Trestle's Internet solutions selected by Hawaii Health Systems and Canadian West Parry Sound Health Centre

Irvine 29 December 2004Trestle Holdings Inc., a supplier of digital imaging and telemedicine applications, has been selected as the primary technology partner for Hawaii Health Systems Corporation (HHSC), a public-benefit company, in a grant project to bring specialized medical service and distance learning statewide to rural, underserved communities in Hawaii. In turn, West Parry Sound Health Centre (WPSHC), a network of health care facilities covering 70.000 people throughout Parry Sound, Muskoka and surrounding communities in Ontario, has deployed its first Trestle Internet microscopy solution. The system, Trestle's MedMicro, uses standard PCs to connect microscopes to the Internet enabling users to view and navigate slides remotely for real-time, accurate consultation and diagnosis.


Like many health care networks with disparate facilities spread over large geographic areas, WPSHC has traditionally used couriers to transport patients' slides to appropriate specialists to obtain the best diagnostic results. But, according to Dr. Ola Kassim, WPSHC's chief pathologist and director of laboratory medicine, this method has several flaws that undermine the network's ability to provide the best health care.

"As a pathologist, I receive specimens from laboratories in our network via physical messenger", explained Dr. Kassim. "This process often takes 24 hours or more, not an acceptable timeframe if we're dealing with an urgent diagnosis. With Trestle's robotic-microscope technology, we've connected all of the facilities and specialists in our network. My lab in Elliot Lake, for example, can place a specimen on their facility's microscope, and I can go on-line and view and navigate that slide from my own PC. This cuts my diagnosis time from hours or days to minutes."

According to Dr. Kassim, Trestle's solutions solve another major flaw in traditional telepathology. "When a doctor sends me a photo of a specimen, I am not able to see nearly the detail that I would with the actual slide", stated Dr. Kassim. "When viewing a specimen, a pathologist often needs to move the slide, zoom in or out and illuminate certain areas. With a photo, or a static digital image, none of this is possible. But with Trestle, we are able to remotely control an actual slide on an actual microscope in another facility from our own computers and even share control of a slide during a consultation between doctors or pathologists in different facilities. The value this adds to our ability to pool our network-wide expertise - instantly sending a possible breast cancer sample to a pathologist who deals exclusively with breast cancer, for example - is immeasurable."

Trestle's solution will further add value to WPSHC's network by cutting costs. As Dr. Kassim explains, when he travels or is not on-site at his West Parry Sound laboratory, the staff will often need to bring in another pathologist at a cost of $1500 to $1800 per day, to be on call for emergencies. With Dr. Kassim now able to view and navigate slides remotely via his laptop, Trestle's solution will save the organisation these costs.

With its first Trestle MedMicro application successfully deployed - "The system is already improving our diagnostic processes", stated Dr. Kassim - West Parry Sound is now evaluating an expansion of Trestle solutions throughout its network. "Trestle's telepathology solutions deliver convenience and improved health care capabilities to physicians and pathologists around the world", stated Maurizio Vecchione, Trestle's CEO. "We look forward to expanding the West Parry Sound Project so that Dr. Kassim can collaborate with an expanded group of experts."

The West Parry Sound Health Centre is a community-focused health facility located in the Parry Sound, Ontario, Canada. The Health Centre resulted from the amalgamation of the Parry Sound District General Hospital and the Parry Sound Area Health Centre, Chronic Care Facility, formerly St. Joseph's Hospital, Parry Sound, in April, 1995. Both of these hospitals have had a long tradition of providing quality care to the community and have been leaders in the rationalization of services. Hospital Services in Parry Sound celebrated its centennial year in 1999.

The Rural Telemedicine and Telepathology Distance Learning Network of Hawaii, formed by HHSC, the Kona Hospital Foundation, Clinical Labs of Hawaii, University of Hawaii School of Medical Pathology, and other health care and education providers, will use the $500.000 Distance Learning and Telemedicine (DLT) grant awarded by the Rural Utilities Service of the United States Department of Agriculture to accomplish three primary goals. First, the network will provide education and training to medical pathology residents. Second, it will provide health professionals, rural patients, families and community members with distance learning services. And third, it will give rural Hawaiian communities access to specialized medical care, especially for chronic conditions.

"Trestle's Internet-enabled microscopy technology will greatly enhance the quality health care that we currently provide to our rural island communities", stated Thomas Driskill Jr., president and chief executive officer of HHSC. "Trestle's applications will allow us to provide real-time review, examination and diagnosis between physicians and specialists at any of our facilities throughout the islands. This will mean broader access to expertise for all of the physicians and pathologists in our network, as well as better medical care for our rural patients."

For the distance learning aspect of this undertaking, Trestle's solutions will play a prominent role as well. "We have on-line teaching conferences planned for residents throughout our inter-island network", explained John Hardman, M.D., neuropathologist and programme director, University of Hawaii School of Medicine Integrated Pathology Residency Programme. "Trestle's applications will help us provide more in-depth instruction on frozen-section diagnosis, cytopathology, surgical pathology and speciality pathology."

According to Dr. Glenn Furuya, medical director at Clinical Labs of Hawaii: "Utilizing remote telepathology will increase our productivity by enabling our pathologists to share information almost instantly. This revolutionizes our second-opinion consultations and frozen-section reviews, and reduces the time needed for diagnosis."

For the state of Hawaii, where communities are separated by the ocean, telepathology can shave days off the time required for a physician to receive an expert diagnosis of a tissue sample. Currently, slides are shuttled back and forth among the islands via courier, and it can take three to five days for a doctor to get an expert "read" of a slide. The Trestle system promises to reduce this to several minutes, and eliminates the possibility of slides being lost or broken.

"Trestle is very proud of our ongoing relationship with HHSC, which commenced in 1999, and looks forward to working with HHSC on next-generation Trestle systems and technologies in areas of improved image acquisition of tissue samples, applications for improved pathology work flow and digital analysis", stated Maurizio Vecchione, Trestle's CEO. "Telepathology is a critical frontier as technology and the Internet bring critical benefits to healthcare systems, physicians and patients."

The partners in this statewide grant project to enhance distance learning and medical services include several of HHSC's 12 medical facilities including Kona Community Hospital, Hilo Medical Center, Kohala Hospital and Kauai Veterans Memorial Hospital.

Established in 1996, HHSC is a public-benefit corporation of the state of Hawaii. As the state's community hospital system, HHSC continues to fulfil the state's promise to provide quality, hometown health care, particularly in rural locations that private hospitals are unable to service. Today, HHSC is the fourth-largest public hospital system in the United States. HHSC is the largest health provider for neighbour island residents, providing acute, rural and long-term care.

Trestle Holdings develops and sells digital imaging and telemedicine applications to the life sciences markets. The company's products link geographically dispersed users with each other, information databases, and analytical tools. This improved integration drives cost savings and process efficiencies, enables improved pre-clinical and clinical phases of research and development for new drugs, and enhances patient care.

Trestle's digital imaging products have the potential to transform the pathologist's work environment by capturing digital images of tissue samples and enabling the sharing, archiving, and analysis of these images. The company's live microscopy products enable multiple physicians and scientists to remotely view, navigate, and share high-fidelity microscope images at sub-micron resolution over standard Internet connections in real time.

The company's slide scanning and imaging products perform high-speed whole-glass slide digitization for virtual microscopy applications. These slide scanning products facilitate image analysis, data management, digital work flow and data association applications for clinical and research customers. For example, for pharmaceutical companies, Trestle's products enable improvements to the pre-clinical and clinical phases of research and development through better capture, management and analysis of tissue sample information. More company news is available iin the VMW November 2004 article Trestle's MedMicro helps Dynacare Kasper provide telepathology services to underserved areas across rural Canada.

Leslie Versweyveld

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