Proceedings of the 16th International Conference of Telemedicine Society of India (TSI)

Abstract

(page number not for citation purpose) Telehealth and Medicine Today 2021. Background: Digital pathology (DP) served education, research, and multidisciplinary discussions at tumor boards as primary purposes at our tertiary cancer institution. The coronavirus 2019 (COVID-19) pandemic posed profound challenges to uninterrupted laboratory services amid a nationwide lockdown. We aim to report our experience, as earliest adopters of DP during the pandemic, for primary surgical pathology diagnosis using existing resources. Methods and Materials: A whole slide image scanner, VENTANA DP 200, was employed for scanning biopsies during a 3-month duration from March 21 to June 20, 2020. The whole slide images were made accessible from a web-based server. A brief verification activity was undertaken before live digital sign-out. Cases were signed out remotely by 18 participating pathologists from their respective homes in a risk-mitigated environment using a web-based image management system (IMS) and synoptic reporting system, which was interfaced with the patient's electronic medical records. We assessed the efficiency indicators and an overall concordance following a rereview of glass slides after a washout period of 2 weeks. Results: Of the 594 cases, 567 cases from seven subspecialties were signed out remotely with a deferral rate of 4.5% and a rescan rate of 2.3%. Additional tests, including special stains and immunohistochemistry, were performed in 203 cases. Network speeds varied between 4 and 80 Mbps, with an average download speed of 20 Mbps. All pathologists used personal laptops for remote sign-out, and 14 of them preferred the digital workflow during the ongoing pandemic. There was an average reduction in Turn Around Time (TAT) by 1 day due to flexibility imparted by same-day reporting, despite staggered on-site working days for different pathologists. The overall concordance rate was 98.8% owing to 1.2% minor discordance and no major discordance. Conclusion: Whole-Slide Imaging (WSI) provides a safe and efficient means for primary diagnosis from the remote site and provides patients an undisrupted access to subspecialty expertise, despite the several challenges posed by a pandemic. The operational convenience resulting from factors such as time saved on commuting to workplace, fast on-demand case accessioning, workload leveling across hospital sites, and availability of a network of expert pathologists for consultation is likely to influence how we function in the post-pandemic era. Background: Owing to the highly valuable information in the medical industry, patient health data (PHD) have become the prime target of hackers. These hackers are continuously trying to breach the defense of hospitals and medical facilities for harvesting the information of patients and doctors. As per the statistics, PHD is sold in Dark Web at 10-20 times the premium of financial data. Some of the biggest healthcare data breaches of 2020 that forces us to deliberate more seriously on the safety of PHD include (1) inadequate security, policies led to LifeLabs data breach of 15M Patients; (2) Magellan Health breach of 365,000