We introduce a novel hybrid telepathology system providing simultaneous transmission of both real-time microscopy and static imagery at a reasonable cost. It is capable of capturing static, true color images at resolution of 1,520 x 1,144 pixels and providing live transmission of real-time video images of the glass slide in Common Intermediate Format (CIF), which can be viewed at 1,024 x 768 pixels or higher. Instant freeze function can be enabled with 4x CIF resolution (1,408 x 1,152 pixels). This system comprises the advantages of real-time transmission and high-resolution static imagery, while direct visual and audio communications are maintained at the same time. It uses standard 'off-the-shelf' components with a total cost of around $30,000 to $40,000. We also conclude that differences in telepathology modality and image quality have an impact on diagnostic accuracy and should be considered for discussion and standards development by professional organizations in the field of telepathology. An effort to ascertain the diagnostic limitations of various telepathology modalities is essential to the future use of this modality of pathology practice.