Telepathology A way to implement and integrate skills

Telepathology: A way to implement and integrate skills/ Internet consensus building Kim Solez, M. D. Kim. Solez@UAlberta. CA

A transition: Telemedicine, telehealth, e-health The primary care physician of the future is the patient (or parent) !

e-health Consumer-driven Telemedicine and Telehealth Provider-driven The public will tell us what they want in e-health. Providers no longer dictate but become partners with patient or parent.

4 Telemedicine - The Past, the Future In the past meant mainly phone based videoconferencing using phone lines or dedicated ISDN lines, largely impractical for developing countries. In the future, Internet based using such programs as Microsoft Netmeeting and Class. Point, practical for developing countries.

5 Telepathology - The Past, the Future In the past meant mainly real time robotic stage connection using dedicated ISDN lines, largely impractical for developing countries. In the future, Internet based using static images from inexpensive digital cameras, practical for developing countries.

6 The Camera to Buy Changes Daily! But the Choice on Nov. 24, 2000 would be: The Nikon Coolpix 990 with MXB 29005 adaptor

7 Details - The Nikon Coolpix 990 3. 34 Megapixel Resolution High-Speed USB Connection $899 US = 2, 032, 405 ITL Photographic results indistinguishable from film!

8 Telepathology Resources on the WWW http: //www. afip. org/telepathology/ http: //www. pathoindia. com/tele. html http: //www. ndp. ox. ac. uk/telepathology/ http: //www. telemicroscopy. org/ http: //telepathology. upmc. edu/ (Latter two - Yukako Yagi) Consultation/Education/Standardization

9 Internet technologies the ideal way to build consensus Three examples: ISN Disaster Relief Task Force ISN Consensus Conferences - COMGAN Banff conferences on allograft pathology

10 Banff Classification Internationally agreed upon classification First developed in 1991, meetings every two years. Published in KI in 1993 and 1999. Employs lesion quantitation g, I, t, v, ah cg, ci, ct, cv, mm and standard diagnostic categories.

11 Banff Classification Inflammation does not equal rejection. Tubulitis suggests rejection, intimal arteritis diagnostic of rejection. Three histologic forms, tubulointerstitial, vascular, and transmural.

12 Banff Classification Anyone can participate in the Banff meetings, on site or remotely. Next meeting April 21 -28, 2001 Important breakthroughs expected in 2001. Chronic rejection classification. EM and C 4 D findings specific for chronic rejectiion, antibody mediated rejection. Donor biopsy classification.

13 Communications for Banff Face to face meetings. Letters, faxes, phone calls. Expensive, cumbersome, slow. Since 1994 the Internet has been the main means of communication for this and other projects.

1997 - Creation of NKF cyber. Nephrology and the ISN Informatics Commission WWW sites: http: //www. cybernephrology. org http: //www. kidney. org http: //www. isn-online. org http: //www. cyber-medicine. org

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