“Share & Meet” project: an innovative telemedicine solution for remotization of pathology and e-oncology

Abstract

Background: The incidence of tumors in developing countries is dramatically increasing;the ability to provide early diagnosis, treatments, follow-up care and the availability of reliable epidemiological data has a strong impact on the cancer survival. Although telemedicine implementation largely remains a privilege of developed countries,it could be of great utility and efficacy in developing countries lacking appropriate health care facilities by allowing for the performance of good level health care practices. There is currently a longstanding partnership between IRST and the Bugando Medical Centre - Mwanza, Tanzania (BMC)."Share & Meet" project includes a novel telematics platform oriented to oncology and its related branches. We are developing the project between BMC departments and Italian stakeholders with cooperative programs including training of medical staff through e-learning programs, remote pathology diagnosis and other e-oncology applications Material and methods: After some years of on-field work,in synergy with the BMC pathology lab we are launching the telepathology facility. We carried out several experimental sessions to investigate the compatibility of Menarini D-Sight+ and Aperio eSlide Manager telepathology web applications with our telematics platform, together with other concurrent telemedicine applications such as Virtual Private Networking, conference calling, LOG80 digital medical record, webconference for e-learning, Internet browsing. Results: The statistical analysis on the detected data confirmed the expected behavior of the platform in terms of transmission parameters optimization, with a strong action of transmission defects compensation and bandwidth enhancement tools. The subjective feedback from medical pathologist performing remote diagnostic activity is very good in standard operating conditions and remains acceptable introducing strong shortage of transmission resources. The goodness of real-time audio/video streaming depends on the application used and the transmission regimen. The operational efficiency of LOG80 is quite impacted in a very low quality transmission regimen Conclusions: We validated the system in a wide range of conditions. The pathology images remotely viewed are compliant with the diagnostic requirements in terms of definition and magnification. Share&Meet is characterized by a high level of innovation which increases efficiency and efficacy of health practices and can boost the use of telemedicine in low income countries.