Telepathology in Tanzania

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Published: 8 Dec 2015
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Dr Matteo Botteghi - Associazione Vittorio Tison Onlus, Italy

Dr Botteghi talks to ecancertv at AORTIC 2015 about the work of the Association Vittorio Tison's work in telepathology in Tanzania.  

Telepathology enables the live diagnosis of diagnostic images as well as document sharing and the transfer of skills.

This addresses the lack of medical pathologists in the country, he says.

He explains the ways in which the initiative will be expanded in the future, including the adding of more sites.

For more information visit the WaidX site.

My main project here, I’m showing here, is my platform of telemedicine and telepathology we are implementing in the site, in the mission site, of Mwanza in Tanzania interconnecting our main institute in Italy which is IRST, Istituto Romagnolo per la Cura e lo Studio dei Tumori, with the mission site, of course, in Mwanza. In my first visit in the mission in Tanzania I found great needs of communication mainly so I started to think and to develop this platform including the goals to interconnect via telephone, conference calling, web conference and then sanitary applications like the remote access to the clinical folder of our institute in Italy. Then finally the telepathology facility, so the possibility to perform a live diagnosis of pathology issues, live sharing diagnostic images between the two sites, so the Mwanza and Italy sites with the remote working group of physicians and pathologists.

How does telepathology work?

Telepathology works sharing microscope images through an ICT platform I designed too, so allowing these remote groups of physicians to look at the same images and to have direct counselling about the diagnostic aspects. So you know pathology requires usually counselling about different problems, issues and so on, to clarify and to come to a final diagnosis. The great problem in African countries is the lack of pathologists, of medical pathologists, so we are developing a model vision to step up the project to a multicentric project including a lot of sites interconnected via my platform of telemedicine in a model named with central laboratories equipped with a lot of medical doctors and instruments and a lot of remote spokes with less structured sites, so without medical pathologists, which is a very rare competence in Africa. Telepathology could help to overcome this problem, to shorten the distance and finally to come to a diagnosis.

What successes have you seen so far with this telepathology project?

For the moment we implement the pilot phase of the study. So I have been working for more or less four years in our site and now the pilot system is working. As we are working we are collecting a lot of on-field data about the usage and the user-friendly aspects of this project. We have good feedback from the technical and medical staff. Several times they used to say to me it’s like to stay to look at the images at the microscope and this is the biggest success for me because that means that the system is comfortable, is very well defined for the images aspect and it could really bring a good diagnosis, compliant with all the requirements of the pathologic diagnosis and the diagnostic process is very hard to repeat without a microscope.

Is this something that doctors or pathologists in Africa can do independently?

The technical aspects are carried out into the platform so it’s really easy for pathologists to go on and to use the system without specific training. The biggest difference from the usual way to do diagnosis in our telepathology system is to stay or not to stay on a microscope. This is the only true training they have to do, the medical specialists have to do. So in the new project, the new sites, we are trying to introduce directly this way to do diagnosis, so without the microscope. The microscope becomes a digital scanner, the digital scanner could work also in unattended mode, so without an operator, and the medical pathologists could perform the diagnosis directly to a screen, a high definition screen of course. This is the way to share, to directly share, the images through the distance, so through more sites. So this is the technical challenge in this model.

Are you providing this service for free?

Completely free. All the vision of the mission, so not only my branch but all the oncology mission in Mwanza is thought to provide free healthcare to the people. So we are funding from Italy, they also are funding it in Tanzania, so the Health Minister for example. It means that people must access this facility for free. Of course, in the new project which is more expensive because a multicentric project will be really bigger, bigger than our pilot phase, we are searching for institutional funders to go on.

Where are you expanding this new project to?

We are supposed to use sites where we already are present like the Congo, Djibouti, Somaliland and also Malawi, Rwanda. We are a group of associations already present since many years ago in these sites. So we have a skill, a specific skill, on these territories and populations so it could be a good point to start for the new project, the new step of the project.