"Community hospitals often still rely on a general, onsite pathologist to diagnose routine cases, but defer to UHN expert consultation for the more challenging cases", explained Dr. Sylvia Asa, Medical Director, Laboratory Medicine Programme and Pathologist-in-Chief at UHN. "Other community hospitals have no pathology services at all and have to ship tissue and blood samples to laboratories in other cities. We needed to find a better way to provide our services to these communities."
Dr. Asa added that transportation times from Ontario's northern communities to downtown Toronto range from 24 to 48 hours, making intra-operative consultation with UHN pathologists virtually impossible. "Now, surgeons in smaller communities can send biopsies during the actual surgical procedure and we can advise them as to the proper course of treatment", Dr. Asa stated. "In the past, a patient would have a biopsy, wait for the result and then sometimes require yet another painful surgery."
"The telepathology system will bring the capacity to provide clinical support and diagnostic capacity to our laboratory that would normally only be found in highly-specialized large city hospitals", stated Timmins and District Hospital CEO, Roger Walker. "In many cases, this will save two or three trips from a home community to our hospital because the work can be done locally and in a single visit."
The project is supported by Canada Health Infoway, the Ontario government and eHealth Ontario. Infoway has provided $600.000 in funding to support the development of the telepathology system. Infoway is an independent, not-for-profit organisation funded by the federal government that jointly invests with every province and territory to accelerate the development and adoption of electronic health record projects in Canada.
"This telepathology programme is a great example of the benefits electronic health record systems can deliver to patients", stated Richard Alvarez, President and CEO of Canada Health Infoway. "It improves access to important specialized pathology services and saves patients time, worry and discomfort, while leading to better health outcomes."
"eHealth Ontario is proud to provide the network for an initiative which advances health care delivery and benefits Ontarians", stated Greg Reed, President and CEO, eHealth Ontario. "This project illustrates how collaboration and innovation within the health care system can improve patient care, safety and access."
The origins of this system lie in similar challenges faced several years ago by the UHN pathology department around transporting slides. Having once been scattered across UHN's three sites, pathology services were consolidated at the Toronto General Hospital. This created a hub of expertise where pathologists of all subspecialties could meet and confer on some of pathology's most challenging cases. The one drawback, however, was that pathologists often had to travel to the other two hospitals to diagnose samples. The time allotted to these cases, including travel back and forth, could sometimes reach three hours, which in some cases could lead to lag in services.
In 2002, pathologist Dr. Andrew Evans began to investigate a digital system and has served as the telepathology co-ordinator since the programme's inception in 2003. While various forms of telepathology have been used around the world since the late 1980s, Dr. Evans said that the University Health Network programme is the first in the world to use cutting edge virtual slide telepathology for primary diagnosis in patient care.