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What is telepathology?


During surgeries, physicians recognize the unfortunate reality that they may discover something that’s just not right. Ordering a biopsy to further investigate the pathology of abnormal cells or tissue is the next step, but waiting for results can be the hardest part.

In the not-so-distant past, getting pathology results could mean manual transport of a specimen by courier to a local laboratory for examination, a process that could take up to a week at times. New innovations in technology have since enhanced this process, offering faster results and better care for patients. This technology is called telepathology and is possible due to partnerships around the state in conjunction with Kalispell Regional Healthcare.

“Telepathology provides options for people in Montana that would otherwise have to come to Kalispell for surgery,” explains Zachary Weber, MD, pathologist at Glacier Regional Pathology and medical director of the laboratory at North Valley Hospital (NVH). “The service allows us to provide pathology services to remote hospitals, and North Valley Hospital is our first facility to launch the technology. While not as remote as some areas in our state, North Valley Hospital was the perfect initial program because it’s close enough to Kalispell that we had a backup plan if the technology didn’t work. So far it has been a fantastic service for our community.”

Telepathology can also be referred to as remote pathology. “Sometimes we say frontier pathology, because we provide this service to rural areas that don’t have a pathologist within 100 miles,” says Dr. Weber. Telepathology is currently operating at North Valley Hospital and the program is approved by the College of American Pathology. Simply explained, a specimen is flash frozen at the biopsy location, sliced thin to view under a microscope, sent digitally as an image to a pathologist, and findings are evaluated with both the surgeon and pathologist on the phone in real time.

“There are small hospitals in rural Montana that have a general surgeon, but not a pathologist,” adds Dr. Weber. “The medical reality is that they may have a surgery – like an appendectomy – and once in surgery, they could find a tumor. This presents an issue in a small hospital without a pathologist. However, with telepathology, the surgeon could get a frozen section, I would examine it under the microscope remotely, and then we could discuss the next step. For patients, it is time saving and reduces stress, but can also be life-saving technology.”

Dr. Weber states, “Kalispell Regional Healthcare, Glacier Regional Pathology, and North Valley Hospital have worked together to expand our outreach and services. I’m really happy NVH decided to do this because it allows us to provide similar services to other hospitals to serve more patients in Montana.”

“Instead of looking at a microscope, I am looking at a computer screen to control the microscope at North Valley Hospital – it’s a touch screen,” Dr. Weber explains. “And, like many functions, it is a learning process for me, since I’ve trained mainly with a microscope. But it’s fun, and it’s often used at larger institutions.”

To explain more about the telepathology process, Dr. Weber is clear that it all happens in real time. “The entire process takes place during surgery, because my role is to provide information to the surgeon that determines their next move in the operating room (OR). For example, if Dr. Melissa Hulvat is doing a breast case, she would remove a lymph node and I would view it. If I determine it has cancer, that changes how the surgery will go, and informs her next step in the OR. The required turnaround time for a frozen section in pathology is 20 minutes, which is easy to accomplish using telepathology.”

Patients benefit from the technology greatly, as it can speed up surgery times, provide better healthcare and reduce travel for patients in rural areas, and improve the surgery process. Since North Valley Hospital is a member of the Kalispell Regional Healthcare family, many patients are now able to have available surgeries at the facility that best suits their needs, and telepathology makes this possible for more procedures. Dr. Weber mentions that it was also driven by surgeons, who operate in multiple KRH facilities, and they wanted to provide scheduling availability options and provide a backup solution for pathology if a general surgery needs pathology work.

“I think the bonus of this is that it provides access to services that patients may not otherwise have access to. North Valley Hospital took on the project and they have worked diligently to train, perfect the systems, and prepare staff. Now that NVH has completed this, it opens doors for rural hospitals to learn from our success,” Dr. Weber says.