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 Prepublished online as a Blood First Edition Paper on September 11, 2003; DOI 10.1182/blood-2003-05-1615.

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Submitted May 20, 2003
Accepted August 14, 2003

Tele-hematology: critical determinants for successful implementation

Urs Luethi, Lorenz Risch, Wolfgang Korte, Margrit Bader, and Andreas R Huber*

Department of Laboratory Medicine, Kantonsspital, Aarau, Switzerland
Institute for Clinical Chemistry and Hematology, Kantonsspital, St. Gallen, Switzerland

* Corresponding author; email: andreas.huber{at}ksa.ch.

Despite modern technologies such as immunophenotyping and molecular probing cytomorphological examination of stained peripheral blood smears by microscopy remains the mainstay of diagnosis in a large variety of diseases. This holds true especially in underdeveloped or rural areas where profound expertise and equipment is not easily available. Although communication technologies have been dramatically improved, tele-hematology has not become routine. To date, little information is available on which procedures are critical for successful implementation. Therefore, a study evaluating possible factors that prevented implementation of tele-hematology was initiated. We found that staining technique, smearing procedure, training skills, number of captured images and prevalent disease influenced the accuracy of diagnosis by the reference lab. Employing real-time teleconferencing allowed for overcoming these deficits. Together, when certain rules are observed, tele-hematology allows for rapid, accurate, standardized and cheap expert advise. This should improve treatment of patients in remote areas where expertise is not available.


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