quality assuring telepathology - ukneqash.org john burthem - quality... · what is telepathology?...
TRANSCRIPT
![Page 1: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/1.jpg)
Quality Assuring Telepathology
John Burthem
![Page 2: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/2.jpg)
What is telepathology?
Microscope
Microscopist
Interpretation
time distance IMAGE
Hematology has been slow to take up this process: many IT issues are solved
![Page 3: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/3.jpg)
The importance of the image
![Page 4: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/4.jpg)
In praise of the single image – underestimated resource: “easy”.
Many quality issues, but accessible and flexible
![Page 5: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/5.jpg)
Big “slide” imaging
![Page 6: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/6.jpg)
Remote driven microscope – attractive as a remote viewer and
if equipped with chat and feedback; tagged and remembered.
Added value: decision support and contact.
![Page 7: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/7.jpg)
Digital slide analysis – Sampling options: added value search and
select and preliminary interpretation; record/archive; excellent
image quality/time
Cellavision
![Page 8: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/8.jpg)
Digital slide analysis – Whole slide scan. Full
image record aiming to reproduce the glass
slide: record/archive; added value
annotation and discussion. BUT large and
still not ideal for cytology
![Page 9: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/9.jpg)
Who is interested in telepathology?
Patient: speed, improved accuracy Provider: Also considers cost : benefit = staff costs vs. setup Manufacturer: cost : benefit market size vs. multi-use technology Deliverer make all this a reality: most affected by quality
DRIVERS
![Page 10: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/10.jpg)
There are two definitions of quality that are important to telepathology: 1. “The standard of something as measured against other things of a similar kind; the degree of excellence of something:” 2. “A distinctive attribute or characteristic possessed by someone or something (positive)”
QUALITY
![Page 11: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/11.jpg)
1. Does telepathology offer an equivalent experience to existing techniques and services? The glass slide
2. Are there unique attributes to be realised and developed that will improve diagnosis? Other stuff
QUALITY
![Page 12: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/12.jpg)
The heart of the issue
4. THE IMAGE
![Page 13: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/13.jpg)
“Rubbish in”
The importance of getting the starting material right
A lesson from DM scheme – people are much more critical of an image than a glass slide – this starts with the sample. Practically this is important.
![Page 14: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/14.jpg)
4 7 9
16 17 18
19 20 21
![Page 15: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/15.jpg)
![Page 16: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/16.jpg)
Digital imaging as an analytical tool for sample quality improvement
![Page 17: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/17.jpg)
Assessing resolution of diagnostic elements
![Page 18: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/18.jpg)
6mm
24mm
A small neutrophil granule can be readily resolved by a high quality lens and is projected across 16-25 pixels on a CCD chip
![Page 19: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/19.jpg)
![Page 20: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/20.jpg)
![Page 21: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/21.jpg)
![Page 22: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/22.jpg)
![Page 23: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/23.jpg)
![Page 24: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/24.jpg)
Your stain (photographed appropriately) should resolve small neutrophil granules as distinct structures: standard materials should allow you to ask the question is my stain adequate
![Page 25: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/25.jpg)
Assessing stain colour
![Page 26: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/26.jpg)
![Page 27: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/27.jpg)
4 7 9
16 17 18
19 20 21
![Page 28: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/28.jpg)
![Page 29: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/29.jpg)
![Page 30: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/30.jpg)
![Page 31: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/31.jpg)
![Page 32: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/32.jpg)
Rubbish out
![Page 33: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/33.jpg)
Assessing the microscope and monitor
![Page 34: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/34.jpg)
![Page 35: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/35.jpg)
![Page 36: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/36.jpg)
![Page 37: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/37.jpg)
![Page 38: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/38.jpg)
Provision of a standard – well fixed preparation allows assessment of imaging quality – lens, camera, monitor: MINIMUM STANDARDS
![Page 39: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/39.jpg)
For radiology quality is simple – minimum electronic image and monitor standards
For haematology more is required – there are a range of largely uncontrolled factors out there – should we address them? If asked why did you report that image – what do you say?
![Page 40: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/40.jpg)
Looking at the bigger pictures
![Page 41: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/41.jpg)
TRADE OFFS: Do we really need a whole slide? How much manipulation? Focus and plane?
![Page 42: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/42.jpg)
![Page 43: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/43.jpg)
![Page 44: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/44.jpg)
1. Am I right? 2. Where did I go wrong? 3. Can I get help?
Added value
![Page 45: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/45.jpg)
Is this a blast?
![Page 46: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/46.jpg)
All parasite forms seen, diagnosis: P.vivax
1.
2.
![Page 47: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/47.jpg)
![Page 48: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/48.jpg)
![Page 49: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/49.jpg)
Finally………
![Page 50: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/50.jpg)
Not just because we can
![Page 51: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/51.jpg)
The permanent record
![Page 52: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/52.jpg)
Lifestyle choices
![Page 53: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/53.jpg)
Lifestyle choices
![Page 54: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/54.jpg)
Lifestyle choices
![Page 55: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/55.jpg)
www.haematologyetc.org
![Page 56: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/56.jpg)
Summary
Quality is our responsibility and our friend - we can use DM to drive this:
• Sample quality
• Equipment quality
• Added features
• Decision support
• Personal audit
![Page 57: Quality Assuring Telepathology - ukneqash.org John Burthem - Quality... · What is telepathology? Microscope Microscopist Interpretation distance time IMAGE Hematology has been slow](https://reader036.vdocument.in/reader036/viewer/2022062908/5ada093f7f8b9ae1768c9874/html5/thumbnails/57.jpg)
Note
• There is a patient at the end of the system
• A poor system is not your friend
• Quality can support you