[A trial of integrated telepathology (iTP) in Nagano prefecture]

The shortage of pathologists is a major issue in Japan, and telepathology (TP) is considered one of the most innovative solutions to resolve this. About twenty years ago, robotic TP systems (RTS) were developed and are still used in Japan. Virtual slide (VS) systems appeared in the early 2000s and have being replacing RTS because of the ease of handling images, easy reference to previous images and synchronous discussion among pathologists. Both systems are currently used for intra-operative consultations, second opinions and consultations by specialists, and in education and research via the internet. With these systems, pathologists participating in consultations have to obtain a patient's clinical information by other methods, such as fax or e-mail, and they often make a diagnosis without this information and previous histological images. The author proposes an "integrated telepathology (iTP)" system in Nagano prefecture. This system is composed of an anatomic pathology information system (APIS) linking the VS system and is designed to connect all pathologists in community hospitals, including Shinshu University Hospital, using a virtual private network. Any registered pathologist can access APIS and view any pathological images of patients with the clinical information. Therefore, pathologists can make a diagnosis with substantial patient information at any time and from any location, and pathologists in different hospitals can consult one another in a secure network. Our iTP system will be able to streamline diagnosis duties in surgical pathology in Nagano prefecture, and may solve the shortage of pathologists by improving diagnosis efficiency.