Slides in two places
If collaborating were an Olympic sport and medical specialists the competitors, the odds-on favorites for the gold would be anatomical pathologists. They want and need opinions from other pairs of eyes peering through a microscope. But what if no one else is around? Maj. Keith Kaplan, a pathologist at Walter Reed Army Medical Center in Washington, D.C., devised a solution. Using microscopes linked to digital cameras and the Internet, he created an interactive pathology consulting system.
With hospitals at far-flung bases in every hemisphere, Kaplan says, the Army runs "the most complicated, diverse healthcare system in the world." But with just 100 or so pathologists in uniform, too many cases were taking too long to diagnose. And until three years ago, says Kaplan, specimens requiring a specialist's eye had to be shipped to an expert or even hand-carried by a patient being transferred to Walter Reed.
Now the expert, wherever based, need only log on to the Web to view a specimen on a microscope in Kentucky or Germany, or even in the war zones of Iraq. And thanks to simple off-the-shelf robotics software, the distant consulting pathologist can control the scope from Walter Reed, zooming in and out and repositioning the specimen at will. "In Korea," Kaplan says, "the turnaround time has gone from three weeks to four hours."
Less surgery? The new approach is already making a real difference--by getting patients with tumors to surgery faster, for instance. "But it can also eliminate misdiagnoses and decrease the number of unnecessary surgeries," says Kaplan. "You don't have to review many cases before the technology starts to pay for itself."
Unlike radiologists, who are happy with E-mailed static digital images, pathologists need to be able to manipulate the tissue specimen. "The holy grail is going to be the virtual slide," says Kaplan, referring to a 3-D scan of an entire specimen sample, "that you can review anywhere, anytime."
That's still years away, and Kaplan's system is suited only for expert consultations and not routine, high-volume jobs. Pathologists in uniform still have to be where the troops are. But when difficult cases arise, a little expert "telementoring" can be just a phone call away. "It's much more gratifying than just looking at slides that show up in the mail," says Kaplan, "and you get much more engaged in the case."
Just one hitch: Because of time differences, "looking at cases from Germany and Korea in the same day does make for a long day," Kaplan observes. He doesn't mind. -Thomas Hayden
This story appears in the July 12, 2004 print edition of U.S. News & World Report.
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