Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 29, 2025
Date Accepted: Feb 10, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Province-Wide Deployment of a Telepathology and mHealth System in China: Improving Diagnostic Accuracy and Reducing Inequity
ABSTRACT
Background:
Telepathology has emerged as a transformative digital health solution to address the global shortage of pathologists and the unequal distribution of diagnostic services, particularly in underserved and rural areas. In China, these challenges are especially pronounced in provinces like Henan, which faces high diagnostic demand and limited pathology expertise, contributing to diagnostic inequity across regions.
Objective:
This study aimed to design, implement, and evaluate a province-wide telepathology system in Henan, China, that integrates mobile and web-based platforms to improve diagnostic accuracy, reduce turnaround time, and enhance equitable access to specialist pathology services.
Methods:
An integrated telepathology network was deployed across 120 healthcare institutions using a three-tiered architecture, secure VPN-based transmission, and a browser/server (B/S) framework. The system enabled standardized workflows for whole-slide image acquisition, data transmission, remote diagnostics, and real-time reporting via both web interfaces and a widely adopted mobile platform (WeChat mini-program). System performance was assessed through diagnostic throughput, turnaround time (TAT), concurrency, and retrospective diagnostic accuracy.
Results:
Since its deployment, the system processed 72,916 diagnostic cases with 355,104 WSIs, averaging nine slides per case. It demonstrated robust performance, supporting 220–300 concurrent users with high stability. The median TAT was 10.06 hours, with 96.41% of cases completed within 72 hours. Diagnostic accuracy improved markedly, with sensitivity and specificity rising from 0.90 and 0.75 (baseline) to 0.96 and 0.95, respectively. The service notably expanded access to county-level hospitals, which accounted for 77.63% of all consultations, reducing diagnostic disparities. Patient costs were reduced by ~50 USD per case, with an estimated annual saving of 405,000 USD.
Conclusions:
The Henan Province telepathology system illustrates how scalable, province-wide digital health platforms-integrating mHealth components-can improve diagnostic accuracy, efficiency, and equity in resource-limited settings. The model offers practical guidance for other regions facing similar healthcare access challenges. Further studies should examine cost-effectiveness, AI integration, and cross-regional interoperability to support global expansion.
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