COVID-19 has changed many traditional medical practices within the field of dermatology and many other fields as well. Just as physicians have been forced to make major revisions to their processes and procedures, there has also been increased interest in virtual tools for both educational and clinical applications as well.
What is Virtual Dermatopathology?
Virtual dermatopathology allows physicians to evaluate and render diagnoses on submitted patient specimens through digital images of their tissue sections and specialized software platforms. In essence, the process simulates using a standard microscope in order to examine tissue placed on a glass slide. Traditionally, this type of virtual tool was primarily used for conferences, along with teaching and educational purposes. Now, along with dermatology residents-in-training and continuing education for already-licensed professionals, there are also those who are giving the process a closer look to see if it can be a workable solution for clinical purposes during the time of COVID-19.
Benefits — Some of the benefits associated with virtual dermatopathology include
- Students and clinicians can view slides from remote locations, and still learn and practice virtually
- Multiple students have instant access to virtual slide libraries vs. waiting for a microscope head
- Multiple clinicians can review a case instantaneously, allowing for easier collaboration and consultation for patient care
- Virtual observation supports social distancing guidelines
- Digital slide quality is maintained for years vs. glass slides that break, stains fade, image becomes faint over time, etc.
Concerns — As with most newer tools, there are also some concerns associated with relying on virtual dermatopathology for both educational and clinical use. These concerns include
- Requires access to a (costly) slide scanner
- Needs specially-trained technicians and software engineers to scan the glass slides
- Each slide takes about 20-30 minutes to complete the scanning process
What is Whole Slide Imaging?
Whole slide imaging involves the actual scanning process of a traditional slide in order to create a single high-resolution digital copy. Typically, this is accomplished by capturing many small high-resolution image strips or tiles, then combining them together to create a complete picture of a histological section.
How well do they perform? Even before COVID-19, a 2017 study published in JAMA Dermatology noted that diagnosis from traditional methods using glass slides with traditional microscopy was not superior to diagnosis rates that came from whole slide digital file images.
Conclusion
With the continuing advances in technology and challenges presented by COVID-19, both in educational and clinical settings, there has been more interest in the use of whole slide imagery in both dermatology and dermatopathology. Whole slide imaging has been particularly helpful for virtual consultations and virtual slide reviews.
CAP offers guidelines for those considering taking advantage of these virtual tools. Interested parties may also want to consider the independent review process of these tests under the decision-making coding guidelines for 2021.
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