Bent on Barriers: A Case for Digital Pathology in the Clinical Setting

In today’s healthcare landscape it’s all about quality care, which patients deserve and have come to expect. Quality requires precious resources like time, money and personnel. With digital pathology (DP), it’s no different. Implementing a digital pathology system (DPS) comes at a cost but brings with it many advantages which not only offsets those costs but saves resources over time. Even still, there is reluctance on behalf of pathologists and institutions as a whole to go digital. In this post, we will explore three barriers to going digital and how and why to overcome those barriers.


Resource Investment

Let’s get right to it. Cost. The financial investment in DP includes many components: you will need hardware like computers, screens and the whole slide image (WSI) scanner itself. There’s of course the software which allows you to store, analyze and share the digital images. And you’ll need IT services, at least temporarily, to make the integration happen. These large upfront one-time purchases should be viewed as a long-term investment in a potential new standard of care. When considering going digital, cost should not be the red light that prevents implementation. Under the continued pressures of forecasted trends, departments that fail to implement a DPS may find it difficult to provide novel services to their patients (i.e., telepathology, image analysis, virtual tumor boards).


When moving away from traditional glass slides and toward digital imaging, savings include a decreased need for vendor services like pathology asset retrieval and labor due to the decreased need for glass slide transport. Departments have the potential to further decrease glass slide storage costs by moving their physical storage facilities to remote, less costly locations. DP allows for glass slide requests, usually managed by several departmental personnel, to be minimized or eliminated as based on the scale of whole slide scanning. This results in personnel savings and frees up personnel to focus on higher-priority tasks and incorporate them into the DP workflow.


Speaking of Workflow Efficiency...

It’s important to note that some inefficiencies in workflow may already exist separate from adopting a DPS. Having a clear picture on the current manual workflow is crucial in order to add digital technology to the mix and to effectively evaluate the return on investment from a time-savings and efficiency standpoint. A great opportunity too often overlooked is the ability to build - or rebuild - your clinical workflow when implementing a new system. Identify where you experience disruption in your current workflow and position the DPS to remedy that disruption. One example is when the histology lab is at its busiest and there are delays in getting glass slides to the pathologist. In the DP setting, as samples are scanned they are immediately available for viewing. This makes the time to final diagnosis shorter. There’s no filing loads of glass work or digging through the mountain-high pile of slide files on your desk to find the right case, both of which are very laborious.


Digital distribution of cases also offers easy sharing of slides throughout the internal organization, thereby allowing distribution of work among a network of pathologists, regardless of their physical location. This allows for real-time workload leveling (i.e. workload distribution) and ensures that pathologists across the organization are fully and evenly utilized. As digital pathology decouples pathologists from the histology laboratory and conventional microscopes, implementation of this technology will also facilitate centralization of pathology services, thereby reducing the number of histopathology labs needed and promote more efficient lab staffing models.


Sound Infrastructure

For labs that have been relying on manual workflow since its inception, it’s unlikely that the IT infrastructure to implement a DPS is already in place. To overcome IT infrastructure constraints, it will take experts in the technology field to get labs set up with sufficient bandwidth needed to support a DPS and its integration with other IT-based medical devices and systems. But whether going digital or not, why stay with the same antiquated infrastructure? There is the old saying, “If it’s not broken, don’t fix it.” Well, one could argue it’s not broken yet. Healthcare technology is moving at breakneck speed and eventually labs will need to revamp their infrastructure to keep up with technology upgrades. Why wait?


One must also consider personnel infrastructure. It’s likely that lab workers and pathologists alike are not DP-ready and training will be required. But beware not of training. Training is a good thing. It keeps personnel knowledgeable about their field and up to date with the latest industry trends. Yes, training will cost time and money but learning is an investment with priceless returns. With a good implementation plan and clear learning objectives, a fully digital workflow can successfully be integrated. Along with establishing a few pathologists as champions of digital pathology, frequent communication with the pathology staff and adequate training and support, digital pathology can be effectively integrated into diagnostic work. Before transitioning to a totally digital workflow, pathologists may benefit from the opportunity to review glass slides alongside digital so that, as well as learning to use the technology, they can adjust their diagnostic skills and gain confidence in their ability to make a correct diagnosis with a digital slide.


The changes needed for digital primary diagnostics are well worth the investment in capital (both human and monetary), which will place the laboratory in a situation to welcome promising technology in the near future while familiarizing the staff with current technology. A laboratory that can perform diagnostics digitally is a laboratory that will benefit the most from technologies such as machine‐learning and image‐processing applications and will reap all the benefits that accompany full digitization.


Built on the vision of better patient outcomes, Instapath was founded in 2017 by engineers and scientists to enable patients to immediately know their cancer diagnosis. Our team made it our mission to develop fast and easy digital pathology technology so diagnosis can be made in minutes instead of days. To learn more about Instapath and our technology, visit https://instapathbio.com or contact us at info@instapathbio.com.


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