The Pitié-Salpêtrière University Hospital testing telepathology in real time

Paris, 22 October 2010 TICsanté (a French healthcare technology firm) – The department of Anatomy and Pathological Cytology (APC) at the Pitié-Salpêtrière Hospital in Paris is trialing a system for generating and sharing digital slides in real time, presented at the 19th National Day of the Association of Communication Technology for Hospitals on 7 October in Saint-Raphaël.

The APC department laboratory at Pitié-Salpêtrière offers an industrial range developed by Tribvn and Orange. The latter enables the “immediate supply” of digital slides for remote expertise or diagnosis. Images are acquired via scanner and analyzed using Tribvn’s ICS Framework software. They are then selected by pathologists at the Pitié-Salpêtrière and stored on a server provided by the AP-HP university hospital group. Finally, images can be viewed in streaming mode from the secured collaborative platform Case Conferencing by Orange, explains Jean-François Pomerol, Head of Medical Imaging at Tribvn, during an interview with TICsanté. Similar to browsing with Google Earth, “the expert is able to choose what they download and the server only sends what is requested of it.” Preliminary analysis of images can assist the search for specific points.

The technology from Orange compresses and decompresses files “without any loss of quality, and refreshing the screen takes no more than a few seconds,” he explains. Plus, Case Conferencing enables examination of a single digital slide by several pathologists simultaneously. They can all take charge in turn! They can also take part directly in any experiment carried out by colleagues. Experts can therefore make immediate comparisons of their opinions on line either in writing, verbally or via video-conference. This process is particularly recommended for extemporaneous examinations, for example in per-operative situations. . It complements TRIBVN’s Teleslide application used by the Pitié-Salpêtrière hospital since 2005. TeleSlide uses another secure portal where images are fully contained and accessible to several users at the same time, although no interaction is included. TeleSlide is ideal for pre-recorded expertise. The transfer time of a digital slide greater than 1 GB in size can actually exceed 30 minutes. “An enlarged color image is heavier than a full-body scan,” states Frédérique Capron, department head at APC department at Pitié-Salpêtrière.

The two solutions are interfaced with the laboratory information management system and the identity management server (Gilda by SQLi). Similar links to patient files from the new clinical information system (Orbis by Afga Healthcare) are planned. However, no structured telepathology network connects Pitié-Salpêtrière with the other 23 departments within APC at the AP-HP university hospital group. “We have every possibility but currently the telepathology between different sites does not include patient files,” states Mr. Capron.

Since late 2009 a collegial working group of pathologists has brought together “those who are invested in telepathology and who are willing to set up a project using other resources than those hastily acquired for experiments,” she explains. These services would like to implement “an exchange manager to formalize and track” remote interventions. They are seeking “external funding in order to avoid further refusal on the grounds of insufficient means. They would like to prove to the administration that early diagnosis can be improved,” she continues. Eventually, this “communal platform” would be “a good way of having a telemedicine network on a regional scale”, she predicts. “We must persuade the institution that it would be beneficial for them. It’s difficult, but we are convinced. We will take the time needed,” she says. For Tribvn, “sharing medical images is a historic process, but not yet significant,” says Jean-François Pomerol. “Some private laboratories are learning,” but APC is “a slowly changing market”, hit by “hospital shortages”, he adds. The first “financial repercussions” are expected to be felt “within two or three years from now,” he predicts. The company boasts around 300 locations in France, the vast majority of which are public institutions.

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