Brauchli Kurt, Oberli Hermann, Hurwitz Nina, Kunze Klaus-Dieter, Haroske Gunter, Jundt Gernot, Stauch Gerhard, Banach Lech, Wirdnam Mark, Mihatsch Michael, Oberholzer Martin
Department of Pathology of the University, Basel, Switzerland.
Virchows Arch. 2004 May;444(5):403-9. doi: 10.1007/s00428-004-0980-x. Epub 2004 Mar 12.
The paper reviews the development of the application of telepathology in a department of surgical pathology between 1991 and 2003. The goal of the efforts during this time was to give up the concept of programming a single application, available only between two fixed workstations with sophisticated devices and special software, and to find the virtual "largest common denominator" for implementing as many different applications as possible with the same basic system.
A new telepathology system was designed as a client-server system with a relational database at its centre. The clients interact together by transferring the questions (texts and images) to a record (case) in the database on the server and by transferring the answers to the same record on the database.
The new "open" telepathology system iPath (http://telepath.patho.unibas.ch) has been very well accepted by many groups around the world. The main application fields are: consultations between pathologists and medical institutions without a pathologist (e.g. for frozen section diagnoses or for surgical diagnoses in hospitals in South Asia or Africa), tumour boards, field studies and distance education (http://teleteach.patho.unibas.ch).
Having observed that with iPath we have succeeded in satisfying all our telepathology needs, we are inclined to put the emphasis on the nature of the tasks being performed, as opposed to the methods or technical means for performing a given task. The three organisation models proposed by Weinstein et al. (2001) can be reduced to only two models: the model of discussion groups and the model of expert groups (virtual institutes).
本文回顾了1991年至2003年间远程病理学在一个外科病理科的应用发展情况。这段时间努力的目标是摒弃编写单一应用程序的概念，这种程序仅在两个配备精密设备和特殊软件的固定工作站之间可用，而是要找到虚拟的“最大公约数”，以便用同一个基本系统实现尽可能多的不同应用程序。
设计了一种新的远程病理学系统，它是一个以关系数据库为中心的客户机-服务器系统。客户机通过将问题（文本和图像）传输到服务器上数据库中的一条记录（病例），并将答案传输到数据库中的同一条记录来进行交互。
新的“开放式”远程病理学系统iPath（http://telepath.patho.unibas.ch）已被世界各地的许多团体广泛接受。主要应用领域包括：病理学家与没有病理学家的医疗机构之间的会诊（例如用于冰冻切片诊断或南亚或非洲医院的手术诊断）、肿瘤委员会、实地研究和远程教育（http://teleteach.patho.unibas.ch）。
观察到通过iPath我们成功满足了所有远程病理学需求后，我们倾向于强调正在执行的任务的性质，而不是执行给定任务的方法或技术手段。温斯坦等人（2001年）提出的三种组织模式可以简化为仅两种模式：讨论组模式和专家组模式（虚拟机构）。
