Transplant Viability via Telepathology: A 5-Year Review of Barriers and Facilitators to Individual Pathologist Adoption of New Technology
Patrick Rush, Sam Barasch, Jimmie Stewart · American Journal of Clinical Pathology · 2014
Organ viability for transplant is an area of pathology where telepathology adds value to patient care through rapid access to biopsy material by offsite diagnosticians. Despite benefits, only a small number of faculty in our large university teaching hospital use the telepathology services that are available on a regular basis. While much has been written on the technical barriers of telepathology implementation, there is a paucity of data concerning the individual barriers that practicing pathologists face when it comes to implementation of a new technology. A retrospective correlation study of the use of an Olympus DP70 camera with Microsuite FIVE Pathology edition, for organ viability assessment; and exploration of the barriers and facilitators to department wide acceptance and use of the telepathology systems available was performed. After retrospective review of all transplant cases (89) at our institution that used telepathology for kidney and liver viability assessment from a remote location, a correlation was made between the telepathology assessments with the final interpretation of the biopsy on paraffin section. Review showed a high concordance rate of 98.88% between telepathology evaluation and conventional light microscopy. In order to determine barriers and facilitators of individual adoption, a focused survey to random faculty in the department was performed. The questionnaire consisted of 18 fixed response questions and 5 open response questions nested into three core areas of interest: user demographics, user experience, and technology. The largest barriers to use were technical: resolution, lag time, and specifics of interface. However, a major component was confidence in program stability and self-confidence in individual interpretative ability. The data showed that a more thorough training coupled with competency test slides may help to foster confidence in the software as well as user confidence in the quality of pathologic evaluation.