A Comprehensive Analysis of a Web-Based Dermatopathology Second Opinion Consultation Practice

Abstract

Abstract Context.—Sharing cases and seeking second opinion consultations is an important part of everyday pathology practice. Internet-based communications and upcoming digital slide technologies have the potential to decrease barriers and open access to the best expertise. We recently developed a dedicated Web-based process for communication with outside practices seeking second opinion consultations. The software allowed us to collect data about the current needs and use of a second opinion consultation practice, a topic that has not been addressed in research studies thus far. Objective.—To analyze the needs for and performance of a Web-based second opinion consultation practice in dermatopathology. Design.—We performed a retrospective analysis on paper and digital records. Results.—The average turn-around time from the time of biopsy to the time the report was issued was 7 days. Eighty-two percent of cases were reported the same day they were received. Biopsies of melanocytic lesions, inflammatory dermatoses, and squamous lesions comprised 82% of consultations. Among the remaining cases, soft tissue tumors, adnexal neoplasms, alopecia, and nonmelanoma nonsquamous lesions were the most common diagnoses. In 69% of cases, the outside report contained information about the diagnosis favored by the submitting pathologists. In 5%, there was a significant change in the diagnosis. Conclusions.—Web-based communication facilitates rapid turn-around time and reduces costs and barriers to second opinion consultation.