JMIR Publications

ABSTRACT

Background:

Telepathology has emerged as a viable solution to deliver timely, high-quality diagnostic services to underserved and remote areas, gaining global adoption. In China, the government strongly supports telepathology to address the shortage of pathologists. This study aimed to survey telepathology in China and analyze the usage and attitudes of both pathologists and patients.

Objective:

This study analyzes the construction, application, and development of telepathology in China from 2018 to 2023, explores the usage, evaluation, and attitudes of pathologists and patients, and identifies challenges and improvement suggestions for telepathology implementation.

Methods:

A web-based survey was conducted among Chinese hospitals in 2018, 2019, 2020, and 2023, alongside a survey of doctors and patients participating in telemedicine services in 2019. Using data from 464, 242, 204, and 188 hospitals in 2018, 2019, 2020, and 2023, respectively, as well as responses from 262 pathologists and 141 patients, we analyzed telepathology in China. Chi-square and Fisher's exact tests were used to assess differences across years, hospital levels, and regions. Ordinal regression was employed to analyze factors influencing pathologists' satisfaction and willingness to use.

Results:

The proportion of hospitals with telepathology software grew at an annual average rate of 7.60%, increasing from 29.53% in 2018 to 42.55% in 2023. The median number of telepathology cases per hospital increased from 51 to 200, with the fastest growth observed in the eastern region.Among pathologists, 61.1% used telepathology weekly, 61.5% spent 11-20 minutes or 21-30 minutes. Pathologists reported a 95.8% satisfaction rate, and 95% of pathologists willing to continue participation. Longer average duration, convenience of system operation and service processes were associated with enhanced satisfaction and sustained engagement willingness. Among patients, 92.2% received diagnostic results within 24 hours, with 100% satisfaction and 99.3% willing to recommend telepathology.

Conclusions:

Telepathology in China has seen significant growth from 2018 to 2023, with high satisfaction among both pathologists and patients. To improve satisfaction and willing to continue participation, telepathology services should focus on: (1) adjusting average duration of telepathology, (2) streamlining system operations, and (3) optimizing workflow efficiency.