ECDON

During the inaugural meeting the EC-DON Terms of Reference was adopted, the chair appointed (Dr Elizabeth Dos Santos, representative from the BVI) and the following key objective was defined for the first-year:

To develop a fully implemented pathology network, providing a forum for peer review, and secondopinions, as well as supporting professional development for local practicing laboratoryprofessionals and clinicians in cancer diagnosis.

A situational analysis of current pathology operations within the OECS was undertaken, needs of pathologists and opportunity for local and regional capacity building was identified through discussions with the EC-DON members, pathologists, other oncology clinicians practicing in the OECS and expert advisers from Martinique and Canada.

The following key building blocks were identified to ensure a robust, functional and sustainable pathology network of high quality in diagnosing cancer in the OECS member states.

1. A user-friendly platform for real time interaction of pathologists with peer review and when necessary second review of pathology slides.
2. Standardization across the OECS of pathology protocols in the pre-analytical, analytical and post analytical areas with easy access and consensus adopted by all.

The following discussions with experts and solutions proposed have been completed to date.

1. An Eastern Caribbean Digital Pathology Network planned that will interconnect all pathologists working in the OECS region.
   • Discussions are ongoing with Dr Andy Evans Director of Telepathology at University Health Network Ontario Canada and EC-DON advisors. Microscopes are to be equipped by digital camera or slides are to be scanned. Partial funding has been secured by OECS Health Unit via French speaking OECS members and EU funds. All cancer diagnosis will be peer reviewed by OECS pathologists. Peer review system will be structured around diagnosis and pathologist expertise.

2. Pre-analytical issues - Specimen and sample handling as per international adopted guidelines.
   • Protocols will be facilitated by advisors and made available to all Eastern Caribbean Digital Pathology Network members, EC-DON members and Pathologists and laboratory professionals working in the Eastern Caribbean.
3. Analytical issues - Implementation of pathologists assistant programme.
   • Discussions on-going with Dr Stephen King, Dr Roy Noel and Ms Yvonne Rubie advisors to EC-DON on implementation of the US based program locally. The aim is to make the accredited programme available to interested individuals in the OECS member states, an important step to increase quality capacity building locally.

4. Post-analytical issues - Standardized pathology reports as per checklists and adopt synoptic reporting as per College of American Pathologists (CAP) guidelines.
   • Discussion are ongoing with Ted Carithers (Manager of Business Development at College of American Pathologists (CAP) and his team for licensing and adoption by EC-DON of the electronic Cancer Checklists (eCC) which enables pathologists to use the CAP cancer protocols directly within their workflow and thus ensure that each report is completed with the necessary required elements.
   • These discussions have been made possible through our advisors DimitriosDivaris that recently concluded his tenure on the CAP Pathology Electronic Reporting (PERT) Committee and Dr John Shrigley that has taken up his place.
   • Through our advisors and the CAP team we have been in contact with mtuitiverepresented by Colin Murphy and his team that offer CAP approved electronic reporting templates for for cancer diagnosing that will be accessible to all pathologists working within the OECS.

The next step is a face to face meeting on the 26^th and 27^th of April 2019 of EC-DON working group members, OECS oncology diagnosticians (pathologists and clinicians) and experts mentioned above to define final operations and plan for procedures and protocols to launch the Eastern Caribbean Digital Pathology Network by the Summer of 2019. Time will also be dedicated to completing and officializing the pathologists assistant programme to launch in early 2020. New objectives and projects will also be discussed.

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The OECS is working in close collaboration with all the Ministries of its Member States on all matters related to Public Health in the Eastern Caribbean. The Council of Ministers of Health is hosted once a year. This meeting aims to harmonize the strategy in Public Health in the OECS Member states.