American Telemedicine Association clinical guidelines for telepathology

The term “telepathology” was introduced into the English language in 1986 by Weinstein,1,2 and since then there have been many advances and publications.3,4,5,6,7,8,9,10,11,12,13 The practice of telepathology involves obtaining macroscopic and/or microscopic images for transmission along telecommunication links for obtaining a remote interpretation (telediagnosis), second opinion or consultation (teleconsultation), quality assurance, education, teaching, self-study, and research (tele-education). A variety of terms has been used interchangeably to refer to telepathology including digital microscopy, remote robotic microscopy, teleconferencing, teleconsultation, telemicroscopy, video microscopy, virtual microscopy, and whole slide imaging (WSI).9,11,14 With advances in technology and widespread access to the Internet, telepathology is increasingly being used around the world, improving rapid sharing of cases and access to expert pathologists. Telepathology can be used for remote-site interpretation of all types of pathology material including, but not limited to, H&E stained paraffin tissue sections, frozen sections, cytology or hematology slides, microbiology specimens, clinical fluids (e.g. urine), electron micrographs, electrophoresis gels, and cytogenetics images.2,15,16,17,18,19,20,21,22,23,24 In practice, these digital images are typically linked to patient information including identification/medical record numbers, clinical history, and relevant laboratory and radiology data.25 Table 1 summarizes milestones of the many technological advances in telepathology.14 The primary modes of telepathology include static imaging, dynamic imaging, hybrid static/dynamic telepathology, and WSI. Tabel 1 Telepathology system classification14