Contributions
Type: Publication Only
Background
In hematology, the microscopic analysis of cellular morphology of blood, bone marrow, lymph node… samples remains the first important stage for diagnosis and patient follow-up. In our field, the application of information technology has allowed remarkable developments: iconographic databases, e-learning systems, automated systems of classification of blood cells, and cytological web-review of clinical protocols. However, the cytological diagnosis itself has yet to really benefit from the great possibilities offered by modern technology.
Aims
In this aim, the French speaking Group of Cellular Hematology in partnership with the College of Hematology established the open access solution of “tele-expertise” in cytology: the ANDRAL network.
ANDRAL proposes remote expert decision-making support in cytology: for any transmitted request for classification, an image file with a clinical/biological form is submitted. The network then allows remote classification and diagnosis to be obtained by opinion of two expert reviewers within 24h.
Methods
The ANDRAL network is accessible on www.gfhc-reseau-andral.fr. It is free and accessible to both hospital and the private biologists. ANDRAL is linked to a group of 45 international expert reviewers, who assure by paired review, continuous cytological care service. Globally, the system satisfies the strictest requirements regarding medical data exchange in terms of security, confidentiality, and sample/patient traceability.
Results
From October 2012 through August 2014, the network recorded more than 300 registrations with approximately 40 % from private biologists, 60 % from biologists practicing in a local or university hospital. 15 % of the subscribers (n=42) practiced outside of France. Over the same period, more than 200 dossiers were submitted. 70 % were de novo diagnoses; 15 % were urgent requests. Image files were selections of images and rarely wide field images. The requests were variable ranging from benign to malignant pathologies and common occurrences to rare hemopathies. The average time of request management was 1h50min, and the time to obtain a classification was on average 6h00min. The ANDRAL network also features specific evaluation tools which allow for follow up activity and also allow the measure of the quality of service provided.
Summary
Today, the assessments and the perspectives offered by ANDRAL network are real and very encouraging. In term of assessments, the constant and rapid increase of membership, the incredible motivation of all the expert reviewers and the high quality of exchanges are highlights. Several developments are further committed: collaboration with other networks and other countries and the development of a permanent economically feasible medical model. For the hematologists involved in morphological diagnoses, the ANDRAL network is a working example of cooperative function of which the first results are very encouraging.
Type: Publication Only
Background
In hematology, the microscopic analysis of cellular morphology of blood, bone marrow, lymph node… samples remains the first important stage for diagnosis and patient follow-up. In our field, the application of information technology has allowed remarkable developments: iconographic databases, e-learning systems, automated systems of classification of blood cells, and cytological web-review of clinical protocols. However, the cytological diagnosis itself has yet to really benefit from the great possibilities offered by modern technology.
Aims
In this aim, the French speaking Group of Cellular Hematology in partnership with the College of Hematology established the open access solution of “tele-expertise” in cytology: the ANDRAL network.
ANDRAL proposes remote expert decision-making support in cytology: for any transmitted request for classification, an image file with a clinical/biological form is submitted. The network then allows remote classification and diagnosis to be obtained by opinion of two expert reviewers within 24h.
Methods
The ANDRAL network is accessible on www.gfhc-reseau-andral.fr. It is free and accessible to both hospital and the private biologists. ANDRAL is linked to a group of 45 international expert reviewers, who assure by paired review, continuous cytological care service. Globally, the system satisfies the strictest requirements regarding medical data exchange in terms of security, confidentiality, and sample/patient traceability.
Results
From October 2012 through August 2014, the network recorded more than 300 registrations with approximately 40 % from private biologists, 60 % from biologists practicing in a local or university hospital. 15 % of the subscribers (n=42) practiced outside of France. Over the same period, more than 200 dossiers were submitted. 70 % were de novo diagnoses; 15 % were urgent requests. Image files were selections of images and rarely wide field images. The requests were variable ranging from benign to malignant pathologies and common occurrences to rare hemopathies. The average time of request management was 1h50min, and the time to obtain a classification was on average 6h00min. The ANDRAL network also features specific evaluation tools which allow for follow up activity and also allow the measure of the quality of service provided.
Summary
Today, the assessments and the perspectives offered by ANDRAL network are real and very encouraging. In term of assessments, the constant and rapid increase of membership, the incredible motivation of all the expert reviewers and the high quality of exchanges are highlights. Several developments are further committed: collaboration with other networks and other countries and the development of a permanent economically feasible medical model. For the hematologists involved in morphological diagnoses, the ANDRAL network is a working example of cooperative function of which the first results are very encouraging.