Analysis of deferrals on static telepathology consultation service

The objective of this study is to analyze the deferrals in static telepathology consultation service. A store and forward approach is used to transmit cases from two remotely located rural centers to Tata Memorial Hospital. A total of 346 tele-surgical pathology cases were accessioned for second opinion and were reported from January 2002 to August 2005. The glass slides and paraffin blocks were reviewed at a later date and the telepathology diagnosis was compared with the final diagnosis rendered on light microscopy. Of all 251 teleconsults referred from one of the referring centers, a telepathology diagnosis was rendered in 205 cases and 46 cases were deferred. The reasons for deferral were as follows: the requirement for ancillary studies (40 cases), clinical details (5 cases) and poor quality sections and images (1 case). In all these deferred cases, a probable diagnosis was rendered by the telepathologist and was compared with the final diagnosis after paraffin block evaluation. In 47% of the cases, the "probable" diagnosis on telepathology matched the final diagnosis.