Consultation with overseas hospitals(Vietnam)—Contributing to improved diagnostic accuracy

The InternationalUniversity of Health and Welfare uses PidPort for overseas consultation.

We interviewed Dr. Ichiro Mori about thebackground to the implementation of PidPort and how it is used.

Challengesbefore the introduction

・First, we set up an environment for remote medicalcheck-ups; however, there was no way to perform consultations for routinediagnosis.
・There was no system in place for convenientconsultations with partners in other countries.

Effectsafter the introduction

・We are now able to specifically focus ondifficult-to-diagnose cases in everyday consultations, which has improveddiagnostic accuracy.
・Based on our success in Vietnam, we wish consider theuse of the system [PidPort] for conferences, and in other regions such asMongolia.

Dr. Mori, you have been working intensively on digital pathology research.
How do you use virtual slides in your daily work?

At our hospital, virtual slides aredouble-checked on a network connected to several affiliated hospitals,including Mita Hospital and Narita Hospital. After the first physician performsa routine diagnosis, a pathologist with expertise in the relevant ailmentconducts an inspection.

Before such a system was established,preparations for microscopy analysis needed to be sent between hospitals.However, this required much time and effort, because it takes a lot of time topack the prepared slides and send them to another hospital by express mail.Because physical travel is involved, it should be noted that a double-checked,long-distance diagnosis can take up to 1 week to complete, requiring 3 days atbest. Because of these obstacles, double-checks were only occurring betweenpathologists working in the same hospital.

Now that hospitals have started sharingvirtual slides with each other, a second diagnosis can be made by a specialist at each hospital,which has achieved a dramatic increase in diagnostic quality. Moreover,as the prepared slides for microscopic analysis no longer need to be sent overa long-distance, adouble-checked diagnosis can be completed in just half a day. Wehave established a system for double-checked diagnosis that makes use of thespecialized expertise across the entire hospital group, resulting in increaseddiagnostic quality. Having realized success through these efforts, our desireto apply this to other domains has grown.

It has been reported that there is now a new effort to connect with Vietnam on PidPort.
How is PidPort being used there?

PidPort is being used in collaborationwith Cho Ray Hospital in Ho Chi MinhCity. Cho Ray Hospital operates the Health Evaluation &Promotion Center CRH-IUHW (HECI) jointly with our hospital, and we provideJapanese-style medical examinations. This is a remote diagnosis systemsupported by Japanese specialists, with radiological imaging performed via adedicated line to our hospital, and pathology examinations are double-checkedby Japanese physicians via a VPN-secured internet connection.

However, as this system was establishedto handle medical exams, there was no way to obtain consultations on routinediagnostic cases. As hospitals are already cooperating with each other, wewould also like to be of service in terms of routine diagnosis. With this inmind, PidPort, which had increasingly been used in student training, was usedto link Japan and Vietnam, and consultations began taking place.

Many of the cases we are consulted onare ambiguous as to whether or notthey are cancer cases, so they are difficult-to-diagnose. There arethree to four pathologists at Cho Ray Hospital, and discrepancies between theirfindings are uploaded to PidPort as consultation requests. Naturally, these arealso difficult cases for us doctors in Japan. However, there are different perspectives, and itis said that ‘if in Japan, the diagnosis would be conducted in this way,’ butwe believe that the quality of diagnosis is sure to rise.

Furthermore, Vietnamese doctors undergotraining at our hospital for several months, become acquainted with us, andgain some familiarity with our diagnostic standards. This facilitatescommunication, and operations are running very smoothly. It is very reassuringto have a system that permits convenient consultation even with overseaspartners.

At present, it is only used forconsultations, but we would gradually like to take on the challenge of hostingconferences, and expand opportunities to exchange opinions and learn from eachother.

What do you plan on devoting your next efforts to?

As our efforts in Vietnam are bringingsuccess, we would like to expand operations to more areas. For example, Mongolia is one of thecandidates for expansion. There are estimated to be 70 pathologistsin Mongolia, but 50 of them are in the capital Ulaanbaatar, leaving a shortageof pathologists in other regions. Even in these areas with a shortage of pathologists, the use ofcloud-based systems, such as PidPort, can provide support without time andlocation limitations. Leveraging cloud-based systems to expand long-distanceconsultation to cross national borders will surely be of great value to futureimprovements in medical care.

Of course, from the mid to long-termperspective, to establish a sustainable support system, it must be managed notjust philanthropically but sustainably as well. Therefore, we must not forgetto make it a viable business. The Medical Exam Center initiative is a modelcase for how this is possible. Much like that initiative, we would like tocontribute to improved regional medical care, not just by providing temporarysupport but by forming a sustainable balance.

Thank you for reading to the end.

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