solomons telepathology
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Solomon Islands
Solomon Islands
Solomon Islands
Solomon IslandsCapital: HoniaraPopulation: 450‘000Islands: ~1000Independence: 1978
Solomon Islands
Solomon IslandsCapital: HoniaraPopulation: 450‘000Islands: ~1000Independence: 1978
National Referral Hospital
Solomon Islands
Solomon IslandsCapital: HoniaraPopulation: 450‘000Islands: ~1000Independence: 1978
National Referral Hospital
Doctors: 15 - 30Radiologists: 1Pathologists: 0Dermatologists: 0
Limitations in Developing Countries
Shortage of general practitioners- many rural clinics are run by nurses only
Shortage of medical specialists - many countries have no dermatologists, pathologists, ophthalmologists, radiologists, etc.
Limited access to current information- medical libraries have no current material, no continuing medical education (CME)
Limitations in Developing Countries
Limited Transportation
Limitations in Developing Countries
Limited Communication Infrastructure
Example: many islands in Solomons have no telephone – communication only my VHF radio.
Existing telephones are often slow and too unreliable for stable internet access.
Limited financial resources
Implications
Patients - cannot afford to visit hospital - visit hospital late
Doctors- no access to specialist knowledge- no advise for patient management- no experience with rare diseases- no communication with patient (unless at hospital)
Solomon Islands Pathology
Problem for Pathology Services:– Specimen sent to Brisbane (AU) by air– Time until diagnosis: 60 days!
Patients do not return:– No communication infrastructure– Limited transport
Suggested solution
Telemedicine:
Access to advice and diagnosis from remote specialists with the help of telecommunication technologies.
Solomon Islands
Telepathology:
Phase 1: Histology Lab- September 2001
Phase 2: Establishing remote diagnostics- 2001-2003
Phase 3: Routine diagnostics - 2003 - ....
Phase 1: Histology Lab
Needs for Histology Lab:
Operational under local conditions:- frequent power cuts- high temperature and humidity
Sustainable- locally available spare parts
Phase 1: Histology LabTissue Processing
Phase 1: Histology LabTissue Processing
Preparing blocks
Phase 1: Histology LabTissue Processing
Preparing blocks
Cutting
Phase 1: Histology LabTissue Processing
Preparing blocks
Cutting
Staining
Phase 1: Histology LabTissue Processing
Preparing blocks
Cutting
Histology slides
Staining
Phase 2: Remote consultations
Step 1:Selected images captured with digital camera (Nikon CoolPix 990) and submitted to server in Basel via email
Step 2:Cases are reviewed by a group of 7 pathologists(Switzerland, Germany and South Africa)
Phase 2: Remote consultations
Results:
360 cases submitted and diagnosed
turn-around time 10 days(1-3 days for diagnosis)
Quality of diagnosis (preliminary results, n=80)*:80% identical diagnosis23% minor discrepancies7% major discrepancies**
* Full report in preparation** Includes two cases of sampling errors (false negative needle biopsies)