Telehematology: critical determinants for successful implementation.

Despite modern technologies, such as immunophenotyping and molecular probing, cytomorphologic examination of stained peripheral blood smears by microscopy remains the mainstay of diagnosis in a large variety of diseases. This holds true especially in underdeveloped or rural areas where profound expertise and equipment are not easily available. Although communication technologies have been dramatically improved, telehematology has not become routine. To date, little information is available on which procedures are critical for successful implementation. Therefore, a study evaluating possible factors that prevented implementation of telehematology was initiated. We found that staining technique, smearing procedure, training skills, number of captured images, and prevalent disease influenced the accuracy of diagnosis by the reference laboratory. Using realtime teleconferencing allowed for overcoming these deficits. Together, when certain rules are observed, telehematology allows for rapid, accurate, standardized, and cheap expert advice. This technology should improve treatment of patients in remote areas where expertise is not available.