Part 1. Why Telepathology Matters in Modern Healthcare
Optimizing Medical Resource Allocation and Supporting Hierarchical Healthcare
China’s high-quality medical resources are mainly concentrated in large cities, especially in the southeastern region and municipalities. In contrast, western regions often have fewer medical resources and lower healthcare standards. Within each province, provincial capitals usually have stronger medical capabilities than towns and counties.
As a result, many patients in underserved areas struggle to access experienced pathologists.
Telepathology helps solve this challenge. It extends high-quality pathology services to remote and underserved regions through digital technology. Consequently, patients can receive expert diagnoses without traveling long distances.
Moreover, telepathology reduces the imbalance between regions with limited medical resources and major medical centers. It also supports the implementation of China’s hierarchical healthcare system by allowing healthcare resources to flow more efficiently.
Case Study: Xiangya Hospital Built a Cloud-Based Telepathology Platform
Xiangya Hospital of Central South University is one of the pioneers in telepathology in China.
As early as 2015, the hospital established a cloud-based pathology consultation platform. At the same time, its Department of Pathology launched a paired assistance program with Jianghua Yao Autonomous County.
Through this program, pathologists at Xiangya Hospital provided remote consultation services for local hospitals. As a result, local clinicians gained timely access to expert pathological diagnoses. This significantly reduced the gap between growing clinical demand and limited local pathology resources.
Improving Primary Healthcare Through Remote Expertise
Telepathology benefits not only patients but also primary-level hospitals.
Through remote consultation platforms, experienced pathologists can guide local doctors in tissue sampling, staining, slide preparation, and pathological diagnosis. Consequently, primary-level doctors continuously improve their diagnostic skills while reducing the risk of treatment errors caused by inaccurate pathology results.
In addition, these platforms provide access to research guidance, continuing medical education, and professional training without requiring doctors to leave their hospitals. This approach is cost-effective, efficient, and sustainable.
As a result, primary hospitals strengthen their clinical practice, research capabilities, and teaching capacity at the same time.
Telepathology not only helps the pathology departments of primary-level hospitals enter a fast track of development but also drives the enhancement of the overall medical standards of the hospital. Some procedures that primary-level hospitals previously dared not or could not perform are now gradually being undertaken.
— Zhou Jianhua, Director of the Pathology Department, Xiangya Hospital, Central South University
Reducing Time and Costs for Patients
Traditional pathology consultation often requires hospitals to mail pathology slides, patients to transport slides themselves, or specialists to travel between hospitals.
These methods increase turnaround time, transportation costs, and the risk of slide loss or damage.
Fortunately, telepathology offers a much faster alternative.
Through Xiangya Hospital’s cloud-based pathology platform, patients typically receive expert diagnostic opinions within 24 hours. Previously, borrowing slides for consultation usually required at least five working days.
Besides saving transportation costs, teleconsultation also improves diagnostic confidence at primary hospitals. Therefore, many patients can now receive accurate diagnosis and treatment locally instead of traveling to higher-level medical centers.
Ultimately, telepathology shortens treatment delays and significantly reduces the overall financial and emotional burden on patients.
Supporting International Pathology Collaboration
Telepathology also plays an important role in international medical collaboration.
Traditionally, international pathology consultation relied on mailing glass slides or arranging overseas expert visits. However, customs inspections, transportation risks, and high costs often made these approaches impractical.
Digital pathology changes this situation.
Instead of shipping physical slides, hospitals can securely transmit high-resolution digital images through the internet. This method is faster, more convenient, and considerably less expensive.
Furthermore, several countries, including China, restrict the cross-border transportation of human tissue for diagnostic purposes. Therefore, remote consultation based on digital pathology images has become the most practical—and often the only feasible—solution for international pathology consultation.
Part 2. The Development Journey of Telepathology Consultation
From Early Exploration to Modern Digital Pathology
The concept of telepathology dates back to 1968. However, the field did not develop rapidly at first.
In 1987, Professor Weinstein from the Department of Pathology at RUSH Medical College in the United States formally introduced the concept of remote pathology consultation.
A few years later, in 1990, Norway established the world’s first frozen section consultation center. At that time, technical limitations and high costs restricted telepathology to a small number of developed countries.
Fortunately, advances in information networks and whole slide imaging (WSI) technology changed the situation. As digital pathology matured, telepathology became more practical, reliable, and widely adopted. Today, it plays an essential role in modern pathology services.
Overall, telepathology has evolved through three major stages:
Static image consultation
Remote-controlled robotic microscopy
Digital pathology based on whole slide imaging (WSI)
The Early Development of Telepathology in China
China began researching telepathology in the mid-to-late 1990s.
In 1996, the Image Center of Beijing University of Aeronautics and Astronautics developed a point-to-point telepathology system that transmitted static images through telephone lines. This achievement laid the technical foundation for remote pathology consultation in China.
One year later, the Air Force General Hospital established a remote pathology consultation workstation. The platform brought together six pathology experts from Beijing and connected consultation centers across 28 large and medium-sized cities.
As a result, hospitals in different regions gained access to specialized pathology consultation services without requiring experts to travel.
Digital Slide Scanning Opened a New Era
The introduction of digital slide scanners marked a major turning point in telepathology.
Unlike traditional microscopy, digital pathology enables permanent slide storage while supporting simultaneous viewing and analysis from different locations. In addition, pathologists can access digital slides at any time without geographic limitations.
Consequently, telepathology entered a completely new stage of development.
Recognizing its value, China’s Ministry of Health officially launched the national pilot program for remote pathology consultation and quality control in December 2011. This initiative further accelerated the adoption of telepathology across the country.
Part 3. Key Components of a Modern Telepathology System
Three Core Components
A modern telepathology system consists of three essential components:
An image acquisition system
An image transmission system
An expert consultation platform
Together, these components enable pathologists to deliver fast, accurate, and efficient remote diagnoses.
The image acquisition system is the digital pathology scanner.
It rapidly scans entire pathology slides at high magnification and converts them into high-resolution digital images.
A high-quality scanner accurately captures every detail on the glass slide. As a result, pathologists can review digital slides that closely match the original specimen.
After scanning, hospitals upload the digital slides and related clinical information to the consultation platform through the network.
Experts at higher-level hospitals then log into the platform, open the digital slides in a web browser, review the case, and provide diagnostic opinions remotely.
Remote Consultation Without Geographic Limitations
High-quality digital pathology images and a reliable consultation platform eliminate many challenges associated with traditional consultation.
For example, hospitals no longer need to borrow or transport fragile glass slides between institutions.
Instead, pathologists can review cases remotely from almost anywhere with an internet connection.
Moreover, experts can access digital slides and electronic medical records at any time. They can also communicate directly with clinicians, patients, and family members to discuss diagnosis and treatment plans.
As a result, patients receive expert opinions much more quickly than through conventional consultation methods.
Research has also demonstrated excellent diagnostic consistency. Studies show that the agreement between remote static-image consultation and conventional microscope diagnosis can reach 98.5%.
KFBIO Supports Large-Scale Telepathology Networks
As one of China’s pioneers in digital pathology, KFBIO began by developing digital pathology slide scanners that convert traditional glass slides into high-quality digital images.
This technology not only simplifies slide review but also creates the foundation for remote consultation, pathology education, and long-term digital slide storage.
Building on these capabilities, KFBIO developed a comprehensive telepathology consultation platform.
Today, the platform supports:
Remote pathology diagnosis
Expert consultation for complex cases
Intraoperative frozen section consultation
Pathologist education and training
Remote expert guidance
These services support individual hospitals, regional healthcare alliances, third-party laboratories, and provincial telemedicine networks.
To date, KFBIO has established more than 200 telepathology consultation platforms across China, helping healthcare organizations expand access to expert pathology services.
Part 4. Applications of Telepathology Consultation
Expanding the Clinical Applications of Telepathology
Today, telepathology supports a wide range of clinical and educational applications.
Healthcare providers commonly use it for difficult, complex, and rare cases. In addition, it supports histopathology, intraoperative frozen section diagnosis, cytopathology, immunohistochemistry (IHC) interpretation, remote slide review, multidisciplinary case discussions, and pathology education.
As digital pathology continues to develop, telepathology is becoming an essential tool for improving diagnostic efficiency and expanding access to expert pathology services.
1. Histopathology Consultation
Histopathology consultation is one of the most common applications of telepathology.
It is particularly valuable for diagnostically challenging cases, including:
Small biopsy specimens.
Cases where distinguishing benign, malignant, or borderline lesions is difficult.
Tumors that are difficult to classify.
Common diseases with atypical pathological features.
Rare or uncommon diseases.
Complex cases that exceed the diagnostic capabilities of primary hospitals.
Through remote consultation, experienced pathologists can provide timely second opinions and help clinicians reach more accurate diagnoses. As a result, patients receive more appropriate treatment without unnecessary delays.
2. Intraoperative Frozen Section Consultation
Intraoperative frozen section diagnosis plays a critical role during surgery.
Surgeons rely on these rapid pathological results to determine surgical procedures, adjust treatment plans, and evaluate patient prognosis.
Telepathology makes this process even more efficient.
Instead of waiting for an on-site specialist, hospitals can immediately connect with remote pathology experts. These experts review digital slides in real time and provide diagnostic opinions during surgery.
Studies have shown that remote frozen section consultation delivers valuable diagnostic information for most patients. In addition, it provides definitive or suggestive diagnoses for more than 86.4% of cases.
Furthermore, remote consultation helps surgeons and pathologists reach a consensus when frozen section findings are inconclusive. Better communication ultimately supports better clinical decision-making.
3. Cytopathology Consultation
Telepathology also supports cytopathology consultation.
This includes:
Exfoliative cytology smears
Liquid-based cytology slides
Fine-needle aspiration (FNA) cytology
Cell block sections
Difficult or atypical cytology cases
Remote consultation allows cytopathologists to review complex cases efficiently and provide expert opinions regardless of location.
4. Immunohistochemistry (IHC) Interpretation
Another important application is the interpretation of immunohistochemistry (IHC) staining results.
Through digital pathology platforms, experienced pathologists can review stained slides remotely and provide accurate interpretations. Consequently, hospitals can improve diagnostic consistency while reducing consultation turnaround time.
5. Remote Pathology Education and Training
Telepathology is also a powerful educational platform.
Using online networks, experienced pathologists can deliver lectures, organize slide review sessions, and discuss representative cases with doctors in primary hospitals.
Moreover, hospitals can provide continuing medical education without requiring participants to travel.
This approach helps improve diagnostic skills, standardize pathology practice, and strengthen the long-term development of pathology teams across different regions.
Part 5. Quality Control in Telepathology Consultation
Why Quality Control Matters
High-quality telepathology depends on more than digital technology alone.
Although studies report diagnostic accuracy rates ranging from 88% to 99%, hospitals must establish a complete quality management system to achieve consistently reliable results.
For example, Halliday and colleagues reported diagnostic agreement rates between 88% and 97.5%, with some studies reaching 100%.
Therefore, every stage of the telepathology workflow requires careful quality control.
Six Key Factors for Accurate Remote Diagnosis
To deliver accurate and efficient telepathology services, healthcare providers should focus on the following six factors.
1. High-Quality Pathology Slides
The consultation begins with high-quality pathology or cytology slides.
Slides should have appropriate thickness, clear staining, and minimal artifacts. High-quality specimens provide the foundation for accurate diagnosis.
2. Reliable Digital Slide Scanners
Hospitals also need high-performance digital pathology scanners.
A reliable scanner accurately reproduces every detail on the original glass slide while maintaining excellent image quality after compression.
Consequently, remote experts can evaluate digital slides with confidence.
3. Stable Network Infrastructure
Fast and reliable network connectivity is equally important.
Large whole slide images (WSIs) require stable transmission. Therefore, hospitals should ensure sufficient bandwidth to support smooth image upload, browsing, and consultation.
4. Complete Clinical Information
Pathologists cannot rely on slide images alone.
Instead, they also need comprehensive clinical information, including:
Medical history
Imaging findings
Laboratory test results
Clinical diagnosis
Preliminary pathological opinions
Complete clinical information improves diagnostic accuracy and helps experts make better clinical decisions.
5. Experienced Pathology Experts
An effective consultation platform should include experienced pathology specialists.
Expert knowledge remains one of the most important factors in achieving high diagnostic accuracy, especially for rare or complex cases.
6. Additional Diagnostic Support
Some challenging cases require more than routine pathological evaluation.
When necessary, hospitals should combine telepathology with immunohistochemistry (IHC), molecular pathology, and other advanced diagnostic techniques.
Together, these technologies help improve diagnostic confidence and support precision medicine.
Hospitals should continuously train pathology technicians and diagnostic physicians, especially those working in primary healthcare institutions. Regular education and competency assessment help maintain consistent diagnostic quality.
At the same time, hospitals should invest in high-quality digital pathology scanners and reliable application platforms. These technologies provide the essential infrastructure for remote pathology consultation.
Current Challenges and Future Opportunities
Despite its rapid development, telepathology still faces several challenges.
First, governments and healthcare authorities need clearer regulations to define legal responsibilities during remote consultation.
Second, hospitals must strengthen patient privacy protection and data security when transmitting digital pathology images.
Finally, although China’s updated medical pricing system now includes telepathology-related services, most provinces have not yet established official reimbursement standards for digital slide scanning and remote pathology consultation.
Addressing these issues will further accelerate the adoption of telepathology nationwide.
Conclusion
Telepathology Is Shaping the Future of Pathology Services
Since its introduction, telepathology has transformed pathology services across China.
It has improved the distribution of high-quality medical resources, strengthened diagnostic capabilities in primary hospitals, and enabled more patients to receive accurate diagnoses close to home.
Furthermore, telepathology has promoted collaboration among hospitals, expanded pathology education, and accelerated the adoption of digital pathology nationwide.
Looking ahead, continued advances in digital pathology, artificial intelligence, network infrastructure, and healthcare policy will further expand the value of telepathology.
As more healthcare providers adopt digital pathology workflows, remote consultation will become faster, more accurate, and more accessible than ever before.
For healthcare organizations seeking to build a modern pathology service, telepathology is no longer an optional technology—it is becoming an essential component of digital healthcare.
About KFBIO Telepathology Solutions
KFBIO has played a pioneering role in digital pathology in China.
Its tray-basedKF-PRO-005 andKF-PRO-020 digital pathology scanners have been widely adopted for telepathology applications. Their excellent image quality and long-term operational stability provide a reliable foundation for remote pathology services.
Combined with KFBIO’s digital pathology platform, these scanners help hospitals build efficient, scalable, and high-quality telepathology networks.
Some content adapted from: “Development and Prospects of Remote Pathology Diagnosis in China,” China Digital Medicine, authors: Liu Yang, Yan Honglin, Tang Qizhu, Liu Xinquan, Xia Liangbing, Yuan Jingping; “Establishment and Application of Remote Pathology Consultation,” Practical Clinical Journal of Hospitals, authors: Xu Gang, Xiao Xue, Chen Liumei.
