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The Role of Simple Tools in Improving Diagnosis and Patient Care ( iPath )

The Role of Simple Tools in Improving Diagnosis and Patient Care ( iPath ) . N.Hurwitz Department of Pathology University of Basel and International Network for Cancer Treatment and Research (INCTR). Widening gap. Pathology in high income countries

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The Role of Simple Tools in Improving Diagnosis and Patient Care ( iPath )

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  1. The Role of Simple Tools in Improving Diagnosis and Patient Care (iPath) N.Hurwitz Department of Pathology University of Basel and International NetworkforCancer Treatment and Research (INCTR)

  2. Wideninggap Pathology in high incomecountries Laboratories: automatization Diagnosticmethods: molecular Pathology in lowincomecountriesLaboratories: manualDiagnosticmethods: morphology

  3. Pathology in Nigeria Pathologytrainingstarted in 1972 Nigeria: 300 pathologists / 140 MillSwitzerland: 400 pathologists / 7 Mill

  4. Concept of „INCTR Online Consultation and CME Program“ • Easy access to consultation and CME is a necessityfor all medicaldisciplines • To meetthisneed an internetplatformforprofessionaldialogue (ipath) has beencreated • Special qualities • Dialoguebetweencasesubmitter and consultants • Casediscussions as toolforcontinuingeducation • Consultationsareadapted to individuallocalneeds

  5. INCTR FacultyforPathology as modelforotherdisciplines (hematology /oncology) • An international group of senior pathologistseitherstaffmembers at Universitiesormajor Hospitals serve as consultants • Online activitiesinclude • Consultations in difficultcasesincludingspecialinvestigations • Improvinglaboratorytechniques • Casediscussions • Collaboration and support in preparationof presentations / publications • Support forintroduction of newmethods An address to askquestions

  6. ParticipatingCentres • Kenyatta National Hospital, Nairobi • Muhimbili University Hospital, Dar es Salaam, • ObafemiAwolowo University Ile-Ife • Université de Lubumbashi • University Colege Hospital, Ibadan • Nigerian National Telepathology Project in collaborationwith INCTR is in preparation • UkrainianCancer Institute, Kiev • Cancer Center Sarawak, Malaisia

  7. Equipment neededforipath

  8. „iPath“internetplatformforcasebasedprofessionaldialoque Independent groups „Case“ in iPath1. Text (clinicaldata) 2. Image galleryfordigitaliseddata 3.Text (discussion)

  9. Results of qualityassessments • 100% Archondakis et al Telecytology: a toolforqualityassessment and improvement of thyroid FNA specimens, Telemed J E Health. 2009;15(7) • 96% S. Desai, Telehealth in thedevelopingworld, ed: R.Wootton 2009 • 95% ownunpublisheddata, National Referral Hospital, Solomons‘ Islands

  10. Limitingfactors • Main limitingfactors • poortissueprocessing (fixation and /orhistologicorcytologictechnique • poorphotographictechnique (focus, whitebalance)

  11. First resultssinceJune 2010 • NrCasesfrom all centers 80 • Time betweencasesubmission andfirstcomment: 4 hours – 6 daysaverage 2-3 days • Online Casediscussions 8 • Online Diagnosticreviewfor BL trial In preparation • Online dicussiongroupforhematology • Online tumorboard

  12. Online Consultation in Oncology I

  13. Online Consultation in Oncologycontd

  14. Data sheethsfortherapytrials, whichcanbeexported to excel-files

  15. Templatefor online pathologyreview

  16. Conventional life long CME

  17. Cyberspace version of double headedmicroscope

  18. Passing on theexperience of caseorientedteaching to thenextgeneration

  19. Telepathologyisitreally a blessing ? Caveats • Anonymousstructure lack of personal contact • Insufficientcontrol of quality of casework-up • Insufficientstandards of consultants • Possibleadverseeffect on localpathology,iflocalpathologistsremain passive (Sami Malani, Nigeria)

  20. Telepathologyformutualbenefit • Directdialoguebetweensubmiter and consultant • Monitoring of casesubmissions(qualitycontrol of casesubmission) • High standards of consultants • Casesubmittershave to takeactiverole in casediscussions (analogy to discussion atdouble headedmicroscope, continuous CMEA toolforongoingdialogue

  21. Thebrain of ipath: Kurt Brauchli The Angel of ipath: Monika Hubler http://www.ipath-network.com/inctr/

  22. My sincerethanks to theteam of the Department of Pathology,University of Basel

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