A pilot study of low-cost dynamic telepathology using the public telephone network

A pilot trial of a low-cost telepathology system was conducted. A video-codec operating to the CIF standard was used to transmit pictures over the public telephone network. Twenty-seven specimens from the routine pathology workload of a district hospital were examined. The average length of time spent examining each specimen was 14 min (range 2-40). The telepathology diagnoses were judged by conventional light microscopy of the specimens, performed by the same observer at a later date, and by a different observer. For the same observer, 23 diagnoses were correct (85%) by telepathology, three were acceptable (11%) and one was incorrect (4%). The results were slightly worse for a different observer: 21 diagnoses were correct (78%) by telepathology, five diagnoses were acceptable (19%) and one diagnosis was incorrect (4%). The technique was slower than conventional dynamic telepathology (such as that based on communication by ISDN or leased circuits) and picture quality was poor by comparison. However, these are not necessarily disadvantages in the context of the developing world, and since only a telephone connection is required, the technique could become an important method of improving the distribution of scarce resources, such as pathology expertise.