SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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U. Lüthi1 , L. Risch2 , M. Zerlauth3 , G. Risch3 , A.R. Huber1

1Department of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland, 2Department of Internal Medicine, Akademisches Lehrkrankenhaus, 6800 Feldkirch, Austria, 3Institute Dr. Risch, Medical Laboratories, 9494 Schaan, Liechtenstein

Background: Telemedical devices designed for use in hematology have recently become available. Telehematology has been proposed useful for delivering expert advice to remote areas as well as to laboratories employing staff with limited hematological experience.
Aim: The present study aims to identify the characteristics and outcomes of telehematology use in daily clinical routine practice.
Methods: A network was established between a hematology reference center and a commercial medical laboratory. Telehematology advice for qualitative judgement of pathological blood smears was sought by transferring 3 pictures per set to the reference center. As a gold standard, light microscopy of the slide used for telehematological processing was accomplished in the reference center.
Statistics: Accuracy of judgement in the commercial lab was determined against the gold standard. Further analysis included the accuracy of the reference center and whether expert advice would have changed the diagnosis of the commercial lab. Further, it was recorded, whether telehematology could save time for the commercial lab to obtain a correct diagnosis.
Results: Telehematological devices improved the accuracy of judgement in the commercial lab. In some cases there was advice for further investigations like imunophenotyping of the peripheral blood, which increased the number of diagnosis additionally. The report from the reference lab was done on the same day on which they received the pictures from the commercial lab, so that there was a time saving from several days compared to sending the slides per mail.
Conclusion: Telehematology is very useful in clinical practice to improve the number of correct diagnosis of hematological diseases and can reduce time in obtaining the diagnosis. This should improve outcome of patients with hematological diseases and reduce costs (early treatment of diseases or complications and avoiding unnecessary transfers of patients in tertiary care centers).

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