BACKGROUND: Challenged with insufficient number and maldistribution of pathologists, the Philippines seemed poised to benefit from telemedicine.

METHODS: The first modern Internet-based telepathology consultation was conducted between the University of the Philippines Manila and the Armed Forces Institute of Pathology in 1997.

RESULTS: While the first remote telepathology consult was a success, more than a decade after this historic referral, telepathology remains in the fringes of mainstream pathology practice despite its huge potential to benefit the underserved population. Challenges with human, organizational, and technology factors hinder its progress.

CONCLUSIONS: While the original consultation faced difficulties in human capacity, connectivity and infrastructure, rapid developments in governance and technology have the potential to eliminate these problems. Substantial improvements in recent years now provide a more conducive environment to deliver telepathology services to remote areas. This paper proposes a framework for the establishment of mature telepathology services to enable its use in areas of greatest need in the country

Human ; Telepathology ; Vulnerable Populations ; Pathologists ; Telemedicine ; Referral And Consultation ; Organizations ; Government ; Internet

Objective: The Philippines has more than a hundred ten million population with a very limited number of general pathologists and subspecialist pathologists. Consultation of pathologists with other pathologists is important to ensure accurate results for difficult cases. However, pathologists are not always accessible to review slides. Telepathology can provide access to other pathologists by sending microscopic images through the internet. This study explores the needs of pathologists for consultation in their practice that may be aided by telepathology. The status of current pathology practice and subspecialty consultations across the different regions in the Philippines were determined and the readiness of pathologists for telepathology was identified. Methodology: This is a cross-sectional descriptive study using an 18-item online survey questionnaire based on the World Health Organization guidelines on needs assessment for medical devices. The survey was distributed among anatomic pathologists practicing in the Philippines. Results: One hundred forty (140) pathologists responded and were included in this study. 5-10% of cases of respondents required subspecialty referral. Diagnostically challenging cases and confirmation of malignancy are the most common reasons for consultation. Respondents practicing outside the National Capital Region (NCR) have fewer subspecialist pathologists available for referrals within their region. Turnaround times for signing out challenging cases are longer outside NCR (>7 days) compared to NCR (4-7 days). Most respondents have access to the basic equipment to perform telepathology, which includes, an internet link, a smartphone with high-resolution camera and a computer. Almost all respondents will use telepathology if it is available. Conclusion A hub-and-spoke telepathology network can provide access to subspecialty consultation to reduce the diagnostic turnaround time and to increase the accuracy of results for challenging cases. The availability of the minimum telepathology infrastructure and the positive attitude of the pathologists towards telepathology may be indicators of readiness for a local telepathology system in the Philippines.
Telepathology ; Philippines ; Pathology ; Needs Assessment ; Telemedicine