RESUMEN
BACKGROUND: Both static images and videoconferencing by smartphone have been tried for telepathology. Combining the two approaches for telepathology might offset some of the limitations of both techniques. METHODS: A total of 150 cases of breast pathology were retrieved and were photographed by a trained junior pathologist using a smartphone camera and binocular microscope and the images were sent as Google photos attachments with email to three pathologists. The pathologists opened the emailed attachments during separate prescheduled google meet videoconferencing sessions and rendered the diagnosis verbally to the junior pathologist. The pathologists were given the option of asking for live dynamic images of the cases during the meet which were transmitted using the rear camera of the smartphone with the video option of google meet. RESULTS: The overall concordance rates for the three pathologists were 96.6%, 99.3% and 98.0% (Mean 98.0%). The reporting pathologists asked for dynamic live images in 23, 20 and 18 cases respectively. Out of these 61 cases, a discrepant diagnosis was made in 7 cases (11.4%). The reporting pathologist was satisfied with the quality of static images (Mean Likert score 4.2/5). However, concerns were raised on the consistency of video quality (Mean Likert score 2.5/5). The screen share option of Google meet was found useful to discuss specific features of the case. (Mean Likert Score 4.6/5) CONCLUSION: The combined approach to telepathology has shown some promise and it is hoped that with adequate training the discordance can be reduced.
