have been reported to be a useful and easy to handle tool for expert consultation. Correct sampling and evaluation of transmitted still images by experts reported revealed no or only minor differences to the original images and good practice of the involved experts. β tests with the new generation medical expert consultation systems (MECES) revealed superior results in terms of performance, still image viewing, and system handling, especially as this is closely related to the use of so--called social forums (facebook, youtube, etc.).

Benefits and expectations: In addition to the acknowledged advantages of the former established systems (assistance of pathologists working in developing countries, diagnosis confirmation, international information exchange, etc.), the new generation offers additional benefits such as acoustic information transfer, assistance in image screening, VS technology, and teaching in diagnostic sampling, judgement, and verification.

Figure 1

Historical roots of virtual microscopy related to acoustic electronic communication. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/1.

Figure 2

Historical roots of virtual microscopy related to visual electronic communication. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/2.

Figure 3

History of telemedicine related to the technological development. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/3.

Figure 4

History of telemedicine related to the communication technology. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/4.

Figure 5

Survey of organization of a virtual pathology institution (VPI). The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/5.

Figure 6

Data of the former VPI Salomon Islands. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/6.

Figure 7

Basic structure of MECES (Medical Electronic Communication Expert System). The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/7.

Figure 8

Basic software of MECES. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/8.

Figure 9

Principle components of MECES. The virtual slide for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1617760077623140/9.