Global pathology efforts expand to Vietnam

Since 2005, the Department of Pathology & Immunology at Baylor and the Department of Pathology at Texas Children’s Hospital have played an important role in global health initiatives, first in Africa and later extending their outreach to Southeast Asia.

The Global Pathology Program at Texas Children’s launched a collaboration with the Vietnam Vascular Anomalies Center in Ho Chi Minh City in 2013, focusing on improving medical care for people in Vietnam through diagnostic pathology.

“One of our major goals is to improve medical care for the people in Vietnam by raising the standard of practice of pathologists who provide diagnostic workup for patients,” said Dr. Thuy Phung, assistant professor of pathology & immunology at Baylor and associate director of Global Pathology at Texas Children’s, who spearheaded the program. “This includes improving physician training and pathology laboratory practice.”

In March, participants of the Global Pathology Program and the Vietnam Vascular Anomalies Center returned to Vietnam for their sixth annual trip, accompanied by a team of more than 30 physicians, medical residents and students from the United States, South Korea and Thailand. Together they held a three-day CME conference in dermatology and skin and gynecologic pathology to train more than 90 pathologists on developing more accurate diagnosis.

Using the new technology of telepathology, participants were able to view digitalized images of stained tissue sections on their own computer monitor as if they were viewing through a microscope.

Telepathology gives pathologists from anywhere in the world the opportunity to connect with one another through the internet to show and share pathology cases for diagnostic consultation, teaching and training. The consultation can take the form of a live videoconference, webcast or one-on-one discussion.

“Logistically, how this works is when pathologists in Vietnam have difficult skin biopsies, and they want my input as an experienced skin pathologist, they scan the tissue glass slides and send me the digital files. With the digital files, I am able to view the slide image and move the virtual slide around to see different areas of the tissue. I can zoom in and out on the image and examine at low and high magnification similar to the way I would do using an actual microscope. This imaging technology allows me to digitally view tissue in any way I want so that I can make the correct histologic diagnosis for the patient,” Phung said.

Through telepathology, Phung has been able to provide expert consultation to pathologists in Vietnam in real time with high accuracy. She holds weekly live videoconferencing with Vietnamese pathologists to view the cases together.

“We view the digital images together and discuss the cases, and I share my opinion of each case. Each week, we do this for about one hour, and usually look at 10 to 12 tissue biopsies that pose diagnostic dilemmas for the Vietnamese pathologists,” she said.

Phung and her team have been holding weekly video meetings for a year and have broadened their training with pathologists in Ho Chi Minh City to include pathologists in other major cities in Vietnam such as Hanoi, Hue and Danang. “By conducting live telepathology, we not only provide correct tissue diagnosis in real time for patients in Vietnam, but equally important, we can use this approach to enhance the training of Vietnamese pathologists in diagnostic skin pathology,” she said.

“My hope is that they will become experts themselves in the future and be able to help even more patients than I can do myself here in the U.S.” said Phung.

There are now six Vietnamese pathologists who regularly participate in telepathology with Dr. Phung, and she believes their efforts will provide them the knowledge base to be experts in skin pathology in their own right. “I like to think of this as innovation in global medical education involving virtual and interactive learning that has been enabled by today’s state-of-the-art technology in telemedicine and digital pathology. This is a way to practically apply advanced technology and medical expertise that we have here at Baylor and Texas Children’s to help improve medical diagnosis and medical education in other countries, no matter where in the world,” she said.

Currently, the Global Pathology team and the Vietnam Vascular Anomalies Center are working on expanding their work to Can Tho and Da Nang, two major provinces in Vietnam.