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Establishment of a remote diagnostic histopathology service using whole slide imaging (digital pathology)
  1. Andrew John Evans1,
  2. Rajkumar Vajpeyi1,
  3. Michele Henry2,
  4. Runjan Chetty2
  1. 1 Pathology, University Health Network, Toronto, Ontario, Canada
  2. 2 Department of Pathology, University Health Network Laboratory Medicine Program, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Professor Runjan Chetty, Department of Histopathology, Brighton and Sussex University Hospitals, Eastern Road, Brighton, BN5 2EE, UK; runjan.chetty{at}


Background Whole slide imaging (WSI) has diverse applications in modern pathology practice, including providing histopathology services to remote locations.

Materials and methods Utilising an existing contractual partnership with a Northern Ontario group of hospitals, the feasibility of using WSI for primary diagnostic services from Toronto was explored by the dedicated working group. All aspects explored from information technology (IT), laboratory information system (LIS) integration, scanning needs, laboratory workflow and pathologist needs and training, were taken into account in the developing the rationale and business case.

Results The financial outlay for a scanner was $CA180K (approximately £105.6 k) after discounts. There were no human resource requirements as staff were reorganised to cater for slide scanning. Additional IT/LIS costs were not incurred as existing connectivity was adapted to allow two site groups (gastrointestinal and skin) to pilot this study. Scanned slides were available for pathologist review 24–96 hours sooner than glass slides; there was a 2-day improvement for final authorised cases, and per annum savings were: $CA26 000 (£15.2 k) in courier costs, $CA60 000 (£35.2 k) travel and $CA45 000 (£26.4 k) in accommodation, meals and car rental expense.

Conclusion WSI is a viable solution to provide timely, high-quality and cost efficient histopathology services to underserviced, remote areas.

  • health services
  • image processing, computer-assisted
  • computer systems

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  • Handling editor Cheok Soon Lee.

  • Twitter @runjanchetty

  • Contributors All authors contributed to the concept, collation of data and writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.