There are many sayings involving time. Time flies. Time is money. Time heals all wounds. But we know these quotes are not all necessarily true. Perspective or context is important in how one would evaluate the truth of these statements. For example, a patient having a biopsy performed intraoperatively will not agree that “time heals all wounds.” From their perspective, time is of the essence. Not only can abnormalities or growths worsen, but worry can also compound for the patient as time passes. The patient will benefit from overall better care the faster sufficient material can be collected for analysis and diagnosis.
Rapid on-site evaluation (ROSE) can be used for intraoperative procedures to determine if sufficient material to render a diagnosis has been collected or whether additional collections or panels are needed. For liability reasons, ROSE is not intended to provide a diagnosis. Instead, the evaluation is whether a collection is adequate for evaluation, inadequate, or uncertain for evaluation. Additional samples can be collected immediately if the initial collection is deemed inadequate or uncertain for evaluation. Another benefit of ROSE is that you can switch your method of collecting samples from core biopsy to fine needle aspiration or vice versa if you find your collection inadequate. ROSE generally requires an on-site pathologist working with a clinician. But what if you don’t have an on-site pathologist? Does analysis and, ultimately diagnosis, have to be delayed while samples are sent off-site or until a pathologist visits your location? Absolutely not. Telepathology can be employed with the use of a few basic tools to connect a cytotechnologist who is on-site with a remote pathologist.
Telepathology is relatively inexpensive to employ. Basic or everyday tools required at the facility include a camera on a microscope, a laptop, and software. The remote pathologist would need a laptop, tablet, or other device such as a smartphone with connectable software and an internet connection. This allows the pathologist to evaluate diagnostic material remotely in a matter of minutes without leaving his or her home, office, or vacation site. Time matters for the pathologist, too, and employing telepathology can be a huge time saver.
Combining telepathology and ROSE can expedite diagnostic reporting. In some cases, preliminary findings could suggest intraoperative action be taken immediately rather than requiring the patient to come back for a second procedure, which saves the patient time, and ultimately leads to overall better care.
Adapted from the NSH Webinar: Diagnostic Cytopathology – An Invaluable Tool for the Pathologist and Clinician in the Diagnosis of Various Body Lesions presented by: Richard J. Ormesher, CT(ASCP).